PRP and Stem Cells Position Statement
Recently, in an effort to fight disease, prevent injury, improve healing after injury or surgery, and stop the aging process and its deleterious effects upon our bodies, scientists and physicians have started investigating and using compounds known as orthobiologics — more commonly known as platelet rich plasma (PRP) and stem cells. We are being asked about these treatment modalities on a daily basis and for this reason decided to make a handout to help you understand what these compounds are, how they are made, and if they truly are as curative as advertised.
PRP is a term used to describe concentrates of platelets prepared from your blood. Platelets are important in order to help blood clot but they also contain numerous proteins called growth factors that are important for the healing of injuries. During the preparation of PRP, blood is drawn from your arm and then the platelets are concentrated in a syringe. This results in a concentration of growth factors that can be 5-10 times greater (or richer) than usual.
In theory, this sounds like a great idea. Some physicians have started marketing the use of PRP to cure or fix a wide range of conditions from hair loss to chronic pain to numerous orthopedic conditions. However, there is no medical evidence that PRP is successful in treating any orthopedic condition or improving postoperative healing.
Part of the reason that we do not recommend the use of PRP is that although it contains a high concentration of growth factors, we do not know which growth factors are useful for which conditions or what concentration of each is required. Moreover, within the PRP preparation there will be some growth factors that may be beneficial to healing and nourishment of one type of tissue but detrimental to others.
Stem cells are unspecialized cells that have the ability to differentiate into multiple different cell types or to replicate themselves. They may be harvested from fat in your body or directly from bone marrow by sticking a needle into a bone. Similar to PRP, stem cells are being marketed as a cure for numerous conditions. Indeed, their ability to differentiate into multiple musculoskeletal cell types, release regenerative growth factors, and dampen immune responses holds great promise for orthopaedic tissue engineering. Unfortunately, like PRP, their function and utility remain poorly understood and controversial.
The research on PRP and stem cells is rapidly expanding and we promise to remain on top of the latest recommendations. Currently, we do not support their routine use for orthopedic conditions.
- AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. Journal of the American Academy of Orthopaedic Surgeons. July 2016, Vol. 24, No. 7.