Efficacy of different platelet‐rich plasma injections in the treatment of mild‐moderate knee osteoarthritis: A systematic review and meta‐analysis

Chou, Shih-Hsiang; Shih, Chia-Lung

doi:10.1111/ijcp.14068

Cited by 9 publications

(7 citation statements)

References 40 publications

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“…Chou et al . 69 for the treatment of mild to moderate knee OA showed that the effect of triple injections of PRP was better than that of single and twice injections, which was consistent with the conclusion of the long-term result of Chouhan et al . 25 The two studies hint to us that the difference in follow-up time of included studies may also be a reason for the inconsistency between our study and the above meta-analysis and the possibility that the chondroprotective effect of triple injections of PRP gradually deteriorates with time.…”

Section: Discussionsupporting

confidence: 89%

“…It suggests that the antiinflammatory effects of single-injection PRP and multiple-injection PRP were similar in the short term, and multiple injections of PRP may have a chondroprotective effect, but the effect is not long term. Chou et al 69 for the treatment of mild to moderate knee OA showed that the effect of triple injections of PRP was better than that of single and twice injections, which was consistent with the conclusion of the long-term result of Chouhan et al 25 The two studies hint to us that the difference in follow-up time of included studies may also be a reason for the inconsistency between our study and the above meta-analysis and the possibility that the chondroprotective effect of triple L Chen, S Jin et al…”

Section: Discussionmentioning

confidence: 99%

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Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

Chen

Jin

Yao

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are non-surgical treatments for osteoarthritis (OA), but the comparison of their efficiency is still inconclusive. Objectives: The objectives of this study were to compare the efficacy of PRP and HA in the treatment of OA by meta-analysis and to explore the effects of different injection times and leukocyte concentration on the efficacy of PRP. Design: Meta-analysis and subgroup analysis were conducted. The data were analyzed by Review Manager v5.4.1. Data sources and methods: Articles were retrieved and screened from PubMed, the Cochrane Library, Web of Science, and Embase. The outcome included the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS), adverse events (AEs), the International Knee Documentation Committee (IKDC), and the satisfaction rate. Results: A total of 30 articles involving 2733 patients were included. The total WOMAC score and IKDC score of the PRP group were better than those of the HA group at the last follow-up time, while there was no significant difference in AEs, satisfaction rate, and VAS between the two groups. In our subgroup analysis, there was no significant difference between single-injection PRP and triple-injection PRP. Leukocyte-poor PRP (LP-PRP) was better than leukocyte-rich PRP (LR-PRP) in IKDC, but there was no significant difference between them in the other scores. Conclusions: In the treatment of OA, compared with HA, PRP performed better in the improvement of the patient’s function. There was no significant difference in VAS and AEs between the two groups, and the safety was comparable. LP-PRP looked to be superior to LR-PRP in functional recovery, but there appeared to be no significant difference in pain relief between them. There was no significant difference between single PRP and triple PRP in the subgroup analysis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

Chen

Jin

Yao

et al. 2023

Therapeutic Advances in Musculoskeletal

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“…The effects of PRP on cell proliferation and ECM formation could lead to restoring cartilage damage in the early stages of OA. Recent evidence has suggested that PRP therapy is clinically more effective in patients with mild or moderate knee OA 73,74 . It is very difficult for PRP to restore the damage generated in the cartilage or synovium in people with more severe OA.…”

Section: Discussionmentioning

confidence: 99%

The mechanism of action of platelet-rich plasma for knee osteoarthritis: a systematic review

