Efficacy of Platelet-Rich Plasma in Pain and Self-Report Function in Knee Osteoarthritis

Xu, Zhongwei; Luo, Jiao; Huang, Xiao; Wang, Bin; Zhang, Jian; Zhou, Aiguo

doi:10.1097/phm.0000000000000746

Cited by 42 publications

(44 citation statements)

References 42 publications

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“…These results highlight that treatment with PRP works better than HA in patients with OA in terms of relieving pain and improving joint functionality. Prior studies [31][32][33] and several meta-analysis 13,34,35 assessing PRP efficacy revealed PRP to not be better than HA in the context of effectively designed double-blind trials, suggesting the possibility that poor blinding protocols could explain any benefits ascribed to PRP. This is not consistent with our conclusions.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

Luo

Xiong

et al. 2020

J Orthop Surg (Hong Kong)

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Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective for maintaining long-term beneficial effects without increasing the risk of intra-articular infection. However, few studies have compared the relative value of HA and PRP for OA treatment. PRP is more effective than HA for OA treatment in recent studies of this topic. We systematically searched Medline, SpringerLink, Embase, Pubmed, Clinical Trials.gov, the Cochrane Library, and OVID for all articles published through May 2018. Any study was included that compared the effect of HA and PRP (consistent treatment cycle and frequency of injection) on patient’s pain levels and functionality improvements. Review Manager 5.3 was used to analyze data regarding these two primary outcomes. We included 10 total studies in the present meta-analysis. International Knee Documentation Committee (IKDC; MD: 10.37, 95% confidence interval (CI): 9.13 to 11.62, p < 0.00001), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC; MD: −20.69, 95% CI: −24.50 to −16.89, p < 0.00001, I2 = 94%), and Visual Analogue Scale (VAS; MD: −1.50, 95% CI: −1.61 to −1.38, p < 0.00001, I2 = 90%) differed significantly between the PRP and HA groups. Knee Osteoarthritis Outcome Scores (KOOSs) did not differ significantly ( χ2 = 23.53, I2 = 41%, p = 0.11). Our hypothesis appears not to be confirmed because PRP and HA did not differ significantly with respect to KOOS score. However, the IKDC, WOMAC, and VAS scores differed significantly. Thus, based on the current evidence, PRP appears to be better than HA at achieving pain relief and self-reported functional improvement. Ia, meta-analyses of randomized clinical trials.

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Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

Luo

Xiong

et al. 2020

J Orthop Surg (Hong Kong)

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“…While PRP was first used in the 1970s for wound and bone healing in the field of oral and maxillofacial surgery,3 there are now several high-quality systemic reviews, meta-analyses and randomized controlled trails supporting its applications in many fields, including dermatology,4 cardiology,5 plastic surgery,6 orthopedic surgery,7 pain management8 and sports medicine 9 10. As the popularity of this autologous derivative of whole blood grows and it is further studied, the definition of PRP is shifting to be having a minimum platelet concentration of 1 000 000/µL or approximately a fivefold increase in platelets from baseline 11…”

Section: Introductionmentioning

confidence: 99%

Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization

Fadadu

Mazzola

Hunter

et al. 2019

Reg Anesth Pain Med

102

126

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Platelet-rich plasma (PRP) has become increasingly popular in pain medicine with hopes of becoming a safe, effective alternative to routine treatments. However, given its autologous nature, PRP injectate may differ depending on the specific manufacturer and protocol. Currently, there is no standardization of reporting protocol. This systematic review compiles and standardizes values on PRP preparation and final product composition of platelets, white cell count, and growth factors for ease of comparison. On review of 876 studies, 13 studies were selected according to our inclusion criteria. Data from 33 PRP systems and protocols were extracted and standardized. Overall, PRP final product concentrations as well as PRP preparation protocols varied widely between systems. However, platelet concentration was directly correlated with both volume of blood collected and device centrifugal force. In conclusion, there is a large heterogeneity between PRP separation systems that must be resolved for proper study of this promising treatment.

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“…Cell conditioning procedures can involve gene modifications, treating cells in hypoxia, 3D culture conditions, or addition of cytokines [46]. Interestingly, MSCs obtained from BMC or SVF have different differentiation capabilities to bone and fat but do not differ in their chondrogenic potential [47].…”

Section: Laboratory Expanded Mscsmentioning

confidence: 99%

How far have biological therapies come in regenerative sports medicine?

Andı́a

Maffulli

2018

Expert Opinion on Biological Therapy

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Regular engagement in sports produces many health benefits, but also exposes to increased injury risk. The quality of medical care available is crucial not only for sports trauma but also to avoid overuse syndromes and post-traumatic degenerative conditions. Areas covered: We provide background information on some clinical needs in sport injuries and describe the main families of biological products used in clinical practice. We also discuss limitations of the current clinical experience. Expert opinion: Sport and exercise impairment affects different segments of the population with different needs. The exceptional demands of elite athletes and subsequent media coverage have created hype around regenerative therapies. Statistical evidence, whether weak (cell products) or moderate (PRPs), is not enough to drive medical decisions because of the heterogeneity of the biological products available and their application procedures. Moreover, the specific needs of the different segments of the population along with the available clinical evidence for each musculoskeletal condition should be considered in the decision-making process. There is urgent need to develop regenerative protocols combined with post-intervention rehabilitation, and gather meaningful clinical data on the safety and efficacy of these interventions in the different populations segments.

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Efficacy of Platelet-Rich Plasma in Pain and Self-Report Function in Knee Osteoarthritis

Cited by 42 publications

References 42 publications

Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization

How far have biological therapies come in regenerative sports medicine?

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