2023, Vol. 27 ›› Issue (12): 1944-1953

Influencing factors and mechanisms of platelet-rich plasma in tendinopathy

Lu Jialin1,2, Gao Yao1, Li Han2, Zhang Ziyu2, Wang Yiming2, Xu Rui2,3, Wang Zhonghan4, Jin Hui1   

Abstract: BACKGROUND: Platelet-rich plasma has been widely used as a promising therapeutic agent for tendinopathy, because it contains a variety of cytokines and other protein components. However, there are controversies about the optimal treatment regimen and efficacy of platelet-rich plasma for tendinopathy.
OBJECTIVE: To summarize the factors that contributed to the efficacy of platelet-rich plasma and the underlying mechanism of platelet-rich plasma in the improvement of tendinopathy, as well as to prospect the potential of platelet-rich plasma combination therapy in the treatment of tendinopathy.
METHODS: Articles published from inception to July 2021 were retrieved on PubMed, Web of Science, and CNKI by the keywords of “PRP, tendinopathy, preparation, mechanism, combination therapy”. A total of 490 articles were picked, and 135 articles were finally selected for this review according to the criteria of inclusion and exclusion.   
RESULTS AND CONCLUSION: Currently, the preparation process of platelet-rich plasma is multifarious. The therapeutic efficacy of platelet-rich plasma is depended on several factors such as preparation methods, composition, activation methods, way of administration, and number of applications. The best way to evaluate the efficacy of platelet-rich plasma in tendinopathy is to determine the role of specific growth factors in molecular signaling pathways associated with tendon repair. In vitro and in vivo basic researchers have found that platelet-rich plasma has the ability to promote tissue regeneration, modulate inflammation and increase mechanical strength, elastic modulus and mechanical load of tendons. In addition, factors influencing tendinopathy treatment are multiple. Platelet-rich plasma combined with other treatment strategy may overcome the limitations of single platelet-rich plasma to a certain extent and has practical significance for treating tendinopathy. Combined with tissue engineering and clinical methods, the therapeutic effect of platelet-rich plasma will be enhanced to a certain degree, can achieve better prognosis, and further expand the application of platelet-rich plasma.
Key words: tendinopathy, platelet-rich plasma, preparation, mechanism, combination therapy, review