Platelet-rich plasma (PRP) is a blood product that contains several growth factors and active proteins. PRP is thought to be used autologously to assist in the repair of injured tissues as well as to treat pain at the site of injury. The mechanism behind PRP in regenerative medicine has been well investigated and includes the identification and concentration of released growth factors and exosomes. The benefits of PRP have been highly recommended and are used widely in orthopaedics and sports medicine, including repair of injured skeletal muscle. This current report summarizes some of the more recent studies in the use of PRP as it relates to muscle healing, in both the in vitro and clinical arenas.
A HamidMSMohamed AliMRYusofAGeorgeJLeeLP. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sports Med. 2014;42(10):2410-2418. doi:10.1177/0363546514541540
2.
A HamidMSYusofAMohamed AliMR. Platelet-rich plasma (PRP) for acute muscle injury: a systematic review. PLoS One. 2014;9(2):e90538. doi:10.1371/journal.pone.0090538
3.
AlvesRGrimaltR. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Ski Appendage Disord. 2018;4(1):18-24. doi:10.1159/000477353
4.
AndiaIPerez-valleAAmoC DelMaffulliN. Freeze-drying of platelet-rich plasma: the quest for standardization. Int J Mol Sci. 2020;21(18):1-20. doi:10.3390/ijms21186904
5.
ArtazaJNBhasinSMageeTR, et al. Myostatin inhibits myogenesis and promotes adipogenesis in C3H 10T(1/2) mesenchymal multipotent cells. Endocrinology. 2005;146(8):3547-3557. doi:10.1210/en.2005-0362
6.
BariaMRMillerMMBorchersJ, et al. High intensity interval exercise increases platelet and transforming growth factor-β yield in platelet-rich plasma. PM R. 2020;12(12):1244-1250. doi:10.1002/pmrj.12368
7.
BernuzziGPetragliaFPedriniMF, et al. Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection. Blood Transfus. 2014;12(suppl 1):S229. doi:10.2450/2013.0293-12
8.
BorrionePFagnaniFDi GianfrancescoAManciniAPigozziFPitsiladisY. The role of platelet-rich plasma in muscle healing. Curr Sports Med Rep. 2017;16(6):459-463. doi:10.1249/JSR.0000000 000000432
9.
BubnovRYevseenkoVSemenivI. Ultrasound guided injections of platelets rich plasma for muscle injury in professional athletes. Comparative study. Med Ultrason. 2013;15(2):101-105. doi:10.11152/mu.2013.2066.152.rb1vy2
10.
ChelliniFTaniAZecchi-OrlandiniSSassoliC. Influence of platelet-rich and platelet-poor plasma on endogenous mechanisms of skeletal muscle repair/regeneration. Int J Mol Sci. 2019;20(3):683. doi:10.3390/ijms20030683
11.
CohnCSLockhartEMcCulloughJJ. The use of autologous platelet-rich plasma in the orthopedic setting. Transfusion. 2015;55(7):1812-1820. doi:10.1111/trf.13005
12.
DaiWLZhouAGZhangHZhangJ. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 2017;33(3):659-670.e1. doi:10.1016/j.arthro.2016.09.024
13.
DhuratRSukeshM. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. J Cutan Aesthet Surg. 2014;7(4):189. doi:10.4103/0974-2077.150734
14.
EveraertCHelsmoortelHDecockA, et al. Performance assessment of total RNA sequencing of human biofluids and extracellular vesicles. Sci Rep. 2019;9(1):1-16. doi:10.1038/s41598-019-53892-x
15.
EvertsPOnishiKJayaramPLanaJFMautnerK. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci. 2020;21(20):1-36. doi:10.3390/ijms21207794
16.
ForcinaLMianoCScicchitanoBMusaròA. Signals from the niche: insights into the role of IGF-1 and IL-6 in modulating skeletal muscle fibrosis. Cells. 2019;8(3):232. doi:10.3390/cells8030232
17.
GarnerALFrelingerALGerritsAJ, et al. Using extracellular calcium concentration and electric pulse conditions to tune platelet-rich plasma growth factor release and clotting. Med Hypotheses. 2019;125:100-105. doi:10.1016/j.mehy.2019.02.036
18.
GarnerALTorresASKlopmanSNeculaesB. Electrical stimulation of whole blood for growth factor release and potential clinical implications. Med Hypotheses. 2020;143:110105. doi:10.1016/j.mehy.2020.110105
19.
