Current State for Clinical Use of Stem Cells and Platelet-Rich Plasma

In the management of common orthopaedic pathology involving tendons, ligaments, bone, and articular cartilage, the application of small molecules and biologic compounds has expanded greatly in the past decade. In particular, the use of platelet-rich plasma (PRP) and stem cells has gained significant attention for potential therapeutic augmentation of healing, modulation of inflammatory cascades, and pain modulation. Despite the increase in clinical application and interest, there has been a paucity of high level of evidence studies supporting the use of these biologic agents. This article examines the current state for the clinical use of stem cells and PRP, with review of the most recent clinical studies involving the treatment of tendon, ligament, bone, and cartilage injury. Current evidence regarding safety profile, therapeutic effect, and validated outcome scores are reported. Though plagued by inconsistency in experimental testing and low numbers of large, multicenter randomized controlled trials, the use of stem cells and PRP appears to have a positive clinical effect with minimal systemic side effects or complications. Further study is needed to elucidate the specific therapeutic indications, dosing regimen, and efficacy of treatment in short and long follow-ups is needed to document the role and effectiveness of these treatments in clinical practice.