Platelet-rich Plasma - The Recipe

BIOTECHNOLOGY OF THE FUTURE BEING PRACTICED TODAY AT AUSTRALIAN OSTEOARTHRITIS CLINIC

Australian Osteoarthritis Clinic has given careful consideration in providing the best possible preparation of PRP. Not all PRP is created equal and, depending upon the chosen ‘recipe’, PRP will have different cellular and biochemical make-up – and, hence, a different effect. Unfortunately, it is not as simple as choosing a technique that yields the greatest platelets; in this case, more is not better. 

Research has indicated that the optimal platelet (molecules that assist with clotting of the blood and have anti-inflammatory properties) concentration for healing is ~1million cells per μl (Marx, 2004). Lower platelet counts may lead to sub-optimal tissue stimulation and higher amounts may in fact have an inhibitory effect. Also, within PRP preparations you do not just have platelets.  You have an autologous (your own) blood medium that also contains inflammatory cells and inflammatory mediators/cytokines (which are proteins) that play an important role in healing. These roles can be stimulatory to the healing process or counterproductive depending upon what you are using the PRP for and how you direct it.

At Australian Osteoarthritis Clinic our practitioners use PRP for treatment of various musculoskeletal conditions and the optimum PRP preparation remains a very ‘fluid’ process. The recipe chosen depends upon what condition our physicians are treating and what they hope to achieve.  Platelet count, white cell count, anti-inflammatory and pro-inflammatory cytokine content are all variables that can be specifically configured to achieve a chosen response.

There are different methods of formulating PRP.  

PRP can be formulated either white blood cell rich or white cell poor depending on the condition being treated (joint or tendon) and whether it is acute or chronic at the time of treatment. At AOAC, we do this by using a specialist filter that is small enough in size (microns) that filters out both white and red cells remaining in the PRP preparation. Since these filters are so specialised, we have had to source them internationally. 
 
With such discrepancies in PRP preparations and outcome results, it can be challenging to determine true efficacy. Research publications with poor outcomes do not conclude that PRP does not work; they conclude that the specific chosen PRP recipe and its protocol for use does not work in the studied situation. This is important to Australian Osteoarthritis Clinic as a different recipe may lead to completely different results. Similarly, if a study shows a positive outcome for the use of PRP, unless you are using the same recipe and protocols you are not guaranteed the same outcome. As the saying goes “Oils ain’t oils”.

Should you have any questions regarding PRP, contact our administration team on 03 9270 8080.