Topic 25 · Everything else

Platelet-Rich Fibrin (PRF) - Beyond PRP

A step past PRP in theory. The ankle evidence does not exist yet.

→ PRF is like PRP but contains more of the healing factors and a fibrin scaffold. Simpler preparation, no additives needed. May provide longer-lasting effects than PRP.

2024 Bulgarian Study on PRF for OLT

A retrospective study of 15 patients with stage IV OLT found [143]:

52.8→84.9

AOFAS improvement (p<0.05)

44.9→16.5

VAS pain reduction (p<0.05)

Mean follow-up: 38.8 months
All surgeries used same arthroscopic algorithm with PRF application

PRF + Autologous Osteochondral Transplantation (2025)

A study combining PRP with AOT in patients with OLT + chronic lateral ankle instability found [144]:

Both groups showed significant VAS and AOFAS improvements
AOT + PRP group showed significantly better "surface of repair tissue" scores on MOCART 2.0

PRF vs PRP

PRF provides a natural fibrin-based biomaterial scaffold rich in platelets, growth factors, and cytokines that facilitates cellular migration and proliferation essential for tissue healing.