Platelet-rich Products Research Articles

Transosseous-Equivalent/Suture Bridge Technique in Combination With Platelet-Rich Plasma Application Yield Optimal Clinical Outcomes in Arthroscopic Rotator Cuff Repair: A Bayesian Network Analysis of Randomized Controlled Trials

To assess the clinical evidence defining the optimal combination of arthroscopic suture technique and platelet-rich products (PRP), and application for arthroscopic rotator cuff repair (ARCR). All level of evidence (LOE) I randomized controlled trials (RCT) focusing on arthroscopic suture technique and/or PRP application in ARCR were included. The exclusion criteria were LOE II or worse, studies with other interventions, studies reported none of the predetermined clinical outcomes; studies unable to extract any precise data; studies from the same patient group of included studies. A pair-wise meta-analysis and Bayesian network analysis were performed on each comparison. The intervention options were ranked by Bayesian network analysis. 27 studies comprising 1,947 individuals met the inclusion criteria. The application of transosseous equivalent/suture bridge repair (SB) with PRP (SB+PRP) significantly reduced retear rate (risk ratio [RR], 0.29; 95% confidence interval [CI], [0.15, 0.55].) and increased Constant-Murley score (mean difference, 1.90; 95% CI, [0.14, 3.74]), compared to SB repair. Single-row repair (SR) with PRP usage (SR+PRP) significantly reduced retear rate (RR, 0.27; 95% CI, [0.12, 0.55]) and pain visual analog scale (VAS) (mean difference:-0.84; 95% CI [-1.39,-0.46].), increased University of California, Los Angeles (UCLA) shoulder score (mean difference: 1.48; 95% CI [0.50, 2.58]) and Constant-Murley score (mean difference: 4.53; 95% CI [2.65, 6.38]), compared to SR repair. The ranking for outcomes demonstrated SB+PRP resulted in the best retear rate, UCLA shoulder score, with the second-best postoperative pain, Constant-Murley score, while SR+PRP resulted in the best postoperative pain, Constant-Murley score, with the second-best retear rate and UCLA score. Arthroscopic rotator cuff repair utilizing SB+PRP yields optimal retear rate and UCLA shoulder score, with the second-best postoperative pain and Constant-Murley shoulder outcome score, while SR+PRP yields the best in these two parameters. Level I, Bayesian network analysis of level I RCT.

Platelet Rich Products and Applications in Dentistry

Otojen trombosit konsantreleri diş hekimliğinde ve çeşitli tıp alanlarında yenilikçi ve umut verici tedavi yaklaşımlarıdır. Hastanın kendi kanından üretilen trombosit bakımından zengin ürünlerin tedavi için kullanılmasının, günümüzde tercih edilen bir yöntem olduğu görülmektedir. Yumuşak ve sert dokudaki iyileşmeleri tetiklemek için uygulanan ve çeşitli proteinler ve büyüme faktörlerinin kontrollü salınımlarının gerçekleştiği bu ürünlerin, içeriğinde doğal yara iyileşmesi için gereken maddeler bulunmaktadır. Biyokimyasal bir işlem gerektirmeyen ve kolay uygulanabilen bu sistemler, hastadan elde edilen kandan, trombosit ve lökositten zengin otolog bir biyomateryal üretilmesini sağlamaktadır. Trombositler aktif olduklarında fibrin matriks içerisinde yer alır ve burada büyüme faktörlerini serbest bırakırlar. Bunlar fibrin ile birlikte yapı oluştururlar ve büyüme faktörleri doku iyileşmesini ve rejenerasyonunu stimule eder. Son 20 yılda trombositlerin yara iyileşmesi üzerindeki fizyolojik etkileri araştırılmış ve özellikle ağız cerrahisinde daha başarılı tedavilerin uygulanabildiği belirtilmiştir. Trombosit ürünlerinin elde edilmesinde farklı yöntemler mevcuttur. Bu farklılıklar santrifüj hızına ve süresine, eklenen kimyasal maddelere, oluşan supernatantlara ve çökeltilerine bağlı olarak oluşmaktadır. Bu varyasyonlar fibrin ağı yapılarında ve trombositlerin lökosit ve büyüme faktörleri içeriğinde farklılıklara neden olmaktadır. Bu ürünler incelendiği zaman her yeni üretilen ürünün kendisinden öncekine kıyasla daha gelişmiş özellikler içerdiği görülmektedir. Bu derlemede trombositten zengin ürünlerin elde edilme şekilleri, yapıları, içerikleri ve diş hekimliğinde kullanım alanları hakkında bilgi verilmek amaçlanmıştır.

