Platelet-Rich Plasma Injections vs Placebo for Patients With Ankle Osteoarthritis

Abstract

HCV testing, and 10.7% (n = 188) offered HCV treatment. Among non-OTPs in 2020, 46.6% (n = 3024) offered HIV testing, 17.9% (n = 1163) offered HIV treatment, 45.8% (n = 2976) offered HCV testing, and 20.5% (n = 1334) offered HCV treatment.For both OTPs and non-OTPs, HIV and HCV testing and treatment were most often available in federally owned facilities and facilities with inpatient services, with the proportion of outpatient-only facilities providing such services being low (Table 2).Of the 117 OTPs in the 7 Ending the HIV Epidemic highpriority rural states in 2020, 46.2% (n = 54) and 4.3% (n = 5) offered HIV testing and treatment, respectively.Discussion | Despite an increasing number of substance use disorder treatment facilities that offered medication for opioid use disorder, the proportion of facilities that also offered HIV and HCV testing did not change between 2017 and 2020. In 2020, only half of the facilities offered HIV and HCV testing. The stagnant trends, including among OTPs, are troubling, as a prior study found declines in HIV testing availability among OTPs between 2000 and 2011. 5 Regardless of OTP status, HIV and HCV testing and treatment availability was particularly low in outpatient-only facilities that can potentially establish routine care and in highpriority rural states with increasing HIV/HCV risk. 3,6 Limitations of the study include that the findings may not be generalizable to clinicians who prescribe medication to treat opioid use disorder outside of the specialty treatment system. While integration of medication for opioid use disorder into primary care and infectious disease clinics remains important, these data highlight that increased efforts are needed to better integrate HIV and HCV testing and treatment in the specialty treatment system.

CORR Insights®: What Is the Efficacy of Intra-articular Injections in the Treatment of Ankle Osteoarthritis? A Systematic Review

“…The current systematic review by Paget et al [10] follows a recent, prominent randomized controlled trial by many of the same authors, who found no benefit to platelet-rich plasma (PRP) injections compared with saline placebo [11]. That report generated numerous letters to the editor, including several from officers of regenerative medicine centers and consultants for manufacturers of PRP harvest systems [3, 6]. The legitimate concern raised in these responses, as well as responses to similar negative results for injections in the knee [4], is that a clear consensus about the optimal formulation of most injected substances does not exist, particularly for PRP.…”

Aging Affects the Efficacy of Platelet-Rich Plasma Treatment for Osteoarthritis

“…The trials found that intra-articular PRP injections did not induce a significant difference in symptoms, structure, or function in the ankle or knee when compared with placebo injections 9,10 . The results from these studies, however, were met with concerns, most of which focused on the fact that the PRP preparation protocol was not one that is standardly used in clinic, thereby raising concerns about insufficient platelet numbers 11,12 . Despite the many concerns raised, one question remained both unasked and unanswered : Do the patient characteristics play a role in the efficacy of PRP?…”