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Platelet-rich plasma (PRP) is an autologous plasma suspension enriched with a supraphysiologic concentrate of platelets, isolated through a process of centrifugation. Administered locally (usually by injection or direct application) to areas of injury, PRP contains a high density of growth factors, which are believed to potentiate the body’s natural regenerative processes. Over the past 20 years, interest in PRP therapy has grown exponentially, as it offers a relatively safe, autologous treatment modality. It has gained particular popularity for a wide variety of musculoskeletal pathologies. There is a growing body of scientific literature that is giving further insight into PRP’s therapeutic effects. This chapter will review the history, preparation techniques, basic science justifications, current clinical evidence, as well as procedural considerations for the therapeutic use of PRP.

This is a retrospective cohort study of adults with a primary diagnosis of deep venous thrombosis (DVT) unaccompanied by pulmonary embolism (PE), seen in 4 emergency departments in 2013 and part of 2014. The purpose was to assess the prevalence of home treatment of DVT in the present era of new oral anticoagulants. Among 96 patients with DVT and no PE, 85 (88.5%) were hospitalized and 11 (11.5%) were discharged to home. Most of the patients discharged to home received low-molecular-weight heparin, 9 (81.8%) of 11. None were prescribed new oral anticoagulants. Early discharge in ≤2 days occurred 28 (32.9%) of 85 patients. Most (64.3%) received enoxaparin and/or warfarin at early discharge. Rivaroxaban was prescribed in 7 (25.0%) of those discharged in ≤2 days. We conclude that in some emergency departments, patients with DVT are uncommonly discharged to home even though new oral anticoagulants are available.

Degenerative disc disease (DDD) is a common etiology of low back pain, contributing to significant disability worldwide. While current treatments primarily focus on symptom management, there is a growing interest in novel regenerative therapies that attempt to reverse the degenerative process. These therapies include autologous products like stem cells, growth factors, and vector-mediated products like gene and cell therapy. Though there remains a need for large-scale randomized placebo-controlled trials in order to validate and to standardize the use of these various regenerative treatment modalities, we believe that the literature supports the potential for regenerative therapies as a well-tolerated, efficacious treatment modality for DDD.