Table 3.
Clinical application of PRF for cartilage repair.
| End Use Destination | Hemocomponent/Experimental Groups | PRFPreparation Protocol | Characterization Parameters | Major Findings | Reference |
|---|---|---|---|---|---|
| Hemophilic ankle arthropathy (focal lesions) |
n = 5 patients (mean age = 33 ± 6.78 years): collagen membrane loaded with BMDCs and PRF |
Preparation according to the Vivostat® system | Mean follow up: 2 years The postoperative outcome was evaluated by: - AOFAS scores - radiographs - MRI and Mocart scores |
- All patients showed complete filling of the talar defect - The implant borders were completely/partially integrated with the adjacent cartilage - In all patients presented inhomogeneous, hyperintense repair tissue was detected - Three patients had subchondral bone edema or cyst - Overall, the data showed good osteochondral regeneration and no progression of joint degeneration |
Buda et al., 2015 [82] |
| Knee cartilage focal lesions |
n = 15 patients: microfractures and PRF; n = 16 patients: microfractures and PRP; n = 17 patients: microfractures alone |
- | Follow up: 2, 5 years Postoperative evaluation of patients was performed by: - clinical scores (i.e., IKDC, VAS pain) - MRI and Mocart scores |
- Platelet concentrates allowed to achieved better clinical results compared to microfracture alone - The PRF was more effective than the PRP at 2 years, with loss of significance at 5 years - According to Mocart score, PRF gave better results earlier than the other two treatments |
Papalia et al., 2016 [84] |
| Knee cartilage focal lesions |
n = 25 patients (mean age = 29 ± 7.3 years): single-step AMIC procedure based on microfracture and application of autologous PRF called CLP-MB membrane, combined with an injectable collagen scaffold (Cartifill) |
- Blood collection by apheresis - Separation of CLP and plasma - Cryoprecipitate formation from freeze/thawed plasma - Mixing of CLP and cryoprecipitate (CLP mix) - Activation of the CLP mix with calcium gluconate - Incubation at 37 °C for 10 min - Centrifugation (7333× g, 25 min) |
Pre-implant characterization: - assessment of blood cell composition, CD34+/CD133+/VEGFR2+ cell content, fibrinogen concentration during each preparation phase - release of PDGF-AB, TGF-β1 and VEGF -mechanical tests Clinical trial: Follow-up: 1, 6 and 12 months Patients were evaluated by: - NMR and/or radiographic scans - VAS pain - IKDC scores |
- Quality control tests during each phase of CLP-MB preparation assured for the obtainment of a standardized, traceable and safe product - The treatment with the hemocomponent provided short-term pain relief and functional improvement |
D’Antimo et al., 2017 [85] |
| Rhinoplasty (dorsal nasal augmentation) |
n = 19 patients: cartilage scales-cartilage pâté compound graft with PRGF n = 21 patients: cartilage scales-cartilage pâté compound graft with i-PRF n = 8 patients: cartilage pâté graft with a-PRF |
Preparation according to Choukroun et al., 2001 [3] | Follow-up controls every 3 months Medical records to assess the surgical outcome included: - follow-up notes - pre- and post-operative photographic documentation |
- Satisfactory dorsal nasal augmentation in 47 patients - 1 mm-horizontal displacement of the graft in one patient 3 months after surgery, with no tendency for further displacement - No dorsal irregularities, nor signs of resorption, erythema, inflammation |
Kovacevic et al., 2017 [86] |
a-PRF, advanced PRF; AOFAS scores, American Orthopedic Foot and Ankle Society scores; BMDCs, Bone Marrow-derived Cells; CLP, leukocyte and platelet concentrate; CLP-MB, leukocyte- and platelet-rich fibrin membrane; i-PRF, injectable PRF; IKDC, International Knee Documentation Committee; MRI, Magnetic Resonance Imaging; NMR, Nuclear Magnetic Resonance; PRF, Platelet-rich Fibrin; PRGF, Platelet-rich Growth Factors; PRP, Platelet-rich Plasma; VAS, Visual Analog Scale.