Use of Autologous Plasma Rich in Growth Factors Membrane (Endoret) for Chronic Diabetic Foot Ulcers: A Case Series of Six Patients

Diabetic foot ulcers (DFUs) are a significant source of morbidity, and pose great financial burden to the health service. Conventional treatments with dressings are often ineffective. Platelet-rich products have been used in recent years for the treatment of DFUs, with promising results. The present study aims to evaluate the efficacy of plasma rich in growth factors (PRGF) membrane therapy in the treatment of chronic non-healing DFUs, in order to improve wound healing and accelerate the epithelisation of chronic wounds.

Advancements in Platelet-Rich Products: Obtaining Methods and Applications in Dentistry

Advancements in Platelet-Rich Products: Obtaining Methods and Applications in Dentistry

Platelet-rich plasma in the treatment of chronic inflammatory diseases of lower extremities

Objectives to evaluate the effectivenes of platelet-rich plasma preparations in the treatment of chronic inflammatory diseases of lower extremities.
 Material and methods. The study involved patients hospitalized in the Research Institute S. V. Ochapovsky Regional Clinic Hospital No.1, Krasnodar, with trophic ulcers and chronic osteomyelitis. The patients received injections of platelet-rich plasma as platelet lysate and/or platelet gel.
 Results. The study involved 19 patients with trophic ulcers of the lower extremities with a duration of more than 2 months. Previously, the patients had underwent therapy without effect. In all cases, the patients received a complex of therapeutic measures, including debridement, dressing, conservative treatment, physiotherapy, antibiotic therapy. In the presence of large ulcers, 8 patients underwent autodermoplasty with complete engraftment. It has been noted that during platelet-rich plasma use the average healing time was 6-7 weeks.
 Four patients were observed with chronic osteomyelitis. During operation, the bone cavity was filled with platelet gel. The postoperative period was uneventful in all cases. The maximum observation period was 1.5 years. No recurrence of osteomyelitis was detected.
 Conclusion. The results of the study demonstrate the positive effects of platelet-rich plasma products use.

Regenerative medicine: characterization of human bone matrix gelatin (BMG) and folded platelet-rich fibrin (F-PRF) membranes alone and in combination (sticky bone)

During the last two decades autologous platelet and leukocyte rich products (PRP; PRF), opened new perspectives in regenerative medicine. In particular regenerative dentistry played a pioneer role in the application of these products in bone regenerative cases. Many aspects of cytokines, such as, growth factor release, blood cell content and its characterization were reported, but some practical questions are still unanswered in the preparation of PRF membranes and sticky bones. A new folding technique was introduced that created a good quality, pliable, and strong F-PRF membrane with a dense fibrin network and more homogenous blood cell distribution. F-PRF produced a very promising sticky bone combined with human freeze-dried cortical bone matrix gelatin (BMG). There hasn’t been much focus on the quality and character of the applied bone and the optimal membrane/bone particle ratio has not been reported. A 0.125 g BMG/ml plasma (1 g/8 ml) seems like the ideal combination with maximal BMG adhesion capacity of the membrane. Particle distribution of BMG showed that 3/4 of the particles ranged between 300–1000 µ, the remnant 1/4 was smaller than 300 µ. The whole F-PRF membrane and its parts were compared with conventional A-PRF membrane concerning their resistance against proteolytic digestion. The F-PRF was superior to A-PRF, which dissolved within 4–5 days, while F-PRF was destroyed only after 11 days, so this provides a better chance for local bone morphogenesis. The F-PRF pieces had similar resistance to the whole intact one, so they can be ideal for surgical procedures without risk of fast disintegration.

