Platelet Rich Plasma (PRP) Supplementation for Phalangeal Pseudoarthrosis Treatment: A preliminary case report

Abstract

Pseudoarthrosis is rare. Though, when it occurs, lots of efforts are required to cure. Platelet rich plasma (PRP), concentrated from blood, have attracted attention as a good source of growth factors that stimulate cells to proliferate, migrate and restore the damaged sites. Two cases of acquired pseudoarthrosis were successfully treated with PRP, produced from the patients' own peripheral blood or bone marrow aspirate, in conjunction with external fixation. Bone union was obtained in both cases. We present these cases as a preliminary report. PATIENTS AND TREATMENT PROCESSING PLATELET RICH PLASMA PRP was produced under the protocol, optimized previously in authors' Department for the clinical use of PRP.1 Under general anesthesia, peripheral blood or bone marrow aspirate was drawn into 20-ml syringes containing 3ml of anticoagulant; citrate-phosphate-dextrose solution (Terumo, Tokyo, Japan), prior to the surgery. After gentle inverting mixture, the mixture was poured into 10-ml tubes with caps. The tubes were set in a centrifuge separator placed besides the operating table and spun at 40g for 20 minutes. Supernatant, including buffy coat and slightly red layer, was decanted to the other tubes. Platelets and other cells are spun down at 800g for 10 minutes. Clear supernatant was decanted off and precipitate was resuspended to get PRP. Approximately, 1x10/ml platelets and 2x10/ml white blood cells were contained in peripheral blood derived PRP. 1x10/ml platelets and 6x10/ml nucleated cells were contained in bone marrow aspirate derived PRP.