GosensTPeerboomsJCVan LaarWDen OudstenBL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med. 2011;39(6):1200-1208. doi:10.1177/0363546510397173
20.
GrassiANapoliFRomandiniI, et al. Is platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? A systematic review and meta-analysis. Sports Med. 2018;48(4):971-989. doi:10.1007/s40279-018-0860-1
21.
HahnOKiebMJonitz-HeinckeABaderRPetersKTischerT. Dose-dependent effects of platelet-rich plasma powder on chondrocytes in vitro. Am J Sports Med. 2020;48(7):1727-1734. doi:10.1177/0363546520911035
22.
HanischKWedderkoppN. Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP. Orthop Res Rev. 2019;11:55-60. doi:10.2147/ORR.S 187638
23.
HuardJLiYFuFH. Muscle injuries and repair: current trends in research. J Bone Joint Surg Am. 2002;84(5):822-832.
24.
IrmakGDemirtaşTTGümüşderelioğluM. Sustained release of growth factors from photoactivated platelet rich plasma (PRP). Eur J Pharm Biopharm. 2020;148:67-76. doi:10.1016/j.ejpb.2019.11.011
25.
IsmaeelAKimJSKirkJSSmithRSBohannonWTKoutakisP. Role of transforming growth factor-β in skeletal muscle fibrosis: a review. Int J Mol Sci. 2019;20(10):2446. doi:10.3390/ijms20102446
26.
IyerSRScheiberALYarowskyPHennRFOtsuruSLoveringRM. Exosomes isolated from platelet-rich plasma and mesenchymal stem cells promote recovery of function after muscle injury. Am J Sports Med. 2020;48(9):2277-2286. doi:10.1177/0363546520926462
27.
JärvinenTAHJärvinenMKalimoH. Regeneration of injured skeletal muscle after the injury. Muscles Ligaments Tendons J. 2013;3(4):337-345. doi:10.11138/mltj/2013.3.4.337
28.
JärvinenTAHJärvinenTLNKääriäinenMKalimoHJärvinenM. Muscle injuries: biology and treatment. Am J Sports Med. 2005;33(5):745-764. doi:10.1177/0363546505274714
29.
JiangGWuYMengJ, et al. Comparison of leukocyte-rich platelet-rich plasma and leukocyte-poor platelet-rich plasma on Achilles tendinopathy at an early stage in a rabbit model. Am J Sports Med. 2020;48(5):1189-1199. doi:10.1177/0363546520906142
30.
KelcRTrapecarMGradisnikLRupnikMSVogrinM. Platelet-rich plasma, especially when combined with a TGF-β inhibitor promotes proliferation, viability and myogenic differentiation of myoblasts in vitro. PLoS One. 2015;10(2):e0117302. doi:10.1371/journal.pone .0117302
31.
KobayashiEFlückigerLFujioka-KobayashiM, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016;20(9):2353-2360. doi:10.1007/s00784-016-1719-1
32.
KobayashiYSaitaYNishioH, et al. Leukocyte concentration and composition in platelet-rich plasma (PRP) influences the growth factor and protease concentrations. J Orthop Sci. 2016;21(5):683-689. doi:10.1016/j.jos.2016.07.009
33.
LevouxJProlaALafusteP, et al. Platelets facilitate the wound-healing capability of mesenchymal stem cells by mitochondrial transfer and metabolic reprogramming. Cell Metab. 2021;33(2):283-299.e9. doi:10.1016/j.cmet.2020.12.006
34.
LiHHicksJJWangL, et al. Customized platelet-rich plasma with transforming growth factor β1 neutralization antibody to reduce fibrosis in skeletal muscle. Biomaterials. 2016;87:147-156. doi:10.1016/j.biomaterials.2016.02.017
35.
LiHUsasAPoddarM, et al. Platelet-rich plasma promotes the proliferation of human muscle derived progenitor cells and maintains their stemness. PLoS One. 2013;8(6):e64923. doi:10.1371/journal.pone.0064923
36.
LiLTuanRS. Mechanism of traumatic heterotopic ossification: in search of injury-induced osteogenic factors. J Cell Mol Med. 2020;24(19):11046-11055. doi:10.1111/JCMM.15735
37.
LiYCumminsJHuardJ. Muscle injury and repair. Curr Opin Orthop. 2001;12(5):409-415.
