Platelet Rich Plasma (PRP) Matrix Grafts
by David Crane, MD and Peter A.M. Everts, PhD
Platelet Rich Plasma (PRP) grafting techniques are now being utilized in
musculoskeletal medicine with increasing frequency and effectiveness. Soft tissue injuries
treated with PRP include tendonopathy, tendonosis, acute and chronic muscle strain, muscle
fibrosis, ligamentous sprains, and joint capsular laxity. PRP has also been utilized to
treat intra-articular injuries. Examples include arthritis, arthrofibrosis, articular
cartilage defects, meniscal injury, and chronic synovitis or joint inflammation.
 Figure 3. Cell Proliferation Triangle.
Platelet Rich Plasma was first used in cardiac surgery by Ferrari et al. in 1987 as an
autologous transfusion component after an open heart operation to avoid homologous blood
product transfusion.1 It is now being utilized by musculoskeletal (MSK)
providers following the effective use in multiple specialties. PRP has also been
successfully used in various specialties such as maxillofacial, cosmetic, spine,
orthopedic, podiatric and for general wound healing.2,3
MSK practitioners began using PRP for tendonosis and tendonitis in the early 1990s.4
PRP techniques have most commonly been applied by MSK practitioners previously trained in
the use of—and on the knowledge backbone of—prolotherapy. Although there is a
paucity of well designed, randomized trials for its use in MSK medicine, animal studies,
case reports, and anecdotal evidence suggests that this technique will continue to develop
as a way to regenerate tissue that has lost its inherent homeostasis and thereby relieve
associated pain and dysfunction.
Standardizing the Nomenclature for PRP
The authors define a PRP Matrix Graft as follows:
"A tissue graft incorporating autologous growth factors and/ or autologous
undifferentiated cells in a cellular matrix whose design depends on the receptor site and
tissue of regeneration."
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— Jan/Feb 2008
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