Evolution and Clinical Advances of Platelet-Rich Fibrin in Musculoskeletal Regeneration

Over the past few decades, various forms of platelet concentrates have evolved with significant clinical utility. The newer generation products, including leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF), have shown superior biological properties in musculoskeletal regeneration than the first-generation concentrates, such as platelet-rich plasma (PRP) and plasma rich in growth factors. These newer platelet concentrates have a complete matrix of physiological fibrin that acts as a scaffold with a three-dimensional (3D) architecture. Further, it facilitates intercellular signaling and migration, thereby promoting angiogenic, chondrogenic, and osteogenic activities. A-PRF with higher leukocyte inclusion possesses antimicrobial activity than the first generations. Due to the presence of enormous amounts of growth factors and anti-inflammatory cytokines that are released, A-PRF has the potential to replicate the various physiological and immunological factors of wound healing. In addition, there are more neutrophils, monocytes, and macrophages, all of which secrete essential chemotactic molecules. As a result, both L-PRF and A-PRF are used in the management of musculoskeletal conditions, such as chondral injuries, tendinopathies, tissue regeneration, and other sports-related injuries. In addition to this, its applications have been expanded to include the fields of reconstructive cosmetic surgery, wound healing in diabetic patients, and maxillofacial surgeries.

Automated summary

Various forms of platelet concentrates have evolved over the past few decades, with newer generation products such as leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) showing superior biological properties in musculoskeletal regeneration compared to the first-generation concentrates. These newer platelet concentrates have a complete matrix of physiological fibrin and facilitate intercellular signaling and migration, promoting angiogenic, chondrogenic, and osteogenic activities. A-PRF, with higher leukocyte inclusion, also possesses antimicrobial activity and can replicate various physiological and immunological factors of wound healing. Its applications have expanded to include the management of musculoskeletal conditions, reconstructive cosmetic surgery, wound healing in diabetic patients, and maxillofacial surgeries.