Autologous Platelet-Rich Plasma Preparations: Influence of Nonsteroidal Anti-inflammatory Drugs on Platelet Function

Gert Schippinger; Florian Prüller; Manuela Divjak; Elisabeth Mahla; Florian Fankhauser; Steve Rackemann; Reinhard Bernd Raggam

doi:10.1177/2325967115588896

Autologous Platelet-Rich Plasma Preparations: Influence of Nonsteroidal Anti-inflammatory Drugs on Platelet Function

Orthop J Sports Med. 2015 Jun 23;3(6):2325967115588896. doi: 10.1177/2325967115588896. eCollection 2015 Jun.

Authors

Gert Schippinger¹, Florian Prüller², Manuela Divjak², Elisabeth Mahla³, Florian Fankhauser¹, Steve Rackemann⁴, Reinhard Bernd Raggam²

Affiliations

¹ Sportchirurgieplus-Clinical Center for Sports Medicine and Orthopaedic Surgery, Graz, Austria.
² Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. ; Research Unit for Perioperative Platelet Function, Medical University of Graz, Graz, Austria.
³ Research Unit for Perioperative Platelet Function, Medical University of Graz, Graz, Austria. ; Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
⁴ Department of Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

Abstract

Background: Autologous platelet-rich plasma (PRP) has been widely used for the treatment of sports injuries. It has been associated with improved healing and regeneration of soft tissues in elite athletes. Athletes are commonly receiving nonsteroidal anti-inflammatory drugs (NSAIDs). As yet, the effect of these drugs on platelet function in PRP formulations has not been taken into consideration.

Hypothesis: The function of platelets in PRP produced under the influence of NSAIDs is inhibited and may lessen a possible healing effect on the site of injury.

Study design: Controlled laboratory study.

Methods: PRP was collected from patients receiving NSAIDs after elective orthopaedic surgery, and platelet function was evaluated using light transmission aggregometry (LTA). Results were compared with those obtained from healthy volunteers without a history of NSAID intake during the previous 2 weeks. Two different systems for blood collection and PRP production (Arthrex ACP double-syringe system and standard 4.5-mL sodium citrate blood collection tubes) were used and compared regarding the quality of PRP that was produced.

Results: For both groups, the baseline platelet counts of whole blood and the platelet counts of PRP formulations were found to be in the normal range. Both collection systems for PRP produced comparable results without significant differences between the groups. Platelet function testing with LTA revealed significantly impaired platelet aggregation in both PRP preparations, obtained from patients taking NSAIDs, irrespective of the type of NSAID (P < .001). All subjects from the control group showed normal platelet aggregation patterns when tested with LTA.

Conclusion: Autologous PRP produced from subjects after NSAID medication shows significantly impaired platelet function and may result in lower quality regarding the content of bioactive compounds.

Clinical relevance: If required, the administration of NSAIDs should be performed after blood collection for preparation of autologous PRP; otherwise, the therapeutic effect may be limited.

Keywords: nonsteroidal anti-inflammatory drugs; platelet function; platelet-rich plasma.