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Meftahpour V, Ghorbani F, Ahmadi M, Aghebati-Maleki A, Abbaspour-Aghdam S, Fotouhi A, Zamani M, Maleki A, Khakpour M, Aghebati-Maleki L. Evaluating the effects of autologous platelet lysate on gene expression of bone growth factors and related cytokines secretion in rabbits with bone fracture. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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da Fonseca L, Santos GS, Huber SC, Setti TM, Setti T, Lana JF. Human platelet lysate - A potent (and overlooked) orthobiologic. J Clin Orthop Trauma 2021; 21:101534. [PMID: 34386346 PMCID: PMC8339333 DOI: 10.1016/j.jcot.2021.101534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/25/2021] [Accepted: 07/25/2021] [Indexed: 01/03/2023] Open
Abstract
The knowledge of the essential role of platelets in tissue healing is gradually increasing and as regenerative medicine prompts new solutions, platelet-derived bioproducts have been proposed as a potential tool in this field. In orthopaedics and sports medicine, the use of PRP has been rapidly increasing in popularity as patients seek novel non-surgical approaches to acute and chronic musculoskeletal conditions. The concept of having platelets as a secretory organ other than a mere sponge-like coagulation component opens up new frontiers for the use of the platelet secretome. Platelet lysate is a solution saturated by growth factors, proteins, cytokines, and chemokines involved in crucial healing processes and is administered to treat different diseases such as alopecia, oral mucositis, radicular pain, osteoarthritis, and cartilage and tendon disorders. For this purpose, the abundant presence of growth factors and chemokines stored in platelet granules can be naturally released by different strategies, mostly through lyophilization, thrombin activation or ultrasound baths (ultrasonication). As a result, human platelet lysate can be produced and applied as a pure orthobiologic. This review outlines the current knowledge about human platelet lysate as a powerful adjuvant in the orthobiological use for the treatment of musculoskeletal injuries, without however failing to raise some of its most applicable basic science.
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Affiliation(s)
- Lucas da Fonseca
- Orthopaedic Department – UNIFESP/EPM, 715 Napoleão de Barros St – Vila Clementino, 04024-002, São Paulo, SP, Brazil
| | - Gabriel Silva Santos
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil,Corresponding author. IOC – Instituto do Osso e da Cartilagem/The Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – 2nd floor, Room #29, Indaiatuba, São Paulo, 13334-170, Brazil. Tel.: +551930174366, +5519989283863.
| | - Stephany Cares Huber
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil
| | - Taís Mazzini Setti
- Indolor - Centro Intervencionista de Controle da Dor, 583 Sul Brasil Avenue – Room #406 – Centro, 89814-210, Maravilha, SC, Brazil
| | - Thiago Setti
- Indolor - Centro Intervencionista de Controle da Dor, 583 Sul Brasil Avenue – Room #406 – Centro, 89814-210, Maravilha, SC, Brazil
| | - José Fábio Lana
- IOC – Instituto Do Osso e da Cartilagem/the Bone and Cartilage Institute, 1386 Presidente Kennedy Avenue – Cidade Nova I, 13334-170, Indaiatuba, SP, Brazil
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Andersen C, Wragg NM, Shariatzadeh M, Wilson SL. The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures. Curr Osteoporos Rep 2021; 19:1-14. [PMID: 33393012 PMCID: PMC7935731 DOI: 10.1007/s11914-020-00643-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 12/02/2022]
Abstract
PURPOSE OF REVIEW The treatment of non-union fractures represents a significant challenge for orthopaedic surgeons. In recent years, biologic agents have been investigated and utilised to support and improve bone healing. Among these agents, platelet-rich plasma (PRP) is an emerging strategy that is gaining popularity. The aim of this review is to evaluate the current literature regarding the application and clinical effectiveness of PRP injections, specifically for the treatment of non-union fractures. RECENT FINDINGS The majority of published studies reported that PRP accelerated fracture healing; however, this evidence was predominantly level IV. The lack of randomised, clinical trials (level I-II evidence) is currently hampering the successful clinical translation of PRP as a therapy for non-union fractures. This is despite the positive reports regarding its potential to heal non-union fractures, when used in isolation or in combination with other forms of treatment. Future recommendations to facilitate clinical translation and acceptance of PRP as a therapy include the need to investigate the effects of administering higher volumes of PRP (i.e. 5-20 mL) along with the requirement for more prolonged (> 11 months) randomised clinical trials.
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Affiliation(s)
- Christian Andersen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
| | - Nicholas M Wragg
- Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
- School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Thornburrow Drive, Hartshill, Keele University, Stoke-on-Trent, Staffordshire, ST4 7QB, UK
| | - Maryam Shariatzadeh
- Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
| | - Samantha Louise Wilson
- Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK.
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Schlundt C, Bucher CH, Tsitsilonis S, Schell H, Duda GN, Schmidt-Bleek K. Clinical and Research Approaches to Treat Non-union Fracture. Curr Osteoporos Rep 2018. [PMID: 29536393 DOI: 10.1007/s11914-018-0432-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Impaired healing outcomes or even non-unions after bone injury are still a highly relevant problem in the daily clinical life. Especially within an aging population, the occurrence of bone fractures increases and thus novel treatment approaches to overcome compromised bone regeneration are needed. RECENT FINDINGS The gold standard to treat delayed or non-healing bone injuries is still the use of autologous bone grafts to foster regeneration. Besides its successful treatment outcome, it also has disadvantages: a second surgery is needed in order to harvest the bone material and the material is highly limited. Looking into the recent literature, a multitude of different research approaches were already conducted to identify new possible strategies to treat impaired bone regeneration: application of mesenchymal stromal cells, platelet lysates, growth factors, interference in the immune system, or bone formation stimulation by ultrasound. This review gives an overview of the treatment approaches actually performed in the clinic as well as at the bench in the context of compromised bone healing. It clearly highlights the complexity of the nature of non-healing bone fractures as well as patient-dependent factors influencing the healing process.
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Affiliation(s)
- Claudia Schlundt
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christian H Bucher
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Serafeim Tsitsilonis
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hanna Schell
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Katharina Schmidt-Bleek
- Julius Wolff Institut and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
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