PLASMA PROTEINS , A2M AND FIBRIN GLUE 

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The use of autologous protein concentrate and fibrin glue derived from a patient's own plasma has become an increasingly valuable tool in orthopedic surgery and in office based orthopedics. These biologic agents promote tissue healing, reduce inflammation, and enhance overall surgical outcomes without introducing foreign substances into the body.

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Normally we discard the plasma during a PRP procedure but more recently we are finding use for different components in the plasma that is left behind. 

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WHAT IS IT?

Protein concentrate, typically rich in growth factors such as platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β), is often prepared using platelet-rich plasma (PRP). In orthopedic procedures, PRP is injected into injured tendons, ligaments, or joints to stimulate cell proliferation, matrix production, and angiogenesis. It is commonly used for conditions like tendinopathies, osteoarthritis, and during surgical repair of soft tissues to accelerate recovery and improve functional outcomes.

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Fibrin glue, also derived from the patient's plasma, consists of fibrinogen and thrombin that form a clot when combined. Fibrin glue serves as a biological adhesive to close wounds, secure grafts, or deliver cells and drugs directly to injury sites. Its biodegradable and hemostatic properties support natural tissue integration and minimize bleeding.

Because these materials are autologous, they reduce the risk of immune reaction, infection, or disease transmission.

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A2M is a broad-spectrum protease inhibitor found naturally in plasma.​

• Cartilage Protection: Binds and neutralizes catabolic enzymes (e.g., MMPs, aggrecanases) that degrade cartilage in osteoarthritis.

• Slows Joint Degeneration: By halting destructive enzymatic activity, it may slow or prevent further cartilage loss.

 

Their use aligns with regenerative medicine principles, emphasizing natural healing and patient-specific treatments. 

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WHEN WOULD WE USE THESE?

• Protein concentrates and A2M might give added benefit in PRP injections and help to boost healing​

• Fibrin might serve as another nonsurgical option when filling in a large tear with MFAT or PRP, as the fibrin glue might act as a scaffold promoting betting results 

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