The Use of Platelet-Rich Plasma in the Management of Foot and Ankle Conditions

Platelet-rich plasma (PRP) contains growth factors derived from venous blood. Bone marrow concentrate (BMC) is an analogous platelet-rich product that is generated from bone marrow aspirate and might have the added advantage of containing mesenchymal stem cells. The active growth factors are platelet-derived growth factor, transforming growth factor β, vascular endothelial growth factor, hepatocyte growth factor, fibroblast growth factor, and epidermal growth factor. It is probable that a multitude of factors and cells play a role in inducing healing of hard or soft tissues that have been acutely or chronically injured or diseased. PRP can be used alone or in conjunction with surgical reconstruction to achieve better healing of tissues. Our group has treated 634 patients with PRP or BMC for nonunions, malunions, arthritis, malalignments, tendinopathies, tendon ruptures, plantar fasciitis, fractures, or ligament injuries that were performed in a variety of healthy and unhealthy patients. Overall, the results were favorable with very limited morbidity. In general, healing was more complete and rapid compared with historic norms, but failures can still occur. Condition-specific retrospective and prospective studies are underway to further establish the role of PRP in foot and ankle conditions and reconstructions.