Role of PRP injection in delayed union and non union of long bone fractures

Abstract

Background: The evidence for PRP osteogenic potential has been suggested by several in vitro studies, i.e. PRP addition in culture medium promoted the proliferation and differentiation of human mesenchymal stem cells (MSCs) and the effect of PRP on osteogenic differentiation was also seen on human adipose derived stem cell (ADSC). We aim to study the role of PRP in accelerating bone healing potential at the fracture site in cases of delayed union or non union of long bones. Materials and Methods: The present study was conducted from JUNE 2018 to JUNE 2019 where 20 patients with delayed/non union of long bone fractures were treated with PRP injection. The patients were assessed for callus formation over radiological examination. Results: In our study 65 percent of the patients benefitted from PRP therapy and showed good callus formation and 35 percent did not benefit from the treatment and required further operative intervention. The pre procedure VAS score in patients with delayed union was 3.5 + 1.3 and non union group was 2.8 +1.4 which reduced to 1.2+0.3 and 1.1+0.3 respectively. Conclusion: The use of PRP in treatment of non union and delayed union of long bone fractures has shown good results with no complications, it is a promising new modality which needs prospective, randomised, placebo-controlled, multicentric-studies with a much larger sample size to clarify the results and better understanding of the effects of PRP in fracture healing. Keywords: Platelet rich plasma, Non union, Delayed unoin, Adiposed derived stem cell, Mesenchymal stem cells.