Efficacy and Safety of a Single Intra-articular Injection of Platelet-rich Plasma on Pain and Physical Function in Patients With Ankle Osteoarthritis—A Prospective Study

Sun, Shu-Fen; Hsu, Chin Wang; Lin, Ge; Lin, Huey‐Shyan; Chou, Yi-Jiun; Wu, Shinyi; Huang, Hung-Ya

doi:10.1053/j.jfas.2020.12.003

Cited by 14 publications

(11 citation statements)

References 33 publications

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“…Previous evidence for PRP injections in ankle osteoarthritis was limited to 4 small case series with methodological flaws. 5,12 Two retrospective case series of 5 and 20 patients reported an improvement of 21% and 67% on the VAS. Two prospective case series, of 20 and 44 patients, reported an improvement of 29% and 59% on the VAS at 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…Two prospective case series, of 20 and 44 patients, reported an improvement of 29% and 59% on the VAS at 6 months. 5,12 In knee osteoarthritis, 14 of the 21 randomized clinical trials of PRP showed methodological limitations, including moderate to high risk of bias and small sample sizes. 7 Four of these trials were placebo-controlled, and all reported beneficial results for PRP.…”

Section: Discussionmentioning

confidence: 99%

“…The mean (SD) baseline AOFAS scores were 63 (13) in the PRP group and 64 (16) in the placebo group. Between baseline and 26-week follow-up, the mean AOFAS score improved by 10 points (95% CI, [6][7][8][9][10][11][12][13][14] in the PRP group compared with 11 points (95% CI, 7-15) in the placebo group (Table 2; Figure 2 and Figure 3). The following 2 baseline variables were associated with the primary outcome, with P <.10: duration of symptoms of ankle osteoarthritis (in years) and radiological talar tilt (in degrees) (eTable 16 in Supplement 2).…”

Section: Primary Outcomementioning

confidence: 99%

“…7 Investigation of PRP for ankle osteoarthritis is limited to 4 small case series, and all have reported statistically significant improvements in symptoms and function. 5,12 Randomized clinical trials comparing PRP with placebo in patients with ankle osteoarthritis have not been performed. The Platelet-Rich Plasma Injections for the Management of Ankle Osteoarthritis (PRIMA) randomized clinical trial assessed the efficacy of PRP injections in ankle (tibiotalar) osteoarthritis.…”

mentioning

confidence: 99%

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Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Paget¹,

Reurink

Vos

et al. 2021

JAMA

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IMPORTANCE Approximately 3.4% of adults have ankle (tibiotalar) osteoarthritis and, among younger patients, ankle osteoarthritis is more common than knee and hip osteoarthritis. Few effective nonsurgical interventions exist, but platelet-rich plasma (PRP) injections are widely used, with some evidence of efficacy in knee osteoarthritis.OBJECTIVE To determine the effect of PRP injections on symptoms and function in patients with ankle osteoarthritis. DESIGN, SETTING, AND PARTICIPANTSA multicenter, block-randomized, double-blinded, placebo-controlled clinical trial performed at 6 sites in the Netherlands that included 100 patients with pain greater than 40 on a visual analog scale (range, 0-100) and tibiotalar joint space narrowing. Enrollment began on August 24, 2018, and follow-up was completed on December 3, 2020.INTERVENTIONS Patients were randomly assigned (1:1) to receive 2 ultrasonography-guided intra-articular injections of either PRP (n = 48) or placebo (saline; n = 52). MAIN OUTCOMES AND MEASURESThe primary outcome was the validated American Orthopaedic Foot and Ankle Society score (range, 0-100; higher scores indicate less pain and better function; minimal clinically important difference, 12 points) over 26 weeks. RESULTS Among 100 randomized patients (mean age, 56 years; 45 [45%] women), no patients were lost to follow-up for the primary outcome. Compared with baseline values, the mean American Orthopaedic Foot and Ankle Society score improved by 10 points in the PRP group (from 63 to 73 points [95% CI, 6-14]; P < .001) and 11 points in the placebo group (from 64 to 75 points [95% CI, 7-15]; P < .001). The adjusted between-group difference over 26 weeks was −1 ([95% CI, -6 to 3]; P = .56). One serious adverse event was reported in the placebo group, which was unrelated to the intervention; there were 13 other adverse events in the PRP group and 8 in the placebo group.CONCLUSIONS AND RELEVANCE Among patients with ankle osteoarthritis, intra-articular PRP injections, compared with placebo injections, did not significantly improve ankle symptoms and function over 26 weeks. The results of this study do not support the use of PRP injections for ankle osteoarthritis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Primary Outcomementioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Paget¹,

Reurink

Vos

et al. 2021

JAMA

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“…An analgesic role is also suggested as a modulator of chondrocyte cannabinoid receptors, and it is thought that it may also enhance the synovial secretion of hyaluronic acid. A more recent study highlighted the efficacy and safety of this treatment on pain and physical function with a single injection only [ 17 ].…”

Section: Pharmacological Strategiesmentioning

confidence: 99%

Conservative Treatment of Ankle Osteoarthritis

Tejero

Prada-Chamorro

González-Martín

et al. 2021

JCM

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Despite the disabling nature of ankle osteoarthritis (OA), there is poor scientific evidence for a conservative treatment compared to the hip and knee OA. In this regard, most of the treatment options in use are not based on clinical studies of the ankle, and they are extracted from evidence obtained from clinical studies of other lower limb joints. However, this does not seem to be a good idea, since the aetiology of ankle OA is quite different from that of the hip or knee. Nonpharmacological and pharmacological treatments such as nonsteroidal anti-inflammatory drugs, hyaluronic acid, corticosteroid, platelet-rich plasma injection and mesenchymal stem cells injections have been reported. However, further research is required in this field to obtain a specific clinical practice guideline for the conservative treatment of ankle OA.

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Platelet-Rich Plasma for Osteoarthritis and Achilles Tendinitis

Katz

2021

JAMA

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Efficacy and Safety of a Single Intra-articular Injection of Platelet-rich Plasma on Pain and Physical Function in Patients With Ankle Osteoarthritis—A Prospective Study

Cited by 14 publications

References 33 publications

Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Conservative Treatment of Ankle Osteoarthritis

Platelet-Rich Plasma for Osteoarthritis and Achilles Tendinitis

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