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Purpose: The aim of this consensus was to develop evidence‐ and expert‐based patient‐focused recommendations on the appropriateness of intra‐articular platelet‐rich plasma (PRP) injections in different clinical scenarios of patients with knee osteoarthritis (OA). Methods: The RAND/UCLA Appropriateness Method was used by the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA), as well as the International Cartilage Regeneration and Joint Preservation Society (ICRS) to reach a consensus and produce recommendations for specific patient categories combining best available scientific evidence with the collective judgement of a panel of experts. Results: Scenarios were defined based on first treatment vs first injective treatment vs second injective treatment, age (<50/50–65/66–80/>80), tibiofemoral vs patellofemoral involvement, OA level (Kellgren–Lawrence/KL 0–I/II–III/IV), and joint effusion (dry knee, minor‐mild or major effusion). Out of 216 scenarios, in 84 (38.9%) the indication was considered appropriate, in 9 (4.2%) inappropriate and in 123 (56.9%) uncertain. The parameters associated with the highest consensus were PRP use after failed injective treatments (62.5%), followed by PRP after failed conservative treatments and KL 0–III scenarios (58.3%), while the highest uncertainty was found for PRP use as first treatment and KL IV OA (91.7% and 87.5% of uncertain scenarios, respectively). Conclusion: This ESSKA‐ICRS consensus established recommendations on the appropriateness or inappropriateness of PRP injections for the treatment of knee OA, providing a useful reference for clinical practice. PRP injections are considered appropriate in patients aged ≤80 years with knee KL 0–III OA grade after failed conservative non‐injective or injective treatments, while they are not considered appropriate as first treatment nor in KL IV OA grade. Level of Evidence: Level I. [ABSTRACT FROM AUTHOR]

The method by which a drug is released can have a significant effect on therapeutic efficacy. The mode of drug delivery is especially relevant when the therapeutic agent is a growth factor because the dose and spatiotemporal release of such agents at the site of injury is crucial to achieving a successful outcome. Here, we highlight delivery technologies designed to facilitate the local and controlled spatiotemporal release of growth factors through the use of biomaterials, 3D micro- or nano-particles, microspheres, gene therapy and PRGF technology. We present some of the most interesting therapeutic applications based on these approaches and, on PRGF technology in particular, in addition to the limitations, future challenges and directions of the field.

Background: Platelet-rich fibrin matrices release a natural mixture of growth factors that play central roles in the complex processes of tendon healing. Hypothesis: Application of autologous platelet-rich matrices during Achilles [...]