Optimal use of platelet-rich plasma and platelet-poor plasma

Platelet-rich plasma (PRP) and, to a lesser extent, platelet-poor plasma (PPP) have emerged as two orthobiologic substances with potentially substantial clinical benefits. PRP has been used across all medical therapeutics, from facial rejuvenation to spinal fusion. Research into the biochemical pathways, in vitro utility, and optimal in vivo clinical applications of PRP and PPP are the subject of active investigation, as interest in the prevention and nonoperative treatment of orthopedic pathologies continues to grow. Orthopedic applications of orthobiologic substances include enhancement of muscle healing, rotator cuff disease, ulnar collateral ligament injuries, hip and knee osteoarthritis, and Achilles tendinopathy, among others. The aim of this chapter is to characterize the most up-to-date information regarding the optimal clinical use of PRP and PPP when applied in their most well-studied musculoskeletal pathologies.