Platelet-Rich Plasma and Cartilage Repair
Platelet-Rich Plasma and Cartilage Repair
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DOI：
10.1007/s12178-018-9516-x
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发表时间：
2018-12-01
影响因子：
4.1
通讯作者：
LaPrade, Robert F.
中科院分区：
文献类型：
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作者：
Kennedy, Mitchell I.;Whitney, Kaitlyn;LaPrade, Robert F.
综述目的评估富血小板血浆 (PRP) 在治疗关节软骨损伤方面的利用和功效，关节软骨损伤的最常见特征是骨关节炎 (OA) 情况下进行性疼痛和关节功能丧失。最新发现 PRP 通过局部应用浓缩的血小板、白细胞和生长因子来调节炎症和分解代谢环境。临床上，PRP 已被证明可能是治疗多种炎症和退行性疾病的可行辅助治疗剂。最近的工作重点是优化输送方法，使血小板能够缓慢地使其生物成分脱粒，这可能会在较长时间内促进愈合并改善 OA 症状。总结影响关节内 OA 进展的因素有多种，包括抑制炎症细胞因子和改变酶表达水平。 PRP 疗法旨在通过分泌抗炎因子和趋化作用来介导退化环境中的炎症和分解代谢因子。越来越多的研究证明 PRP 对于非手术治疗 OA 具有临床益处。为了验证 PRP 在这种情况下的治疗效果，需要进行额外的长期随访随机对照试验。此外，为了阐明 PRP 对软骨修复和再生的有效性，以供未来临床应用，需要持续的基础研究以及精心设计的临床前研究和报告标准。
Purpose of ReviewTo assess the utilization and efficacy of platelet-rich plasma (PRP), for the treatment of articular cartilage injury, most commonly characterized by progressive pain and loss of joint function in the setting of osteoarthritis (OA).Recent FindingsPRP modulates the inflammatory and catabolic environment through a locally applied concentrate of platelets, leukocytes, and growth factors. Clinically, PRP has been shown to be possibly a viable treatment adjuvant for a variety of inflammatory and degenerative conditions. Recent efforts have focused on optimizing delivery methods that enable platelets to slowly degranulate their biological constituents, which may promote healing and improve OA symptoms for a longer duration.SummaryThere are various factors that affect the progression of OA within joints, including inhibition of inflammatory cytokines and altering the level of enzymatic expression. PRP therapy aims to mediate inflammatory and catabolic factors in a degenerative environment through the secretion of anti-inflammatory factors and chemotaxic effects. There are a growing number of studies that have demonstrated the clinical benefit of PRP for non-operative management of OA. Additional randomized controlled trials with long-term follow-up are needed in order to validate PRP's therapeutic efficacy in this setting. Additionally, continued basic research along with well-designed pre-clinical studies and reporting standards are necessary in order to clarify the effectiveness of PRP for cartilage repair and regeneration for future clinical applications.