| Objective:To investigate,the evidence-based outcomes of clinical application of platelet-rich plasma(PRP)for the treatment of fracture nonunion,through a systematic review of the current literature.To improve bone healing,through biological agents by non-operative or intra-operative are most advantageous strategy.Data Sources:A search of English and Chinese language articles(the Chinese language was translated)was observed in PubMed/ MEDLINE/ CNKI using keywords ‘‘PRP,’’ ‘‘platelet plasma,’’ and‘‘platelet concentrate’’ combined with ‘‘therapy OR treatment of fracture non-union”.The search was conducted through January 2015 to February 2017.Study Selection:The articles with all levels of evidence were included.Nonhuman studies were excluded.Oral and facial surgeries were also excluded.Search was limited to in vivo studies.Tissue engineering approaches,which included a combination of PRP with adult stem cell types(bone marrow),were also excluded.Data Extraction:In this literature data were reviewed and systematized according to the year of study and journal,patient demographics,study type,activation agents used,follow up,and results.Data Synthesis:The selected studies concentrated on the clinical application of PRP in the treatment of nonunion.Three RCT studies shows clear clinical and radiological outcome with effective results of treatment management by PRP for bone nonunion.In single study on the use ofPRP in nonunion,no statistically eloquent differences were observed with regards of clinical outcomes,nor reducing time of healing and also no radiologically effective.Conclusions:Currently,PRP application in bone regeneration for bone nonunion has several possible benefits,including faster recovery and,possibly,a reduction in recurrence,with neglecting amount of adverse reactions described.However,only 3 randomized clinical trials have been conducted and the results of several experimental studies indicate that PRP increases the early healing rate and alleviates the final outcome especially when used in combination with autologous bone graft.Thus the future of this method of treating nonunion fractures is shinny and might change the current management. |
