Xerthra™ PRP kit is a new generation, high-performance platelet (PLT) separation device, dedicated to preparation of platelet-rich plasma (PRP) from patient’s blood. Large number of growth factors released from PLTs delivered by PRP will lead to improvement of regenerative properties of patient’s cells and tissues.

Xerthra™ kit procedure pack consists of a highly efficient separation device, which due to its unique construction allows to separate and isolate the very high number of PLTs for the final injection. Thus, the final blood-derived product acquired with Xerthra™ PRP kit is characterized by PLTs concentration way above 1 000 000 PLT/µl which constitutes as a threshold of a therapeutical effectiveness for PRP. This is due to ability of XerthraTM separation device to concentrate PLTs in average 7 times more than in patients peripheral blood1.
High number of platelets delivered by PRP obtained with Xerthra™ secrete great number of growth factors that in turn will lead to recovery of the homeostasis at the injection site, and further initiation of regeneration and repair processess2,3.

  1. Data on file Biovico / Biovico Research Report Series - Xerthra™ PRP kit – concentration performance test
  2. Farley, A., Hendry, C., & McLafferty, E. (2012). Blood components. Nursing Standard (through 2013), 27(13), 35.
  3. Zhou, Y., & Wang, J. H. (2016). PRP treatment efficacy for tendinopathy: a review of basic science studies. BioMed Research International, 2016.
Prolonged overload or trauma negatively affects the homeostasis of musculoskeletal tissues like cartilage, synovium, bone or tendon, shifting it towards aggravation of catabolic state, in turn related with intense production of tissue degradation enzymes, increased oxidative stress, enhanced inflammation and finally elevated damage1,2. However, scientific and clinical data show that platelet-rich plasma (PRP) therapy can be a respectful treatment for joint or tendon deterioration and pathology3,4. PLT are the key functional component of the PRP as they release a wide range of bioactive proteins with multiple biological functions. Due to this PLTs are able to greatly regulate musculoskeletal tissues homeostasis. Interestingly, alongside PLTs, leukocytes are also isolated and used within PRP solution which secrete factors with wide range of biological function5. Thus leukocytes by secretion of growth factors and specific cytokines are able to control processes like phagocytosis and immunomodulation6,7.
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Xerthra™ kit procedure pack contains a highly efficient separation device, which due to its unique design and construction allows to separate and isolate a very high number of PLTs in the final injection product.
Xerthra™ separation device is made of Makrolon® polycarbonate that maximize the recovery rate of both platelets and growth factors. This effect is provided due to a very low surface energy of Makrolon® polymer which prevent binding of the proteins and cells to the walls of the device, resulting in maximal number of PLT in final injection product.
As a result, the blood-derived product acquired by Xerthra™ PRP separation device delivers PLTs concentration way above the threshold of a therapeutical effectiveness for PRP stated by PRP definition on 1 000 000 PLT/µl. This is due to ability of XerthraTM separation device to concentrate PLTs 7 times than in patients peripheral blood8. Such high effectiveness delivers 3, 2 or 1 mL of highly concentrated PRP from 15 mL of patient’s peripheral blood.
The main advantages of PRP obtained by Xerthra™ is its safety as well as simple preparation and administration methods. Moreover, due to the product autologous characteristics, no unintentional immune response will be triggered after the injection9 and no donor-recipient disease transmission is possible. 
Package of Xerthra™ PRP Kit contains:
  • Xerthra™ separation device (1 pc)
  • Venofix® A, 21G butterfly needle (1 pc)
  • Microlance™ 3, 21Gx1½” needle (3 pcs)
  • Microlance™ 3, 27Gx¾” needle (1 pc)
  • dicoNEX Single use syringe, 20 mL (1 pc)
  • dicoNEX Single use syringe, 10 mL (1 pc)
  • dicoNEX Single use syringe, 5 mL (1 pc)
  • dicoNEX Single use syringe, 2 mL (1 pc)
Recent clinical data show that PPR administration can be clinically more effective when administered at least two times with 7 days intervals, what can bring up to 12 months clinical effectiveness10,11.

The product is meant to use by medical practitioners only.
  1. Oliva F, Marsilio E, Asparago G, Frizziero A, Berardi AC, Maffulli N. The Impact of Hyaluronic Acid on Tendon Physiology and Its Clinical Application in Tendinopathies. Cells. 2021 Nov 9;10(11):3081
  2. Smith, M. D., Triantafillou, S., Parker, A., Youssef, P. P., & Coleman, M. (1997). Synovial membrane inflammation and cytokine production in patients with early osteoarthritis. The Journal of rheumatology, 24(2), 365-371.