Procedures for production, storage and utilization of platelet-rich plasma and correlated products in Brazil: a cross-sectional study

Introdução: O plasma rico em plaquetas (PRP) é uma tecnologia com potencial aplicação em diversas áreas da medicina e odontologia. A alta variabilidade no processo de produção desta tecnologia e de tecnologias relacionadas desafiam a regulamentação de sua produção, do controle de qualidade e do uso. Objetivo: Avaliar práticas de produção, armazenamento e utilização do PRP e produtos relacionados no Brasil, permitindo a identificação de variabilidade operacional ao longo destes processos. Método: Estudo transversal com coleta de dados realizadas por meio de um questionário eletrônico, autoaplicado e com preservação de anonimato. As perguntas foram definidas a partir de revisão de literatura e por consulta a especialista da área. O questionário foi encaminhado a pesquisadores e a profissionais de várias áreas atualmente envolvidas na produção do PRP. Esses profissionais foram identificados por diferentes estratégias, tais como participação prévia em eventos relacionados e publicações na área. Resultados: Foram obtidas 64 respostas, sendo 36 respostas completas (56,3%) e 28 respostas parciais (43,7%). A taxa de respondentes não pôde ser calculada, considerando-se as formas de divulgação do questionário. Para a produção de PRP, as respostas indicaram predomínio de protocolos com centrifugação dupla e utilização de métodos variados para ativação plaquetária. A maioria dos respondentes referiu utilizar o PRP nas áreas de ortopedia, fisiatria e medicina esportiva. Para a produção do plasma rico em fibrina (PRF), houve predomínio de respostas indicando utilização de protocolo de centrifugação única, sem utilização de métodos de ativação plaquetária. A maioria dos respondentes indicou utilizar o PRF em áreas da odontologia. No geral, observou-se grande variabilidade nos procedimentos de obtenção e do perfil de utilização entre os principais tipos de concentrados de plaquetas. Conclusões: Os achados corroboram a necessidade do desenvolvimento de medidas regulatórias com foco nos pontos críticos identificados, visando promover a segurança durante a produção e utilização dos concentrados de plaqueta.

Platlet-Rich Plasma - Review of Literature.

Wound healing is a dynamic and physiological process for restoring the normal architecture and functionality of damaged tissue. Platelet-rich plasma (PRP) is an autologous whole blood product that contains a large number of platelets in a small volume of plasma with complete set of coagulation factors, which are in physiological concentrations. PRP has haemostatic, adhesive properties and acts supraphysiologically in the process of wound healing and osteogenesis. Platelets play a very important role in the wound healing process by providing growth factors that enhance the rate and quality of wound healing by many different mechanisms. The aim of this review is to describe: the biology of platelets and their role in the wound healing process, the terminology of platelet rich products, PRP preparation, activation and concentration of PRP, as well as the use of PRP in plastic surgery.

Platelet-Rich Product Supplementation in Rotator Cuff Repair Reduces Retear Rates and Improves Clinical Outcomes: A Meta-analysis of Randomized Controlled Trials

The purpose of this study was to conduct a comprehensive systematic review and meta-analysis to investigate the clinical and imaging outcomes of all 4 types of platelet-rich therapies (pure platelet-rich plasma [P-PRP], leukocyte and platelet-rich plasma, pure platelet-rich fibrin, and leukocyte and platelet-rich fibrin) in rotator cuff repairs. A systematic literature search was performed to identify rotator cuff tears comparing any of the 4 types of platelet-rich products (PRP) to a control in rotator cuff repair. Data extracted from the studies included retear rates diagnosed with imaging studies, as well as outcome scores such as Constant, American Shoulder and Elbow Surgeons (ASES), University of California Los Angeles (UCLA), Simple Shoulder Test (SST), and visual analog scale (VAS). Meta-analyses compared postoperative outcome scores and retear rates between the control and study groups. Seventeen studies were included in the meta-analysis. When pooling data from all studies, retear rate for the treatment group was 19.3%, compared to 25.4% for the control group (odds ratio [OR] 0.59, P= .0037). When stratified based on PRP type, only P-PRP resulted in a significant reduction in retear rate (OR 0.26, P= .0005). Overall, treatment with PRP significantly improved Constant scores when compared to controls (mean difference [MD] 2.41, P=.0027), as well as VAS scores (MD-0.12, P= .0014), and SST scores (MD 0.41, P= .0126). There was no significant difference in ASES scores (MD 0.37, P= .7762) or UCLA scores (MD 0.76, P=0.2447) between treatment and controls when pooling data from all studies. This analysis demonstrates significant reductions in retear rates when rotator cuff repair is augmented with PRP. P-PRP appears to be the most effective formulation, resulting in significantly improved retear rates and clinical outcome scores when compared with controls.

