PRP vs. PRF: What’s the Difference?

At Spine & Joint Solutions, we are proud to offer the newest and most exciting addition to the field of regenerative medicine. Up to this point, platelet-rich plasma (PRP) has been the only platelet-based product offered for treatment of tissue damage. More recently, platelet-rich fibrin (PRF) has emerged as a more advanced and effective product in the world of musculoskeletal care, as well as within anesthetic medicine.

PRP vs PRF: What’s the difference?
Although there are some basic similarities between platelet-rich plasma and platelet-rich fibrin, it is the differences between these two products that makes platelet-rich fibrin stand out as a superior treatment option. Both of these products require blood to be taken from the patient. PRP requires more blood to be taken than PRF. Both of the products require the whole blood sample to be placed into a centrifuge, where the blood is then processed to help separate the blood into distinct layers. Platelet-rich plasma is spun at a higher speed, which effectively causes all of the heavier cells in the blood, such as white blood cells and stem cells, to collect in the bottom part of the test tube and allows the lighter platelets and plasma to collect in the top part of the test tube. The platelets and plasma are then collected from the upper part of the test tube and injected into the region with tissue damage. However, newer research is showing that a platelet product that has an even higher concentration of platelets, as well as a concentration of some white blood cells and stem cells, is even more effective than traditional platelet-rich plasma. With this new information, platelet-rich fibrin was created. The PRF product is spun at a lower speed so that the layers of the blood do not separate out as distinctly. This allows some of the white blood cells and stem cells to remain within the platelet layer that is collected for treatment. Thus, there are more healing factors within PRF than is typically seen in PRP. In addition, the lower spin speed causes less trauma to the individual cells of the blood, allowing more stem cells to remain in the final PRF product.

Another distinct difference between platelet-rich plasma and platelet-rich fibrin is the concentration of platelets within the final product. Literature states that an ideal concentration of platelets for a platelet rich plasma sample is between 2-5 times the level of platelets typically found within the body. Newer literature now points out that an even higher concentration of platelets may be even more effective in the treatment of tissue damage. Platelet-rich fibrin products contain approximately 10 times the platelet concentration that is found within the body.

A final difference worth mentioning between platelet-rich plasma and platelet-rich fibrin is the fact that with PRF, no anticoagulant is used during the processing of the blood. With platelet-rich plasma, the blood that is collected is placed in test tubes that have an anticoagulant called acid citrate dextrose (ACD), which keeps the blood product from clotting too quickly. In an effort to keep the platelet product as natural as possible, the platelet-rich fibrin test tubes do not have any anticoagulant within them. Without any anticoagulant in the test tubes, the natural fibrinogen within our blood is converted to fibrin by thrombin in the early stages of clot formation. This creates a spongy fibrin matrix that activates the platelets and allows for a slow release of growth factors, which starts the tissue healing process.