  3. Zhou, Y., & Wang, J. H. (2016). PRP treatment efficacy for tendinopathy: a review of basic science studies. BioMed Research International, 2016.
  4. Andia, I., & Maffulli, N. (2013). Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nature Reviews Rheumatology, 9(12), 721-730.
  5. Boswell, S. G., Cole, B. J., Sundman, E. A., Karas, V., & Fortier, L. A. (2012). Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy: The journal of arthroscopic & related surgery, 28(3), 429-439.
  6. Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R. Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection. Am J Med. 2004 Oct 15;117(8):556-62.
  7. Saffery NSI, Genasan K, Chan CK, Ayob KA, Teo SH, Al-Fayyadh MZM, Othman I, Abidin SAZ, Raman MM, Raghavendran HRB, Kamarul T. Typical response of CD14++CD16- monocyte to knee synovial derived mediators as a key target to overcome the onset and progression of osteoarthritis. Front Med (Lausanne). 2022 Aug 29;9:904721..
  8. Data on file Biovico / Biovico Research Report Series - Xerthra™ PRP kit – concentration performance test
  9. Guillibert C, Charpin C, Raffray M, Benmenni A, Dehaut FX, El Ghobeira G, Giorgi R, Magalon J, Arniaud D. Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee Osteoarthritis: A Prospective Routine Care Study. Int J Mol Sci. 2019 Mar 15;20(6):1327.
  10. Andriolo, L., Altamura, S. A., Reale, D., Candrian, C., Zaffagnini, S., & Filardo, G. (2019). Nonsurgical treatments of patellar tendinopathy: multiple injections of platelet-rich plasma are a suitable option: a systematic review and meta-analysis. The American journal of sports medicine, 47(4), 1001-1018.
  11. Yurtbay, A., Say, F., Çinka, H., & Ersoy, A. (2021). Multiple platelet-rich plasma injections are superior to single PRP injections or saline in osteoarthritis of the knee: the 2-year results of a randomized, double-blind, placebo-controlled clinical trial. Archives of orthopaedic and trauma surgery, 1-14.
Therapeutic rational of platelet-rich plasma (PRP) for joint and tendon associated injuries
PRP is a concentrated and isolated fraction of the peripheral blood, which contains very high amount of platelets (PLTs). However, PRP may contain other blood components, such as leukocytes and fibrin protein1. Growth factors released by the PLTs, as a natural signaling molecules for the cells and tissues, provide the necessary molecular information at the injury and damage site. Up to date, more than 300 biologically active molecules were identified in the platelet secretome2. Among all, the signaling proteins like growth factors are closely linked with the beneficial effects of the PRP therapy – including platelet derived growth factors (PDGF), transforming growth factor β1 (TGF- β1), insulin-like growth factor 1 (IGF-1), fibroblast growth factor 2 (FGF-2), hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF)3 and many more. 
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One of the crucial effects of PLT-derived growth factors in general can be describes as anti-inflammatory when applied into the OA affected joint or into the tendon affected by tendinopathy. This anti-inflammatory effect lays mainly in the ability of PRP to inhibit the production of strong proinflammatory cytokines, such as IL-6 and IL-84.
Foremost, PRP with high concentration of PLTs and thus loads of different growth factors was described as potent modulator of cell metabolism in OA affected joint or in tendinopathy. Growth factors secreted by the PLTs can positively affect the production and secretion of tissue extracellular matrix (ECM) components like ACAN, COL1A1, COL2A1, COL3A1 and HA. As this leads to induced biosynthesis of ECM components like aggrecan, type II collagen and hyaluronic acid (associated with joint cartilage tissue5); and type I and III collagen (associated with tendon tissue6) PRP will contribute significantly to increase of regeneration processes of both articular cartilage and tendon.
Furthermore, the effect of PRP treatment includes also the induction of specific tissue cell proliferation, which is a major process in tissue healing. Data show that PRP-derived growth factors are able to induce the migration and proliferation of tendon or cartilage progenitor cells7,8.
Finally, all of these processes induced by PRP, when combined, will substantially restore the proper homeostasis balance in OA affected join and in tendinopathy, thus contributing to tissue regeneration and reduction of degradation processes.
All of the mentioned effects makes the PRP injections a highly recommendable therapy for tendon and joint associated pathologies. Based on significant meta-analysis, the PRP treatment was estimated as an therapeutically effective against tendinopathy9 and osteoarthritis10. Clinical studies describe that intra-articular PRP administration has clinical effectiveness, characterized with pain alleviation from 8 weeks11 after the injection, which lasts up to 12 months12.
