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The role of Platelet Rich Plasma and other orthobiologics in bone healing and fracture management: A systematic review
Open accessAbstract
Background Treatment of large bone defects and fracture healing complications (delayed and non-union) presents a substantial challenge for orthopaedic surgeons. Given that bone healing requires mechanical stability as well as a favourable biological microenvironment, orthobiologics such as Platelet-Rich Plasma (PRP) may have a significant clinical role to play. Aims To perform a systematic review of the available literature to assess the clinical effect of PRP, with or without other orthobiologics, on bone healing. Method Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical studies of any evidence, assessing effect of PRP with or without other orthobiologics on bone healing, were included. A qualitative analysis was carried out on the clinical and radiological outcomes reported. Result 27 articles with 1631 patients (mean age = 43.56, 57.1% male, mean follow-up = 17.27 months) were included in the qualitative. Of the 27 studies, 13 dealt with fracture complications (delayed or non-unions), 7 with acute fracture healing, 4 with tibial osteotomies and lengthening procedures and 3 with lumbar spine pathology. 18/27 studies showed a clinical benefit of PRP, 8/27 showed no significant effect, and 1/27 showed a worse outcome with PRP. Conclusion Our review suggests PRP may play a clinical role in bone healing but further randomised controlled trials (RCTs) using standardised outcomes should be performed to establish its efficacy.
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“PRP’s efficacy in Achilles tendinopathy and knee osteoarthritis has yielded mixed results, with some trials reporting no significant benefit over placebo, underscoring the lack of standardization in PRP preparation [13,95,96].”
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Cited by
Sorted by citations
Goulian, A. J., Goldstein, B., & Saad, M. A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14062061 · Cited by 25
“PRP’s efficacy in Achilles tendinopathy and knee osteoarthritis has yielded mixed results, with some trials reporting no significant benefit over placebo, underscoring the lack of standardization in PRP preparation [13,95,96].”
Metadata
- Authors
- Jamal, M. S., Hurley, E. T., Asad, H., Asad, A., & Taneja, T.
- Affiliations
- Queen Mary University of London (GB)
- NYU Langone Health (US)
- Corresponding author
- Jamal, M.S.
- ORCID
- Hurley, E.T.
- Venue
- Journal of Clinical Orthopaedics and Trauma
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 25
- Pages
- 101759
- ISSN
- 0976-5662 (ISSN-L)
- PMC
- PMC8749440
- OpenAlex
- W4206772798
- Cited by
- 28
- References
- 0
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 10 · 2023: 2 · 2022: 5
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Orthopaedics and Trauma (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
- Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
- Physical Sciences › Engineering › Biomedical Engineering › Bone Tissue Engineering Materials
- Keywords
- platelet-rich plasma, orthobiologics, bone regeneration, fracture healing, delayed union, nonunion, bone defects, tibial osteotomy, bone lengthening, lumbar spine disorders, mechanical stability
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