Orthobiologics are not all the same: a mechanism-based scoping review of PRP, cytokine-rich serum, and extracellular vesicle–based strategies in musculoskeletal conditions - Takeaways - MDSpire
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Diverse Orthobiologics: A Mechanism-Focused Scoping Review of PRP, Cytokine-Enriched Serum, and Extracellular Vesicle Approaches in Musculoskeletal Disorders

  • By

  • Luigi Di Lorenzo

  • Alfonso M. Forte

  • Bruno De Meo

  • Francesco Forte

  • Carmine D'Avanzo

  • Hassan Zmerly

  • August 17, 2026

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  • 1

    Autologous blood-derived orthobiologics like PRP and cytokine-rich serum are widely used in musculoskeletal medicine.

  • 2

    PRP operates mainly through growth factor release, while formulations with leukocytes focus on immune modulation.

  • 3

    Acellular cytokine-rich sera provide immunomodulatory effects via soluble mediators, differing from cellular-based products.

  • 4

    Extracellular vesicles, including exosomes, are experimental with unclear clinical efficacy and should not be conflated with PRP.

  • 5

    A mechanism-focused classification system for orthobiologics is necessary to clarify their unique compositions and clinical applications.

Original Source(s)

Orthobiologics are not all the same: a mechanism-based scoping review of PRP, cytokine-rich serum, and extracellular vesicle–based strategies in musculoskeletal conditions

  • by Luigi Di Lorenzo, Alfonso M. Forte, Bruno De Meo, Francesco Forte, Carmine D'Avanzo, Hassan Zmerly

  • August 17, 2026

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