Role of Platelets Rich Plasma in Management of Osteoporotic Fractures
Ajai Singh *
Department of Orthopaedic Surgery, King George's Medical University, Lucknow-226003, India.
Sabir Ali
Department of Orthopaedic Surgery, King George's Medical University, Lucknow-226003, India.
Abbas Ali Mahdi
Department of Biochemistry, King George's Medical University, Lucknow-226003, India.
Rajeshwar Nath Srivastava
Department of Orthopaedic Surgery, King George's Medical University, Lucknow-226003, India.
*Author to whom correspondence should be addressed.
Abstract
Management of osteoporotic fracture is challenging. In most clinical settings, skeletal regenerations are biologically optimized, but still many patients continue to experience delayed or impaired healing. Methods to enhance these healing processes, are needed to decrease patient’s agony, so that they can return to their work and regain their socioeconomic status in the community. Till this time, autologous bone grafting remain the standard procedure against which all new technologies are compared and analyzed.The success rate of union even after these grafts varies between 80-85% which further becomes decreased in case of repeated bone graft surgeries with donor site morbidities. Considering the concept that the healing of fracture started as soon as the formation of fracture clot, several investigators have suggested that degranulation of platelets at fracture clot elaborates the bioactive component, that aided the healing process. Because autologous platelet rich plasma products are safe and easy to prepare and administer, in this review, we reviewed the role of bioactive component released by activated platelet rich plasma in the fracture healing process and hypothesized that by combining the advantages of autologous bone grafts with autologous platelets concentrate, better and prompt results in orthopedic trauma managements can be obtained. We also observe that the use of these bioactive factors to enhance skeletal repair/healing represents the future of skeletal trauma management.
Keywords: Osteoporotic fracture, fragility fractures, bone grafting, platelets bioactivity, Non-unions, platelet rich plasma