The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures.

The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures.
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富含血小板血浆(PRP)在骨不连治疗中的应用

DOI:
10.1007/s11914-020-00643-x
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发表时间:
2021-03
影响因子:
4.3
通讯作者:
Wilson SL
Wilson SL
中科院分区:
医学2区
文献类型:
--
作者:
Andersen C;Wragg NM;Shariatzadeh M;Wilson SL

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骨不愈合骨折的治疗是骨科医生面临的一个重大挑战。近年来,生物制剂已被研究并用于支持和改善骨愈合。在这些药物中,富血小板血浆(PRP)是一种越来越受欢迎的新兴策略。本综述的目的是评估目前关于PRP注射的应用和临床效果的文献,特别是治疗不愈合骨折的文献。大多数已发表的研究报道PRP加速骨折愈合;然而,这些证据主要是四级证据。目前,缺乏随机临床试验(一级-二级证据)阻碍了PRP作为不愈合骨折治疗的成功临床转化。尽管有积极的报道称,当单独使用或与其他形式的治疗联合使用时,它具有治愈不愈合骨折的潜力。为了促进临床转化和接受PRP作为一种治疗方法,未来的建议包括需要调查使用更大剂量PRP(即5-20 mL)的效果,以及需要进行更长的随机临床试验(大约11个月)。
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. 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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