38.
LiYFosterWDeasyBM, et al. Transforming growth factor-β1 induces the differentiation of myogenic cells into fibrotic cells in injured skeletal muscle: a key event in muscle fibrogenesis. Am J Pathol. 2004;164(3):1007-1019. doi:10.1016/S0002-9440(10)63188-4
39.
LinCCJChenWNChenCJLinYWZimmerAChenCC. An antinociceptive role for substance P in acid-induced chronic muscle pain. Proc Natl Acad Sci U S A. 2012;109(2):e76-e83. doi:10.1073/pnas.1108903108
40.
LiuXWangLMaCWangGZhangYSunS. Exosomes derived from platelet-rich plasma present a novel potential in alleviating knee osteoarthritis by promoting proliferation and inhibiting apoptosis of chondrocyte via Wnt/β-catenin signaling pathway. J Orthop Surg Res. 2019;14(1):470. doi:10.1186/s13018-019-1529-7
41.
MagalonJBaussetOSerratriceN, et al. Characterization and comparison of 5 platelet-rich plasma preparations in a single-donor model. Arthroscopy. 2014;30(5):629-638. doi:10.1016/j.arthro .2014.02.020
MarianiEPulsatelliL. Platelet concentrates in musculoskeletal medicine. Int J Mol Sci. 2020;21(4):1328. doi:10.3390/ijms21041328
44.
MartínezCESmithPCPalma AlvaradoVA. The influence of platelet-derived products on angiogenesis and tissue repair: a concise update. Front Physiol. 2015;6:290. doi:10.3389/fphys.2015.00290
45.
MehtaSWatsonJT. Platelet rich concentrate: basic science and current clinical applications. J Orthop Trauma. 2008;22(6):433-438. doi:10.1097/BOT.0B013E31817E793F
46.
NohKCLiuXNZhuanZ, et al. Leukocyte-poor platelet-rich plasma-derived growth factors enhance human fibroblast proliferation in vitro. Clin Orthop Surg. 2018;10(2):240-247. doi:10.4055/cios.2018.10.2.240
47.
PiccinADi PierroAMCanzianL, et al. Platelet gel: a new therapeutic tool with great potential. Blood Transfus. 2017;15(4):333-340. doi:10.2450/2016.0038-16
48.
PiferMAMaerzTBakerKCAndersonK. Matrix metalloproteinase content and activity in low-platelet, low-leukocyte and high-platelet, high-leukocyte platelet rich plasma (PRP) and the biologic response to PRP by human ligament fibroblasts. Am J Sports Med. 2014;42(5):1211-1218. doi:10.1177/0363546514524710
49.
QianYHanQChenW, et al. Platelet-rich plasma derived growth factors contribute to stem cell differentiation in musculoskeletal regeneration. Front Chem. 2017;5:89. doi:10.3389/fchem.2017. 00089
50.
MarxRECarlsonEREichstaedtRMSchimmeleSRStraussJEGeorgeffKR. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(6):638-646. doi:10.1016/s1079-2104(98)90029-4
51.
RibohJCSaltzmanBMYankeABFortierLColeBJ. Effect of leukocyte concentration on the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis. Am J Sports Med. 2016;44(3):792-800. doi:10.1177/0363546515580787
52.
RossiLAMolina RómoliARBertona AltieriBABurgos FlorJAScordoWEElizondoCM. Does platelet-rich plasma decrease time to return to sports in acute muscle tear? A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(10):3319-3325. doi:10.1007/s00167-016-4129-7
53.
SánchezMAnituaEDelgadoDSánchezPOriveGPadillaS. Muscle repair: platelet-rich plasma derivates as a bridge from spontaneity to intervention. Injury. 2014;45(suppl 4):S7-S14. doi:10.1016/S0020-1383(14)70004-X
54.
SassFAFuchsMPumbergerM, et al. Immunology guides skeletal muscle regeneration. Int J Mol Sci. 2018;19(3):835. doi:10.3390/ijms19030835
55.
SetayeshKVillarrealAGottschalkATokishJMChoateWS. Treatment of muscle injuries with platelet-rich plasma: a review of the literature. Curr Rev Musculoskelet Med. 2018;11(4):635-642. doi:10 .1007/s12178-018-9526-8
56.
