PRP or not PRP? That is the question.

Since the introduction of platelet concentrates as a topical
adjuvant therapy to treat chronic leg ulcers in the late 1980,
the use of platelet products has been extended to many fields
of medicine, with the aim of promoting the healing process of
various pathologies in numerous kinds of tissues.
Platelet-rich plasma (PRP) and other blood derivates,
used alone or in combination with biomaterials, are under
investigation in innumerable preclinical studies or even
already used in clinical practice. Fields of application
include dermatology, ophthalmology, dentistry, cosmetic,
plastic and maxillofacial surgery, neurosurgery, urology,
cardiothoracic surgery, as well as orthopedics, sport medicine,
and recently, breakthroughs have been claimed even
for the treatment of baldness. Looking more specifically
into the orthopedic field, applications of PRP are numerous
and heterogeneous: it has been used as adjuvant to promote
the healing of bone defects and nonunions, bone fractures,
laminectomy, spinal fusion, joint arthroplasty, bone implant
osseointegration, and the treatment of various traumatic or
degenerative pathologies of tendons, ligaments, muscle, and
cartilage.
The rationale for using platelets in so many fields for the
treatment of different tissues is that platelets constitute a
reservoir of critical growth factors (GFs) and bioactive
molecules that govern and regulate the healing process,
which is quite similar in most tissues. Moreover, the
attractive possibility of using patients’ own growth factors,
concentrated and in physiologic proportions, to enhance
reparative processes in tissues with low healing potential,
promising preliminary clinical findings, and their safety
might explain the wide use of this biological approach.
However, although the popularity of PRP has reached a
peak and there is lot of enthusiasm, talking, and advertising,
it is realistic to say that nothing works for everything.