Advancements in Platelet-Rich Products: Obtaining Methods and Applications in Dentistry

Advancements in Platelet-Rich Products: Obtaining Methods and Applications in Dentistry

Decontamination of rough implant surfaces colonized by multispecies oral biofilm by application of leukocyte- and platelet-rich fibrin.

Decontamination of biofilm-infected rough implant surfaces is challenging. Platelet rich blood products have been shown to have anti-microbial properties against periodontal pathogens. Our aim was to investigate the effect of a potential biological implant surface disinfectant, leukocyte- and platelet-rich fibrin (L-PRF), on a mature oral multispecies biofilm on a rough titanium surface. Sandblasted, large grit, acid-etched (SLA) titanium disks were inoculated with subgingival dental plaque and cultured anaerobically for 21 days. The L-PRF membranes were collected from 12 donors in three trials (four donors in each trial). The disks were rinsed with 0.9% NaCl and exposed to the cell-rich portion of the L-PRF membranes for 48hours followed by scanning electron microscope (SEM) analysis immediately or after rinsing with 0.9% NaCl prior to fixation. The presence of platelet factor-4 in the rinse samples was analyzed by Western blotting. Remaining bacteria were quantified from SEM images of the implant surfaces and their numbers statistically compared. The L-PRF-treated samples without rinsing displayed numerous cells with multiple pseudopodia in immediate contact with bacteria that appeared perforated and increased in size. The cells were identified as platelets based on morphological criteria and by positive reaction for platelet factor-4 by Western blotting. After post-treatment rinsing, the L-PRF-treated disks displayed a significant reduction in bacterial counts (in average 92% reduction). Application of L-PRF significantly reduced bacterial counts on contaminated SLA titanium surface, most likely through anti-microbial action by platelets.

Surgical Treatment of Periodontal Diseases—a Review of Current Clinical Research

This manuscript reviews the literature concerning the surgical treatment of periodontal diseases focusing on studies published within the last three years (2016–2019). A thorough review of four databases was completed including clinical human research studies and systematic reviews. Several recent studies have focused on evaluating the effects of combining alloplastic materials with autologous platelet-rich products and growth factors. The results of most of these studies are similar to those with traditionally used allografts. New membranes of human, animal, stem cell, or alloplastic origin, used for guided tissue regeneration procedures, perform similarly to the traditionally used resorbable collagen membranes. Addition of pharmacologic agents to regenerative procedures presents moderately favorable results. Tissue engineering and stem cell research are also expanding, although most of these studies are in vitro or in animal models. Newer minimally invasive surgical techniques and equipment that allow for better visibility and less invasive surgical approach have shown favorable results. Finally, systematic reviews conclude that there is lack of evidence to support LASERs as an alternative to more traditional surgical periodontal treatment. The focus of many recent human clinical studies has been to evaluate the combination of alloplastic and xenogeneic materials with autologous platelet-rich products, growth factors, and pharmacologic agents. The results of these combinations are similar to traditionally used allografts. The great variability between study design, materials, and techniques highlights the need for well-designed randomized controlled trials and longitudinal studies.

Comparative evaluation of angiogenesis using a novel platelet-rich product: An in vitro study.

Background:In vivo angiogenesis is normal and vital process in growth and development, wound healing, and formation of granulation tissue wherein new blood vessels form from preexisting vessels as part of revascularization. Platelet-rich products promote wound healing associated with angiogenesis. Biomaterials such as titanium were found to be angiogenic. Unlike in vivo situations, in vitro angiogenesis, study cells, within a controlled environment.Aims:The aim of this study is to evaluate the angiogenic potential of a novel platelet-rich product.Materials and Methods:Blood was drawn from volunteers with informed consent. Blood samples were centrifuged to obtain platelet-rich products. Platelet concentrates prepared were platelet-rich plasma (PRP), platelet-rich fibrin, and a novel platelet-rich product which is titanium-prepared PRP (TPRP), obtained using titanium. The study which compared platelet concentrate was divided into four groups subjected to tissue culture. Phase-contrast microscope was used to determine the rate of growth by cell counting.Statistical Analysis:ANOVA was used for comparison within groups and post hoc for multiple comparisons.Results:TPRP group showed granular ground substance. Group with platelet-rich fibrin (PRF) shows a high rate of growth whereas those with TPRP showed better growth rate when compared to its counterpart, PRP.Conclusions:This is the first study which introduces TPRP. Previous studies have proved that titanium-prepared PRF has better structural quality than its counterpart platelet-rich fibrin. This study concludes that TPRP has better angiogenic potential than its counterpart PRP. Further in vivo studies are needed to promote TPRP as a new generation of platelet products.