PRP vs Corticosteroids
PRP treatment was proven to be clinically efficient and safe, based on the reports which pointed out the lack of adverse events related to the therapy, in contrast to corticosteroids injection (CS) which safety has been put into serious consideration13–16. There is vast of scientific publications which describes that CS injections contributes to cartilage thinning and damage17 or leads to significant tenocyte viability reduction and increase in possibility of future tendon rupture18
  1. Zhou Y, Wang JHC. PRP Treatment Efficacy for Tendinopathy: A Review of Basic Science Studies. BioMed Research International. 2016;2016:1-8. doi:10.1155/2016/9103792
  2. Andia I, Maffulli N. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol. 2013;9(12):721-730. doi:10.1038/nrrheum.2013.141
  3. Andia I, Sanchez M, Maffulli N. Tendon healing and platelet-rich plasma therapies. Expert Opinion on Biological Therapy. 2010;10(10):1415-1426. doi:10.1517/14712598.2010.514603
  4. Bendinelli P, Matteucci E, Dogliotti G, et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: Mechanisms of NF-κB inhibition via HGF. J Cell Physiol. 2010;225(3):757-766. doi:10.1002/jcp.22274
  5. Sundman EA, Cole BJ, Karas V, et al. The Anti-inflammatory and Matrix Restorative Mechanisms of Platelet-Rich Plasma in Osteoarthritis. Am J Sports Med. 2014;42(1):35-41. doi:10.1177/0363546513507766
  6. Schnabel LV, Mohammed HO, Miller BJ, et al. Platelet rich plasma (PRP) enhances anabolic gene expression patterns in flexor digitorum superficialis tendons. J Orthop Res. 2007;25(2):230-240. doi:10.1002/jor.20278
  7. Zhou Y, Zhang J, Wu H, Hogan MV, Wang JHC. The differential effects of leukocyte-containing and pure platelet-rich plasma (PRP) on tendon stem/progenitor cells - implications of PRP application for the clinical treatment of tendon injuries. Stem Cell Res Ther. 2015;6(1):173. doi:10.1186/s13287-015-0172-4
  8. Krüger JP, Hondke S, Endres M, Pruss A, Siclari A, Kaps C. Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res. 2012;30(6):845-852. doi:10.1002/jor.22005
  9. Fitzpatrick J, Bulsara M, Zheng MH. The Effectiveness of Platelet-Rich Plasma in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Clinical Trials. Am J Sports Med. 2017;45(1):226-233. doi:10.1177/0363546516643716
  10. Dai WL, Zhou AG, Zhang H, Zhang J. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2017;33(3):659-670.e1. doi:10.1016/j.arthro.2016.09.024
  11. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis: A Prospective, Double-Blind, Randomized Trial. Am J Sports Med. 2013;41(2):356-364. doi:10.1177/0363546512471299
  12. Vaquerizo V, Plasencia MÁ, Arribas I, et al. Comparison of Intra-Articular Injections of Plasma Rich in Growth Factors (PRGF-Endoret) Versus Durolane Hyaluronic Acid in the Treatment of Patients With Symptomatic Osteoarthritis: A Randomized Controlled Trial. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2013;29(10):1635-1643. doi:10.1016/j.arthro.2013.07.264
  13. Rodas G, Soler-Rich R, Rius-Tarruella J, et al. Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study. Am J Sports Med. 2021;49(6):1492-1504. doi:10.1177/0363546521998725
  14. Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy: A Double-Blind, Randomized Controlled Trial. Am J Sports Med. 2014;42(3):610-618. doi:10.1177/0363546513518416
  15. Chen P, Huang L, Ma Y, et al. Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses. J Orthop Surg Res. 2019;14(1):385. doi:10.1186/s13018-019-1363-y
  16. Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of Platelet-Rich Plasma in Patients with Primary and Secondary Knee Osteoarthritis: A Pilot Study. American Journal of Physical Medicine & Rehabilitation. 2010;89(12):961-969. doi:10.1097/PHM.0b013e3181fc7edf
  17. McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017;317(19):1967. doi:10.1001/jama.2017.5283
  18. Crimaldi S, Liguori S, Tamburrino P, et al. The Role of Hyaluronic Acid in Sport-Related Tendinopathies: A Narrative Review. Medicina. 2021;57(10):1088. doi:10.3390/medicina57101088

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