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Tianping Zhou, Yihong Xu, Aiai Zhang, Lan Zhou, Qing Zhang, Zhou Ji, and Weidong Xu

anterior cruciate ligament reconstruction (ACLR) surgeries performed annually has increased to over 100 000 and continues to increase ( 2 ). However, despite great progress made in ACLR research, many controversies and problems still remain ( 3 ). No clear

Nikolaos K. Paschos and Stephen M. Howell

strategies . J Am Acad Orthop Surg 2000 ; 8 : 141 - 150 . 2 Mall NA , Chalmers PN , Moric M , et al. . Incidence and trends of anterior cruciate ligament reconstruction in the United States . Am J Sports Med 2014 ; 42

Joanna Baawa-Ameyaw, Ricci Plastow, Fahima Aarah Begum, Babar Kayani, Hyder Jeddy, and Fares Haddad

: 810 – 817 . 6. Nakamae A Adachi N Deie M et al. Risk factors for progression of articular cartilage damage after anatomical anterior cruciate ligament reconstruction: a second-look arthroscopic evaluation . J

Francisco Figueroa, David Figueroa, Rafael Calvo, Alex Vaisman, and João Espregueira-Mendes

further permission provided the original work is attributed. References 1. Indelli PF Dillingham M Fanton G Schurman DJ . Septic arthritis in postoperative anterior cruciate ligament reconstruction . Clin

Emanuele Diquattro, Sonja Jahnke, Francesco Traina, Francesco Perdisa, Roland Becker, and Sebastian Kopf

. Funding There are no funders to report for this submission. References 1. Hettrich CM Dunn WR Reinke EK MOON Group & Spindler KP . The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction: two

Yusuf Omar Qalib, Yicun Tang, Dawei Wang, Baizhou Xing, Xingming Xu, and Huading Lu

lesions on magnetic resonance imaging in patients with anterior cruciate ligament reconstruction . Am J Sports Med 2017 ; 45 : 2233 – 2237 . 19. Hatayama K Terauchi M Saito K Takase R Higuchi H

Thomas Collins, Dinesh Alexander, and Bilal Barkatali

  • The aim of this article was to synopsize platelet-rich plasma (PRP) use in musculoskeletal pathologies through evidence-based assessment of the preparation, classification, mechanism of action and applications of PRP, thereby answering which PRP type is best for each clinical indication.

  • The literature search was performed using Medline, EMBASE and Cochrane Reviews databases for papers containing the key terms “platelet-rich plasma” AND “orthopaedics” AND (“classification” OR “mechanism of action” OR “preparation” OR “clinical application”). Generated papers were evaluated for pertinence in following areas: preparation, classification, mechanism of action, clinical application within orthopaedics. Non-English papers were excluded. Included studies were evaluated for quality.

  • Sixty studies were included in our review. There are many commercial PRP preparation kits with differing component concentrations. There is no consensus on optimal component concentrations. Multiple PRP classifications exist but none have been validated. Platelet-rich plasma acts via growth factors (GFs) released from α-granules within platelets. Growth factors have been shown to be beneficial in healing. Grossly elevated concentrations of GFs may have inhibitory effects on healing. Multiple systematic reviews show efficacy of PRP in tendinopathies, early osteoarthritis, acute muscle injuries and in combination with rotator cuff repair and anterior cruciate ligament reconstruction.

  • The literature suggests leukocyte-rich PRP (L-PRP) is more beneficial in tendinopathies and pure PRP (P-PRP) is more beneficial in cartilage pathology. However, different PRP preparations have not been directly compared in any pathology. Classification of PRP type is frequently not stated in research. Standardization of PRP research parameters is needed to streamline findings and generate clear indications for PRP types to yield maximum clinical benefit.

Cite this article: EFORT Open Rev 2021;6:225-235. DOI: 10.1302/2058-5241.6.200017

Francisco Figueroa, David Figueroa, and João Espregueira-Mendes

cruciate ligament reconstruction . Am J Sports Med 2003 ; 31 : 564 - 73 . 5. Freedman KB D’Amato MJ Nedeff DD Kaz A Bach BR Jr . Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis

Juan Carlos Monllau, Simone Perelli, and Giuseppe Gianluca Costa

. Johnson DL & Fu FH . Anterior cruciate ligament reconstruction: why do failures occur? Instructional Course Lectures 1995 44 391 – 406 . 9. Tischer T Beaufils P Becker R Ahmad SS Bonomo M Dejour D Eriksson K Filardo G Feucht MJ

Alli Gokeler, Bart Dingenen, Caroline Mouton, and Romain Seil

Cotic M Saier T . Patient expectations of primary and revision anterior cruciate ligament reconstruction . Knee Surg Sports Traumatol Arthrosc 2016 ; 24 : 201 - 207 . 4 Ardern CL Taylor NF Feller JA