Autologous Conditioned Plasma (ACP) is a platelet-rich plasma that is extracted from autologous blood using centrifugation. It can support regeneration in a variety of orthopedic conditions and surgical procedures
Contents
Description
In an increasing number of orthopedic treatments, for example in the case of tendon and ligament injuries, torn muscles and osteoarthritis, there is growing interest in autologous blood products. In this therapy approach, substances occurring naturally within the body known as growth factors promote healing.
Definition
Autologous Conditioned Plasma (ACP) is an autologous blood plasma ‒ occurring naturally within the body ‒ that is conditioned as part of a special production process, which means that it is largely separated from the other blood components (such as erythrocytes), and concentrated. ACP is a platelet-rich plasma (PRP). PRP is a general term for a type of plasma that contains an increased concentration of thrombocytes (in comparison with whole blood) and that is extracted from whole blood using a separation process. Main components of ACP include thrombocytes (platelets), and several growth factors that play an important role in the healing process. Unlike other platelet-rich plasma formulations, ACP is distinguished by a low concentration of white blood cells such as neutrophil granulocytes that can be detrimental to the healing process when present in high concentrations.
Production
ACP is extracted from autologous blood. For this purpose, a small quantity of blood (10 - 15 ml) is drawn from a superficial vein (such as the antecubital in the same way as in the case of a blood test. In a second step, a centrifuge is used to separate the ACP from the other blood components. For this purpose, centrifugation only needs to be carried out for a short interval at low speed. In the next step, the ACP can be separated as a supernatant. Manufacturers such as Arthrex offer dedicated syringe systems for this purpose that can be used to take blood from the patient, condition it, and then inject it again into the region to be treated. In this respect, the blood product remains in the syringe system throughout the entire process, offering the maximum possible level of protection against contamination.
Application
ACP can be used to promote healing in the case of injuries to the musculoskeletal system, ligaments or tendons, but also in the case of muscle injuries or tendinitis. In laboratory tests, a significant increase in cell proliferation has been demonstrated in muscle, tendon and bone cells. Furthermore, the effectiveness of ACP in different fields of application has been demonstrated in numerous clinical studies.
Possible indications – acute
Possible indications – chronic
Action
The healing of injured tissue involves a complex series of natural processes within the body. Growth factors play a key role in this respect, as they initiate and regulate these complex processes. Many of these growth factors are released by thrombocytes that are contained in the blood and activated in the event of injury. As injury or inflammation involves the destruction of tissue or cells, growth factors such as platelet-derived growth factor (PDGF), transforming growth factor (TGF), basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) are released. These are involved in cellular processes that promote healing and are associated with tissue growth. Accordingly, they initiate the proliferation and differentiation of a variety of cell types (such as osteoblasts and chondroblasts), promote matrix formation through the production of collagen and proteoglycan, and stimulate angiogenesis. This is in contrast to the immune response that is regulated by leukocytes/neutrophils and involved in the reduction of damaged tissue, and that counteracts possible infection with free radicals (Reactive Oxygen Species, ROS), proteases and antimicrobial peptides. However, these have the biological potential to also damage healthy tissue. By adding ACP at the treatment site, an increased concentration of thrombocytes (2 - 3 times higher than that of whole blood) is applied with neutrophils almost entirely absent. This supports the natural process of healing within the body, i.e. the formation of blood vessels, new cells and tissue, while inhibiting painful inflammation.