PRGF in the cartilage defects in the knee joint

Abstract

In the last few years the improvements of biotechnology allowed the development of new techniques for the stimulation and the acceleration of tissue healing and bone regeneration, particularly of platelet-rich therapies. The progressive knowledge of the tissuetal phases after a traumatic injury showed the role of a range of growth factors and cytokines, secreted by serum and degranulating platelets, in the repair process. Every growth factor such as PDGF, TGF-beta, IGF-1 and VEGF has a specific function, but for the healing of the tissue the release of the pool of these growth factors is important. The platelets may be considered like a reservoir of growth factors; among the platelet-rich preparations, the importance of platelet release growth factor (PRGF) was given by their versatility. The effect of these preparations is not only mytogenic, but also an angiogenic effect, antibacterial and anti-inflammatory. In clinical fields, PRGF, often associated to some biomaterials, can be used for the treatment of chronic ulcers and for bone and soft tissue regeneration. Particularly in orthopaedic field, PRGF accelerate healing process and avoid further degeneration of the bone, the cartilage, the tendons and the ligaments. For example, platelet-rich preparations can be used during a tendon suture or a ligament reconstruction (ACL) or, finally, for the treatment of tissue avascular like the cartilage with the purpose of an acceleration in functional recovery. The arthroscopic repair of chondral lacerations or meniscus tears represents the future step of these versatile preparations. Symptomatic cartilage defects in the knee joint have aroused attention and clinical interest in recent years because these lesions can be difficult to treat. Despite the fact that, biological surgery of the past had poor consistent results, now there is a new interest for these techniques, particularly for platelet-related-growth-factors (PRGF). The recent improvement of tissue engineering and the biological innovation of biomechanical properties of the materials used (matrix scaffolds, cartilage grafts, growth factors and genetic engineering) have increased the research in the cartilage resurfacing and hyaline tissue regeneration.