ShenWPriskVLiYFosterWHuardJ. Inhibited skeletal muscle healing in cyclooxygenase-2 gene-deficient mice: the role of PGE2 and PGF2α. J Appl Physiol. 2006;101(4):1215-1221. doi:10.1152/japplphysiol.01331.2005
57.
ShethUDwyerTSmithI, et al. Does platelet-rich plasma lead to earlier return to sport when compared with conservative treatment in acute muscle injuries? A systematic review and meta-analysis. Arthroscopy. 2018;34(1):281-288.e1. doi:10.1016/j.arthro .2017 .06.039
58.
SlaterMPatavaJKinghamKMasonRS. Involvement of platelets in stimulating osteogenic activity. J Orthop Res. 1995;13(5):655-663. doi:10.1002/jor.1100130504
59.
SommelingCEHeynemanAHoeksemaHVerbelenJStillaertFBMonstreyS. The use of platelet-rich plasma in plastic surgery: a systematic review. J Plast Reconstr Aesthetic Surg. 2013;66(3):301-311. doi:10.1016/j.bjps.2012.11.009
60.
SundmanEAColeBJFortierLA. Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med. 2011;39(10):2135-2140. doi:10.1177/0363546511417792
61.
TaoSCYuanTRuiBYZhuZZGuoSCZhangCQ. Exosomes derived from human platelet-rich plasma prevent apoptosis induced by glucocorticoid-associated endoplasmic reticulum stress in rat osteonecrosis of the femoral head via the Akt/Bad/Bcl-2 signal pathway. Theranostics. 2017;7(3):733-750. doi:10.7150/thno.17450
62.
TayapongsakPO’BrienDAMonteiroCBArceo-DiazLY. Autologous fibrin adhesive in mandibular reconstruction with particulate cancellous bone and marrow. J Oral Maxillofac Surg. 1994;52(2):161-166. doi:10.1016/0278-2391(94)90401-4
63.
ThéryCOstrowskiMSeguraE. Membrane vesicles as conveyors of immune responses. Nat Rev Immunol. 2009;9(8):581-593. doi:10.1038/nri2567
64.
TonogaiIHayashiFIwameTTakasagoTMatsuuraTSairyoK. Platelet-rich plasma does not reduce skeletal muscle fibrosis after distraction osteogenesis. J Exp Orthop. 2018;5(1):1-8. doi:10.1186/s40634-018-0143-7
65.
TorreggianiEPerutFRoncuzziLZiniNBaglìoSRBaldiniN. Exosomes: novel effectors of human platelet lysate activity. Eur Cells Mater. 2014;28:137-151. doi:10.22203/eCM.v028a11
66.
Van LieshoutEMMDen HartogD. Effect of platelet-rich plasma on fracture healing. Injury. 2021;52(suppl 2):S58-S66. doi:10.1016/j.injury.2020.12.005
67.
WarrenGLSummanMGaoXChapmanRHuldermanTSimeonovaPP. Mechanisms of skeletal muscle injury and repair revealed by gene expression studies in mouse models. J Physiol. 2007;582(2):825-841. doi:10.1113/jphysiol.2007.132373
68.
YuWWangJYinJ. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci. 2011;121(4):176-180. doi:10.3109/00207454.2010.544432
69.
ZhaoKLiuYSNieLY, et al. The influence of sample size and gender composition on the meta-analysis conclusion of platelet-rich plasma treatment for osteoarthritis. J Orthop Transl. 2020;22:34-42. doi:10.1016/j.jot.2019.10.002
70.
ZhaoYChenMLianD, et al. Non-coding RNA regulates the myogenesis of skeletal muscle satellite cells, injury repair and diseases. Cells. 2019;8(9):988. doi:10.3390/cells8090988
71.
ZieglerCGVan SlounRGonzalezS, et al. Characterization of growth factors, cytokines, and chemokines in bone marrow concentrate and platelet-rich plasma: a prospective analysis. Am J Sports Med. 2019;47(9):2174-2187. doi:10.1177/0363546519832003
72.
ZitschBPJamesCRCristBDStokerAMDella RoccaGJCookJL. A prospective randomized double-blind clinical trial to assess the effects of leukocyte-reduced platelet-rich plasma on pro-inflammatory, degradative, and anabolic biomarkers after closed pilon fractures. J Orthop Res. Published online June29, 2021. doi:10.1002/jor.25123
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
