Autologous peripheral blood-derived orthobiologics: Different types and their effectiveness in managing knee osteoarthritis

Table 1 A brief description of different types of autologous peripheral blood-derived orthobiologics and associated recent clinical evidence evaluating their efficacy for the management of knee osteoarthritis

APBOs	Ref.	Description	Most recent clinical evidence
PRP	Xiong et al[2]	PRP is derived from whole blood and is rich in platelets, can be LR or LP, is poor in erythrocytes, and can be activated using external activators	An up-to-date systematic review and meta-analysis examined 24 RCTs with 1344 patients and reported significant improvements in the VAS, KOOS, WOMAC, and IKDC scores in the PRP group compared to the controls (saline and/or HA)
PL	Hosseini et al[3]	PL is derived from PRP and formulated via a double freeze/thaw cycle	A recent RCT involving 50 patients reported significant improvements in VAS, WOMAC, and ROM scores at the 6-mo follow-up in the PL group compared to the baseline and PRP group
ACS	Raeissadat et al[4]	ACS is formulated by incubating whole blood with CrSO4-coated glass beads	A recent meta-analysis investigated eight clinical studies involving 439 patients with at least 3 mo of follow-up and reported significant improvements in VAS and WOMAC scores post-treatment with ACS compared to the baseline
GOLDIC	Tulpule et al[5]	GOLDIC is a type of ACS and involves incubating whole blood with gold particles	A recent prospective study involving 65 patients (106 knees) reported significant improvements in VAS and WOMAC scores at the 12-mo follow-up in patients treated with serial injections of GOLDIC compared to the baseline
PRGF	Ríos Luna et al[6]	PRGF is formulated by activating erythrocyte poor and LP-PRP with CaCl2	A recent retrospective observational study involving 79 patients (85 knees) reported significant improvements in the KOOS score at the 11-mo follow-up post-administration of PRGF compared to the baseline
GFC	Saraf et al[7]	GFC is an acellular formulation prepared by incubating whole blood with an external platelet activator	A recent RCT involving 58 participants reported significant improvements in VAS and WOMAC scores at the 12-mo follow-up in patients treated with serial injections of GFC compared to the control
APS	Kuwasawa et al[8]	APS is derived from and formulated by exposing LR-PRP to polyacrylamide beads	A recent retrospective study assessed 148 knees and reported significant improvement in the KOOS score at the 12-mo follow-up post-injection of APS compared to the baseline
PRF	Cheeva-Akrapan and Turajane[9]	PRF is derived from whole blood, formulated without the use of an anticoagulant, and consists of autologous platelets and a LR fibrin matrix	A recent prospective cohort study involving 368 participants reported that nearly 80% of patients had their surgery postponed over 3 yr following the administration of PRP supplemented with PRF, supporting its utility in treating osteoarthritis patients for long-term effects
HS	Olmos Calvo et al[10]	HS is formulated by mechanically releasing, via pressing or centrifugation, growth factors and cytokines from the PRF clot	A recent clinical study involving 24 patients reported significant improvements in Lysholm-Tegner, VAS, and KOOS scores at the 6-mo follow-up in patients treated with serial injections of HS compared to the baseline
ACP	Korpershoek et al[11]	ACP is a single-spin LP-PRP formulation	A recent real-world prospective case series involving 260 patients (307 knees) reported significant improvement in KOOS and NPRS at the 12-mo follow-up compared to the baseline after administration of 3 weekly intra-articular injections of ACP. Interestingly, despite a statistically significant outcome for the KOOS score, the MCID was not accomplished

ACP: Autologous conditioned plasma; ACS: Autologous conditioned serum; APBOs: Autologous peripheral blood-derived orthobiologics; APS: Autologous protein solution; GFC: Growth factor concentrate; GOLDIC: Gold-induced cytokine; HA: Hyaluronic acid; HS: Hyperacute serum; IKDC: International knee documentation committee; KOOS: Knee injury and osteoarthritis outcome score; LP: Leukocyte-poor; LR: Leukocyte-rich; MCID: Minimally clinically important difference; NPRS: Numeric pain rating scale; PL: Platelet lysate; PRF: Platelet-rich fibrin; PRGF: Plasma-rich in growth factors; PRP: Platelet-rich plasma; RCT: Randomized controlled trial; ROM: Range of motion; VAS: Visual analogue scale; WOMAC: Western Ontario and McMaster Universities arthritis index.