Journal of the Pediatric Orthopaedic Society of North America (Feb 2024)
Platelet-rich plasma and other injectables in the young athlete
Abstract
ABSTRACT: Pediatric sports participation and subsequent injuries have increased in parallel. Additionally, pediatric athletes and families are highly invested in rapid return to pre-injury status and the ability to sustain high impact loads and tension. Recently, an increase and diversification of biologically derived substances, known as orthobiologics, have been used to accelerate tissue healing. While commonly used in adults, the indications are ambiguous, and evidence for effectiveness is conflicting. Despite this, an interest in pediatric indications for orthobiologics has increased as both a standalone intervention and as a supplement to current treatment. There is a dearth of literature pertaining to the pediatric population, which warrants a review of what research has been performed. The purpose of this review was to critically examine the indications and results of orthobiologics in immature athletes. Much of the existing literature is composed of case studies or studies performed with relatively small sample sizes. As such, we believe more research is needed in almost every context for absolute guidelines and recommendations to be established. While orthobiologics have been purported to provide a significant healing benefit to augment the treatment of sports injuries, we find no additional benefit compared to standard treatment. Key Concepts: 1) While orthobiologics have been used in small sample sizes to provide additional healing for pediatric patients being treated for sports-related injuries, there is little research in large cohorts of pediatric athletes. 2) Adding to the ambiguity, the literature that does exist presents conflicting findings regarding benefits of orthobiologics. 3) Orthobiologics have the potential to provide significant advanced healing benefits, however significantly more research of larger cohort size, higher evidence level, and a pediatric-only population is necessary for absolute guidelines and recommendations to be made.
