Platelet-Rich Plasma Augmentation in Meniscal Repair Surgery: A Systematic Review of Comparative Studies

Haunschild, Eric D.; Huddleston, Hailey P.; Chahla, Jorge; Gilat, Ron; Cole, Brian J.; Yanke, Adam B.

doi:10.1016/j.arthro.2020.01.038

Cited by 36 publications

(23 citation statements)

References 37 publications

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“…PRP is currently characterized by its absolute platelet concentration, thereby shifting from the initial definition of PRP consisting of a platelet concentration above baseline values [ 1 ] to a minimum platelet concentration of more than 1 × 10 6 /µL or an approximately five-fold increase in platelets from baseline [ 53 ]. In the extensive review by Fadadu et al [ 35 ], 33 PRP systems and protocols were evaluated.…”

Section: A Contemporary Prp Formulation: “Clinical Prp”mentioning

confidence: 99%

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Everts

Onishi²,

Jayaram

et al. 2020

IJMS

394

241

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Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

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Section: A Contemporary Prp Formulation: “Clinical Prp”mentioning

confidence: 99%

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Everts

Onishi²,

Jayaram

et al. 2020

IJMS

394

241

View full text Add to dashboard Cite

show abstract

“…PRP is currently characterized by its absolute platelet concentration, thereby shifting from the initial definition of PRP consisting of a platelet concentration above baseline values (1) to a minimum platelet concentration of more than 1 x10 6 /μL or an approximately five-fold increase in platelets from baseline (54). In the extensive review by Fadadu et al (36), 33 PRP systems and protocols were evaluated.…”

Section: A Contemporary Prp Formulation: "Clinical Prp"mentioning

confidence: 99%

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Everts¹,

Onishi²,

Jayaram³

et al. 2020

Preprint

104

109

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Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

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“…Accordingly, biologic augmentation techniques have been introduced in clinical practice, but their real efficacy is still controversial. 25 The aim of this systematic review and meta-analysis was to evaluate the safety, clinical results, and failure rate of biologic augmentation techniques for meniscal repair. The hypothesis was that biologic augmentation would improve the results of meniscal repair.…”

mentioning

confidence: 99%

Biologic Augmentation Reduces the Failure Rate of Meniscal Repair: A Systematic Review and Meta-analysis

Zaffagnini

Poggi

Reale

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Clinical results after isolated meniscal repair are not always satisfactory, with an overall failure rate of around 25%. To improve the success rate of meniscal repair, different biologic augmentation techniques have been introduced in clinical practice, but their real efficacy is still controversial. Purpose/Hypothesis: To evaluate the safety, clinical results, and failure rate of biologic augmentation techniques for meniscal repair. The hypothesis was that biologic augmentation would improve the results of meniscal repair. Study Design: Systematic review and meta-analysis of comparative studies. Methods: A systematic review of the literature was performed in March 2020 of 3 electronic databases (PubMed, Scopus, and the Cochrane Library) regarding meniscal repair combined with biologic augmentation techniques. Articles combining biologic augmentation with other surgical procedures besides meniscal suture were excluded. The quality of the included studies was assessed using a modified Coleman Methodology Score, and the risk of bias was evaluated using the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) and the RoB 2.0 (Revised Tool for Risk of Bias in Randomized Trials) for nonrandomized and randomized controlled trials, respectively. Results: A total of 11 studies were included in the qualitative analysis: platelet-rich plasma (PRP) augmentation in 6 comparatives studies, fibrin clot augmentation in 2 case series, and mesenchymal stem cells augmentation in 2 case series and 1 case report. One severe adverse event of septic arthritis was reported for PRP 1 month after surgery. The quality of evidence evaluated with the modified Coleman Methodology Score was low overall. Five studies reporting on 286 patients (111 PRP augmentation, 175 control) were included in the quantitative synthesis. A significantly lower risk of failure was documented in the PRP augmentation group as compared with the control group: 9.9% (4.5%-19.1%) versus 25.7% (12.7%-38.7%) ( P < .0005). Conclusion: The literature on biologic meniscal augmentation is recent and scarce. Only a few comparative trials are available, all focusing on the potential of PRP. The meta-analysis documented that PRP is safe and useful in improving the survival rate, with a 9.9% rate of failure versus 25.7% for the control group. Further high-level studies are needed to confirm these findings and identify the most effective biologic augmentation strategy to improve the outcome of meniscal repair.

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Platelet-Rich Plasma Augmentation in Meniscal Repair Surgery: A Systematic Review of Comparative Studies

Cited by 36 publications

References 37 publications

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Biologic Augmentation Reduces the Failure Rate of Meniscal Repair: A Systematic Review and Meta-analysis

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