1H-NMR and MALDI-TOF MS as metabolomic quality control tests to classify platelet derived medium additives for GMP compliant cell expansion procedures.

IntroductionEx vivo cell expansion under Good Manufacturing Practice (GMP) guidelines can be performed using medium additives containing human growth factors from platelets. These products can differently affect proliferation of adipose mesenchymal stromal stem cells (ASC). Qualification of medium additive performance is required for validation under GMP regulations: assessment of growth factor concentrations is not sufficient to predict the biological activity of the product batch. Proton nuclear magnetic resonance spectrometry (1H-NMR) and matrix-assisted laser desorption/ionization time of flight mass spectroscopy (MALDI-TOF MS) provide wide molecular characterization of samples.AimsWe aimed to assess if 1H-NMR and MALDI-TOF MS techniques can be used as quality control test potentially predicting the impact of a medium additive on cell proliferation.MethodsWe tested the impact on ASC growth rate (cell proliferation assessment and cell morphology analysis) of four medium additives, obtained by different methods from human platelet apheresis product. In order to classify each medium additive, we evaluated growth factor concentrations and spectra obtained by 1H-NMR and by MALDI-TOF MS.ResultsMedium additive obtained by CaCl2 activation of platelet rich products induced higher proliferation rate vs additive derived from platelet depleted ones. Additives obtained by freeze-and-thaw methods weakly induced ASC proliferation. As expected, principal component analysis of growth factor concentrations did not unravel specific biochemical features characterizing medium additives in relation with their biological activity. Otherwise, while 1H-NMR showed a partial resolution capacity, analysis of MALDI-TOF MS spectra allowed unambiguous distinction between the medium additives we used to differently stimulate cell growth in vitro.DiscussionMALDI-TOF and, despite limitations, 1H-NMR are promising cost effective and reliable quality controls to classify the potential of a medium additive to promote ASC growth. This can represent, after further investigations and appropriate validation, a significant advantage for GMP compliant manufacturing of advanced cell therapy products.

Comparative histologic evaluation of titanium platelet-rich fibrin and platelet-rich fibrin in hypertensive and smoker participants: A cell cytology study

Introduction:In recent years, a growing interest has emerged with the use of platelet-rich products for the treatment of many clinical conditions in dentistry.Objective:The present study aimed to define the structural characteristics of titanium platelet-rich fibrin (TPRF) and PRF in hypertensive and smoker participants.Materials and Methods:Ten milliliters of blood samples was drawn using a syringe form ninety participants (healthy, hypertensive, and smokers). Five milliliters of blood was transferred to each of dry glass tube and titanium tube. The clot obtained after centrifugation from each tube was processed for light microscopy analysis.Results:The TPRF samples have demonstrated a highly organized and thicker fibrin network with continuous integrity as compared to PRF in healthy participants. The hypertensive and smokers showed less prominent fibrin border between the cellular structures in both the platelet concentrates, but sufficient fibrin mesh network was found in TPRF clot as compared to PRF clot in the test participants.Conclusion:This is the first human histologic study to define the fibrin meshwork in both TPRF and PRF clots in hypertensive and smokers. The platelet activation by titanium offered high characteristics to fibrin network.

Short term storage stability at room temperature of two different platelet-rich plasma preparations from equine donors and potential impact on growth factor concentrations.

