Efficacy of Platelet-Rich Plasma (PRP) Therapy in Tendon and Ligament Healing

Abstract

Platelet-rich plasma (PRP) treatment has gained increasing scientific interest as a biologically viable, less invasive treatment of musculoskeletal connective tissue injuries, specifically tendin and ligamental ones. PRP is an autologous blood-derived concentrate, which provides an extremely enriched milieu of growth factors such as platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-b), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and insulin-like growth factor- 1(IGF-1), which work together to coordinate the cellular and molecular processes of tissue healing. The aim of the study was to provide a rigorous evaluation of the therapeutic effects of PRP as an agent in tendon and ligament healing, its mechanistic understanding, clinical outcome measures through validated functional indices, as well as critically analyze the challenges that are currently deterring its use in a broader context. A combined approach of a prospective interventional cohort of 30 patients with a systematic review of peer-reviewed articles was used as a comprehensive methodological framework. Outcome measures included pain intensity, which was measured using the Visual Analog Scale (VAS), functional recovery, which was measured using the Disabilities of the Arm, Shoulder and Hand (DASH) scale and the Victorian Institute of Sport Assessment (VISA) score, and structural tissue changes measured by ultrasound and magnetic resonance imaging (MRI) at three and six months of follow-up. Findings showed that there was a significant decrease in pain (VAS between 7.2 + 1.3 baseline and 1.9 + 0.7 six months, p < 0.001), there was a significant increase in functional performance (DASH between 58.3 + 8.4 to 22.5 + 6.3, VISA between 34.2 + 7.6 to 78.5 + 9.1), and, finally, imaging-defined structural changes in 70-83% of individuals. Although such positive results were achieved, such obstacles as inter-preparation inconsistency in platelet concentration, the lack of standardized dosing regimens, and economic inaccessibility of PRP device are still noteworthy. The conclusion of this review is that PRP is a clinically relevant intervention that should be further standardized with placebo-controlled trials that are designed rigorously.