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IOC consensus paper on the use of platelet-rich plasma in sports medicine
  1. Lars Engebretsen1,2,3,
  2. Kathrin Steffen1,2,
  3. Joseph Alsousou4,
  4. Eduardo Anitua5,
  5. Norbert Bachl6,
  6. Roger Devilee7,8,
  7. Peter Everts8,9,
  8. Bruce Hamilton10,
  9. Johnny Huard11,
  10. Peter Jenoure12,
  11. Francois Kelberine13,
  12. Elizaveta Kon14,
  13. Nicola Maffulli15,16,
  14. Gordon Matheson17,
  15. Omer Mei-Dan18,
  16. Jacques Menetrey19,20,
  17. Marc Philippon21,
  18. Pietro Randelli22,
  19. Patrick Schamasch1,
  20. Martin Schwellnus23,
  21. Alan Vernec24,
  22. Geoffrey Verrall25
  1. 1IOC Medical Commission, Lausanne, Switzerland
  2. 2Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  3. 3Oslo University Hospital, University of Oslo, Norway
  4. 4Nuffield department of Orthopaedic Rheumatology and Musculoskeletal Science (NDORMS), University of Oxford, Oxford, UK
  5. 5Fundación Eduardo Anitua, Vitoria-Alava, Spain
  6. 6Department of Exercise Physiology, University of Vienna, Vienna, Austria
  7. 7Department of Orthopaedic Surgery and Traumatology, Catharina-Ziekenhuis, Eindhoven, The Netherlands
  8. 8Expertise Center for Regenerative Medicine, Da Vinci Clinic, Eindhoven, The Netherlands
  9. 9Foundation FERET Eindhoven, The Netherlands
  10. 10Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  11. 11Department of Orthopaedic Surgery, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
  12. 12Crossklinik, Swiss Olympic Medical Center, Basel, Switzerland
  13. 13Clinique Parc Rambot Provençale, Aix-en-Provence, France
  14. 14Clinica Ortopedica e Traumatologica III, Rizzoli Orthopedic Institute, Bologna, Italy
  15. 15Centre for Sports and Exercise Medicine, Queen Mary University of Royal London, London, UK
  16. 16Barts and the London School of Medicine and Dentistry, London, UK
  17. 17Division of Sports Medicine, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
  18. 18Meir University Hospital, Sapir medical Canter, Kfar-Saba, Israel
  19. 19Swiss Olympic Medical Center, Geneva, Switzerland
  20. 20Unité d'orthopédie et traumatologie du sport, University Hospital of Geneva, Geneva, Switzerland
  21. 21Steadman Philippon Research Institute, Vail, Colorado, USA
  22. 22Università degli Studi di Milano, IRCCS Policlinico San Donato, Milan, Italy
  23. 23UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
  24. 24World Anti-Doping Agency, Montreal, Canada
  25. 25SPORTSMED.SA Sports Medicine Clinic, Adelaide, Australia
  1. Correspondence to Professor Lars Engebretsen, Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0608, Norway; lars.engebretsen{at}medisin.uio.no

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Introduction

Acute and chronic musculoskeletal injuries in sports are common and problematic for both athletes and clinicians. A significant proportion of these injuries remain difficult to treat, and many athletes suffer from decreased performance and longstanding pain and discomfort.1

In 2008, the International Olympic Committee (IOC) published a consensus document on the importance of molecular mechanisms in connective tissue and skeletal muscle injury and healing.2 This document predicted an increase in the use of autologous growth factors, as it has indeed happened following that publication.

Platelet-rich plasma (PRP) (also referred to as platelet-rich in growth factors, platelet-rich fibrin matrix, platelet-rich fibrin, fibrin sealant, platelet concentrate) is now being widely used to treat musculoskeletal injuries in sports and draws widespread media attention despite the absence of robust clinical studies to support its use.3 Of the few studies on the effectiveness of PRP in clinical settings published, very few are of sufficient methodological quality that would enable evidence-based decision-making.

PRP and its variant forms were originally used in clinical practice as an adjunct to surgery to assist in the healing of various tissues. PRP has also been used in prosthetic surgery to promote tissue healing and implant integration, and to control blood loss.4 5 Furthermore, the application of activated PRP has an effect on pain and pain medication use following open subacromial decompression surgery.5

Initially, PRP was mainly used in oral surgery.6 7 Subsequently, PRP has also been used at the time of surgery involving shoulder,8 hip9 and knee joint procedures,10 11 including anterior cruciate ligament (ACL) reconstruction,12 and it has been used to improve bone healing.13 More recently, PRP in an injectable form has been used for the management of common muscle,14 tendon15 and cartilage injuries.16 As predicted …

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