BackgroundThe increasing interest in platelet-rich plasma (PRP) based therapies is as yet accompanied by inconsistent information regarding nearly all aspects of handling and application. Among these storage stability of processed platelet-rich products may be the basis for a more flexible application mode. The objective of this study was (1) to estimate the storage stability of growth factors platelet derived growth factor BB (PDGF-BB) and transforming growth factor ß1 (TGF-ß1) in both, a single-step softspin centrifugation-based pure-PRP (P-PRP, ACP®), and a gravity filtration system-based leukocyte-rich-PRP (L-PRP, E-PET), over a six hours time span after preparation at room temperature and (2) to identify possible factors influencing these growth factor concentrations in an equine model.ResultsGrowth factor concentrations remained stable over the entire investigation period in L-PRP as well as P-PRP preparations revealing a mean of 3569 pg/ml PDGF-BB for E-PET and means of 1276 pg/ml PDGF-BB and 5086 pg/ml TGF-ß1 for ACP®. Pearson correlations yielded no significant impact of whole blood platelet (PLT), white blood cell (WBC) and red blood cell (RBC) counts on resulting cytokine values. In case of ACP® no significant dependencies between PLT, WBC and RBC counts of the processed platelet-rich product and resulting cytokine content occurred with exception of TGF-ß1 concentrations showing a strong correlation with the WBC content. PDGF-BB content of E-PET preparations showed a strong positive correlation with PLT and a strong negative with WBC of these preparations but not with RBC.ConclusionsL-PRP ad modum E-PET and P-PRP ad modum ACP® are applicable over at least a six hours time span at room temperature without loss of growth factor content. Based on the results of this study factors influencing the resulting growth factor concentrations still remain questionable. Additional studies implicating a further standardization of preparation protocols are necessary to identify consistent impact on cytokine content after PRP processing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-016-0920-4) contains supplementary material, which is available to authorized users.

Effectiveness and efficiency of platelet rich plasma in the treatment of diabetic ulcers.

"There is a growing body of evidence suggesting that wound healing in chronic diabetic foot ulcers is growth factor dependent, and that the therapeutic delivery of these growth factors to wounds topically, has the potential ability to accelerate wound healing in conjunction with conventional wound care". There is, however, confusion about the utility of platelet rich plasma because the studies that have evaluated them use a wide range of products (different platelet and leukocyte concentrations, different techniques and frequencies of application, very heterogeneous simple, and different endpoints) making almost impossible to compare data and draw conclusions. In this study, we have analyzed the different platelet rich plasma products from a new perspective: cost-efficiency. According to our data, we observe that platelet rich plasma is a cost-effective option that allows faster healing of ulcers, and that should be taken into account in patients with long evolution ulcers.

The Effect of Platelet Rich Plasma Formulations and Blood Products on Human Synoviocytes

The Effect of Platelet Rich Plasma Formulations and Blood Products on Human Synoviocytes

Role of Platelets Rich Plasma in Management of Osteoporotic Fractures

Management of osteoporotic fracture is challenging. In most clinical settings, skeletal regenerations are biologically optimized, but still many patients continue to experience delayed or impaired healing. Methods to enhance these healing processes, are needed to decrease patient’s agony, so that they can return to their work and regain their socioeconomic status in the community. Till this time, autologous bone grafting remain the standard procedure against which all new technologies are compared and analyzed.The success rate of union even after these grafts varies between 80-85% which further becomes decreased in case of repeated bone graft surgeries with donor site morbidities. Considering the concept that the healing of fracture started as soon as the formation of fracture clot, several investigators have suggested that degranulation of platelets at fracture clot elaborates the bioactive component, that aided the healing process. Because autologous platelet rich plasma products are safe and easy to prepare and administer, in this review, we reviewed the role of bioactive component released by activated platelet rich plasma in the fracture healing process and hypothesized that by combining the advantages of autologous bone grafts with autologous platelets concentrate, better and prompt results in orthopedic trauma managements can be obtained. We also observe that the use of these bioactive factors to enhance skeletal repair/healing represents the future of skeletal trauma management. Review Article Annual Research & Review in Biology, 4(8): 1187-1210, 2014 1188

Platelet rich plasma and knee surgery.

In orthopaedic surgery and sports medicine, the knee joint has traditionally been considered the workhorse. The reconstruction of every damaged element in this joint is crucial in achieving the surgeon's goal to restore the knee function and prevent degeneration towards osteoarthritis. In the last fifteen years, the field of regenerative medicine is witnessing a boost of autologous blood-derived platelet rich plasma products (PRPs) application to effectively mimic and accelerate the tissue healing process. The scientific rationale behind PRPs is the delivery of growth factors, cytokines, and adhesive proteins present in platelets and plasma, as well as other biologically active proteins conveyed by the plasma such as fibrinogen, prothrombin, and fibronectin; with this biological engineering approach, new perspectives in knee surgery were opened. This work describes the use of PRP to construct and repair every single anatomical structure involved in knee surgery, detailing the process conducted in ligament, meniscal, and chondral surgery.