PRP (platelet rich plasma) contains concentrated platelets and serum. As we surgeons have known for years, these platelets are the main source of healing. They contain hundreds of different growth factors in their structures and enable the formation of blood clots in cases such as bleeding. When you injure any muscle, ligament or tendon in your body, platelets collect in the damaged area through internal bleeding. They then form a blood clot that will stop the bleeding. Then, they initiate and coordinate tissue repair by secreting growth factors that will provide healing in the tissue. During the first 7-10 days, they secrete hundreds of growth factors at regular intervals, like a timed pill.
These growth factors provide the arrival of stem cells to the damaged area and the formation of new vessels that will increase blood circulation. To prepare PRP, a certain amount of blood is taken from your veins. Then, the platelets are rotated in special centrifuge devices for certain periods and the concentration is increased to 3-5 times their normal concentration. The effect of this platelet-rich concentration (PRP) in the body is like giving a damaged flower a little more water and fertilizer to help it recover. PRP and the growth factors it secretes are like fertilizers for the body. In other words, it heals damaged tissues that can heal on its own in a long time, or it provides support in cases where we are helpless to heal in some way and when the body is insufficient in self-healing.
PRP application may attract some stem cells to the damaged area, but the actual stem cell application is much different. To continue with the same example, while PRP is like fertilizer and water for the plant, mesenchymal stem cell (MSC) is more like planting new seeds and growing that seed. MSCs not only transform or regenerate lost or damaged tissue, but also coordinate the repair response just like a gardener. For this reason, MSC applications are more beneficial in degenerative processes such as calcification, chronic joint pain, partial tendon tears, spinal disc diseases.
In the past, MSC preparation required a much more difficult and longer process than PRP, but now it is possible to obtain MSC from adipose tissue in about half an hour. This increases the use of MSCs. To summarize, it is useful to try PRP first, if there is a chance of recovery, but there is a hangover or slowness in the healing process. If there is advanced damage to the tissue due to age or use, then stem cells should be tried. I should mention that the use of stem cells and similar regenerative treatments in orthopedics will increase gradually in the future.