Abstract
New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.
Highlights
Autologous platelet concentrates are simple and cost-effective methods that allow high local concentrations of growth factors at a target tissue [1]
The presence of white blood cells (WBCs), that secrete a large quantity of growth factors, is a key feature of Platelet-rich fibrin (PRF) which is named for this reason leukocyte-PRF (L-PRF)
The results revealed that the levels of basic fibroblast growth factor in PRF were significantly higher than that in activated platelet-rich plasma (PRP)
Summary
Autologous platelet concentrates are simple and cost-effective methods that allow high local concentrations of growth factors at a target tissue [1]. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate developed by Choukroun et al because of legal restrictions on blood handling. The polymerization of the fibrin produces a 3-dimensional cross-linked fibrin matrix [4,5,6,7,8]. This serves as a binding site for both platelets and growth factors [9,10]. By increasing the local concentration of growth factors at a specific tissue location, PRF promotes tissue regeneration by closely mimicking the wound repair process over a prolonged period of time [2,3,11,12,13,14]. We discuss the promising clinical benefits of PRF with a focus on its ability to promote wound and muscle healing
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