Platelet-Rich Plasma Augmentation for Hip Arthroscopy

Platelet-Rich Plasma Augmentation for Hip Arthroscopy

Abstract

Biological augmentation and therapeutics are being increasingly used in musculoskeletal and orthopaedic care. Platelet-rich plasma (PRP) is produced from centrifugation of peripheral blood, a process that concentrates platelets within autologous plasma. The process of PRP preparation is fundamental in controlling the contents, and it influences its therapeutic potential. Platelets contain alpha granules that store and release a variety of growth factors and other proteins that may augment the healing environment; PRP also has the added benefit of promoting postsurgical hemostasis. The purpose of this report was to detail our institutional preparation protocol and method of administration of PRP during hip arthroscopy.

Biological augmentation and therapeutics are being increasingly used in musculoskeletal and orthopaedic care1,2,3 Platelet-rich plasma (PRP) has been used by orthopaedic surgeons and other health practitioners to enhance healing and modulate the environment of tendinopathy, surgical repair of tendons, ligament reconstruction, diffuse arthritis, and focal chondral defects4,5,6.

PRP is produced from centrifugation of peripheral blood, a process that concentrates platelets within autologous plasma.2 Platelets contain alpha granules that store and release a variety of growth factors, such as cytokines and chemokines, as well as other proteins including insulin growth factor 1, transforming growth factor β1, and vascular endothelial growth factor.1 These biological factors can be modulated by the preparation method used to produce the PRP. For example, leukocyte-rich PRP may increase inflammation and catabolic pathways, whereas leukocyte-poor PRP may decrease inflammation and anabolic pathways.7, 8 In addition, PRP can be prepared as a fibrinous product with adhesive hemostatic properties through endogenous or exogenous activation. The PRP-fibrin preparation can enhance endothelial, epithelial, and epidermal regeneration, by stimulating angiogenesis, improving collagen synthesis, and decreasing scarring.9

PRP has been historically described as \"a volume of plasma with a platelet count above baseline,\"10 but a more recent quantitative definition requires PRP to contain more than 1 million platelets per milliliter of serum or a 5-fold increase from the baseline platelet concentration.11 The preparation of PRP is essential in determining the therapeutic potential for biological augmentation. The purpose of this report was to detail our institutional PRP preparation protocol and method of administration during hip arthroscopy.

Abstract

Biological augmentation and therapeutics are being increasingly used in musculoskeletal and orthopaedic care. Platelet-rich plasma (PRP) is produced from centrifugation of peripheral blood, a process that concentrates platelets within autologous plasma. The process of PRP preparation is fundamental in controlling the contents, and it influences its therapeutic potential. Platelets contain alpha granules that store and release a variety of growth factors and other proteins that may augment the healing environment; PRP also has the added benefit of promoting postsurgical hemostasis. The purpose of this report was to detail our institutional preparation protocol and method of administration of PRP during hip arthroscopy.

Biological augmentation and therapeutics are being increasingly used in musculoskeletal and orthopaedic care1,2,3 Platelet-rich plasma (PRP) has been used by orthopaedic surgeons and other health practitioners to enhance healing and modulate the environment of tendinopathy, surgical repair of tendons, ligament reconstruction, diffuse arthritis, and focal chondral defects4,5,6.

PRP is produced from centrifugation of peripheral blood, a process that concentrates platelets within autologous plasma.2 Platelets contain alpha granules that store and release a variety of growth factors, such as cytokines and chemokines, as well as other proteins including insulin growth factor 1, transforming growth factor β1, and vascular endothelial growth factor.1 These biological factors can be modulated by the preparation method used to produce the PRP. For example, leukocyte-rich PRP may increase inflammation and catabolic pathways, whereas leukocyte-poor PRP may decrease inflammation and anabolic pathways.7, 8 In addition, PRP can be prepared as a fibrinous product with adhesive hemostatic properties through endogenous or exogenous activation. The PRP-fibrin preparation can enhance endothelial, epithelial, and epidermal regeneration, by stimulating angiogenesis, improving collagen synthesis, and decreasing scarring.9

PRP has been historically described as \"a volume of plasma with a platelet count above baseline,\"10 but a more recent quantitative definition requires PRP to contain more than 1 million platelets per milliliter of serum or a 5-fold increase from the baseline platelet concentration.11 The preparation of PRP is essential in determining the therapeutic potential for biological augmentation. The purpose of this report was to detail our institutional PRP preparation protocol and method of administration during hip arthroscopy.

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