Simental‐Mendía¹,

Acosta-Olivo²,

González-Candelaria³

et al. 2022

RMU

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Background: Platelet-rich plasma (PRP) is a biological intra-articular therapy that has shown good clinical outcomes in patients with knee osteoarthritis (OA) and has been widely studied from in vitro to pre-clinical animal models. We aimed to synthesize non-clinical evidence regarding the different effects related to PRP. Methods: A systematic literature review was conducted in the MEDLINE, EMBASE, and Google Scholar databases in December 2020. Studies were included if they were non-clinical basic science publications describing the effect of PRP treatment, studies focused on knee OA, and articles reporting the use of PRP or a similar platelet-derived product. Included articles were assessed and categorized based on the effect or the mechanism of the action described. The main findings of each study were obtained and analyzed. Results: A total of 41 articles were included to review the outcomes of interest. The most frequently reported mechanism was the modulation of genes involved in synthesizing and degrading the cartilage extracellular matrix (ECM), followed by ECM morphological analysis, inflammation, and cell proliferation. PRP preparations with low and high content of leukocytes were equally reported. Conclusions: The studies reviewed provide evidence for several ways in which PRP can act once it is present in the intra-articular environment. The vast majority of data support a beneficial effect of PRP therapy, especially for leukocyte-poor PRP formulations. The evidence collected gives us a clue as to what the mechanism of action could be. However, the great heterogeneity in the study formulations and models implies further investigation.

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“…The pooled improvements among different injection therapies were investigated recently. Chou et al discovered that 3-injection PRP therapy in the treatment of mild-to-moderate knee OA had the best efficacy for pain relief and function improvement compared to one- and 2-injection therapies ( Chou and Shih, 2021 ). To date, the preparation and usage of PPR were not unified, the dosage and frequency of use were also different, and the follow-up time of clinical research was short, so a consensus on the curative effect of PRP had not been formed.…”

Section: Discussionmentioning

confidence: 99%

CD226 Is Required to Maintain Megakaryocytes/Platelets Homeostasis in the Treatment of Knee Osteoarthritis With Platelet-Rich Plasma in Mice

Liu

Zhang

et al. 2021

Front. Pharmacol.

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Platelet-rich plasma (PRP) is a platelet-based application used to treat osteoarthritis (OA) clinically. The co-stimulatory molecule CD226 is expressed in T cells, NK cells, and also platelets. However, exact effects of CD226 on platelets and whether its expression level influences PRP efficacy are largely unknown. Here, CD226fl/flPF4-Cre mice were obtained from mating CD226 fl/fl mice with PF4-Cre mice. Blood samples and washed platelets were collected from the mice eyeballs to undergo routine blood tests and transmission electron microscopy. Differentially expressed proteins were detected by iTRAQ-based proteomics analysis. Animal OA models were established through surgical destabilization of the medial meniscus (DMM) for C57BL/6 wildtype mice, followed by PRP injection to evaluate the effects of platelet CD226 on PRP efficacy. The results showed that deletion of platelet CD226 increased the number of megakaryocytes (MKs) in bone marrow (BM) but reduced MKs in spleen, combined with significantly decreased platelet amounts, α-granule secretion, and reduced immature platelets; indicating that absence of platelet CD226 may disrupt MK/platelet homeostasis and arrested platelet release from MKs. Sequencing analysis showed abnormal ribosomal functions and much downregulated proteins in the absence of platelet CD226. Autophagy-related proteins were also reduced in the CD226-absent MKs/platelets. Moreover, deletion of platelet CD226 diminished the protective effects of PRP on DMM-induced cartilage lesions in mice, and PDGF restored it. Therefore, deficiency of platelet CD226 inhibited platelet maturation, secretion, and normal ribosomal functions, which may lead to depressed PRP efficacy on OA, suggesting that CD226 is required to regulate platelet growth, functions, and its application.

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Efficacy of different platelet‐rich plasma injections in the treatment of mild‐moderate knee osteoarthritis: A systematic review and meta‐analysis

Cited by 9 publications

References 40 publications

Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

The mechanism of action of platelet-rich plasma for knee osteoarthritis: a systematic review

CD226 Is Required to Maintain Megakaryocytes/Platelets Homeostasis in the Treatment of Knee Osteoarthritis With Platelet-Rich Plasma in Mice

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