Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis

Jang, Soojin; Kim, Jae-Do; Cha, Seong-Sook

doi:10.1007/s00590-012-1037-5

Cited by 138 publications

(99 citation statements)

References 25 publications

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“…The majority of these studies (26) examined PRP administration for knee OA, while only 3 of the studies involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies.…”

Section: Resultsmentioning

confidence: 99%

“…It is important to mention that improved outcomes have been shown in up to grade 3 OA (according to the Kellgren-Lawrence classification). 25,26 Lack of uniformity was evident in terms of indications, inclusion criteria, pathology definitions, and classifications used in the different studies. In the knee studies, not all authors reported the degree of OA or degeneration, using a general description such as "degenerative joint disease," or "primary and secondary OA," or even "osteoarthritis," whereas others varied in the classifications used to quantify the level of OA.…”

Section: Level Of Oamentioning

confidence: 99%

“…Studies with 1 year of follow-up are inconsistent in terms of the outcomes at this time point, with some reporting an improvement trend and others already showing deterioration at this time point. One study 26 observed relapsed pain 8.8 months after PRP treatment. This is an important aspect when assessing the benefits of PRP treatment, suggesting it has a limited or short-term effect that might necessitate further treatment cycles to maintain and prolong these effects.…”

Section: Leukocyte Concentrationmentioning

confidence: 99%

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PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

et al. 2016

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Objective: To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects. Design: Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis." Results: The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies. Conclusion: Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

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Section: Resultsmentioning

confidence: 99%

Section: Level Of Oamentioning

confidence: 99%

Section: Leukocyte Concentrationmentioning

confidence: 99%

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PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

et al. 2016

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“…13,[24][25][26][27][28] Although these studies may provide evidence in regard to the safety of the PRP procedure, due to the lack of comparator, they cannot give an insight into the effectiveness of the procedure. The largest case series described the results of 261 patients injected three times with PRP at 2-week intervals.…”

Section: Resultsmentioning

confidence: 99%

Platelet-rich plasma: a case study for the identification of disinvestment opportunities using horizon scanning

Mundy

2017

Aust. Health Review

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Objective. This paper discusses the potential for horizon scanning to identify low-value, inappropriate clinical practices that deliver minimal benefit to patients and represent a considerable financial burden on the health system.Methods. Platelet-rich plasma (PRP) was identified by routine horizon scanning as a potentially innovative treatment alternative for osteoarthritis of the knee. A rapid, non-systematic assessment of the evidence pertaining to the safety and effectiveness of PRP compared with nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of osteoarthritis of the knee was conducted.Results. The evidence base supporting the use of PRP for the treatment of osteoarthritis was poor. No comparative studies were identified that compared the use of PRP to NSAIDs, the current treatment option for osteoarthritis of the knee in Australia. Despite the lack of effectiveness evidence, the use of PRP injections was rapidly increasing in the private sector using an inappropriate Medicare Benefits Schedule item number.Conclusions. This assessment highlights the potential of using established horizon scanning methodologies to identify targets for full or partial disinvestment of ineffective, inefficient or harmful clinical practices.What is known about the topic? PRP is rapidly diffusing in the private health system in Australia, however the use of a Medicare Benefits Schedule item number meant that this practice was being subsidised by the public reimbursement of treatment fees. What does this paper add? Traditional horizon scanning tends to identify technologies for health systems to invest in. The evidence on the effectiveness of PRP was examined with the purpose of exploring investment in an innovative treatment that may have reduced the number of invasive procedures being performed in the public hospital system. The current evidence base does not support the use of PRP injections for the treatment of osteoarthritis. It does, however, support the use of horizon scanning as an inexpensive methodology to identify possible disinvestment targets associated with potential patient harm and high health service expenditure. What are the implications for practitioners? Practitioners should be aware that public funding for the injection of PRP should not be used for the treatment of osteoarthritis.

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“…However, when this increase seen in the 12th month was compared with the scores of the 6th month, no significant difference was determined. In a study by Jang et al, [25] of 65 patients suffering from knee pain due to osteoarthritis, it was determined that although the clinical improvement within the first 6 months of the 1 year postPRP injection follow-up period was promising, it was emphasized that throughout such a 1-year follow-up, clinical improvement decreased and that the treatment was effective on early osteoarthritis but increasing age and degeneration decreased the effectiveness of PRP. Lee et al [14] was evaluated the quantitative meaurement of platelet counts and growth factor levels in PRP which was activated by thrombin and calcium chloride.They stated that there was no influence of activation of PRP using thrombin and calcium chloride on the secretion of growth factors and on the amount of platelets concentrated in plasma.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Effect of Platelet–Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

Aydoğan¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Trombositten zengin plazma'nın (TZP) eklem içi uygulaması, diz osteoartriti tedavisinde alternatif bir yöntem olabilir. Bu çalışmanın amacı, eklem içine uygulanmadan önce trombositten zengin plazmanın aktivasyon yöntem-lerinin karşılaştırılmasıdır. Gereç ve Yöntem: 51 hasta (76 diz) rastgele iki gruba ayrıldı. 1. grupta TZP aktivasyonu kalsiyum klorid (CaCl) eklenerek sağ-landı. 2. grupta ise TZP aktivasyonu, hazırlandıktan sonra -70 derecede 24 saat bekletilip, tamamen çözülmesi için 37 o suda 5 dakika bekletilerek eklem içine uygulandı. Hastalar VAS ve WOMAC ağrı skorları ile başvuru anında, ikinci, altıncı ve onikinci aylarda değerlendirildiler. Bulgular: VAS ve WOMAC skorları başvuru anında; 2., 6., ve 12. aya göre kıyaslandığında istatistiksel olarak anlamlı derecede yüksekti (p=0.06). 2., 6., 12. aylarda gruplar arasında istatistiksel anlamlı fark saptanmasa da 2., 6., ve 12. aylarda her iki skorda kademeli olarak düşme eğilimi olduğu görüldü. Tartışma: Hastalar her iki aktivasyon yönteminden de oldukça fazla klinik fayda gördüler. Klinik faydaları açısından TZP'nın CaCl veya -70 derecede aktivasyonu arasında anlamlı fark yoktur. Bu nedenle -70 derecede aktivasyon CaCl gibi ilave malzeme ihtiyacı-nı ortadan kaldıracağından öncelikli tercih edilebilir. Anahtar KelimelerTrombositten Zengin Plazma; Osteoartrit; Diz Abstract Aim: Intra-articular application of platelet rich plasma (PRP) can be an alternative treatment method for knee osteoarthritis. The objective of this study was to compare the activation methods of platelet rich plasma before intraarticular application. Material and Method: A total 51 patients (76 knees) was randomly selected into two groups. In group 1, activation of PRP was managed by adding calcium chloride (CaCl). In group 2, activation of PRP was managed by keeping the solution at -70° degrees for 24 hours after preparation and immersed in water at 37 o C for a period of 5 minutes for complete dissolution. Then PRP was applied. The patients were assessed with VAS and WOMAC pain scores both baseline and after 2nd, 6th and 12th months of the treatment. Results: VAS and WOMAC pain scores were significantly higher at baseline compared to the results obtained at the 2nd, 6th and 12th months (p=0

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Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis

Cited by 138 publications

References 25 publications

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

Platelet-rich plasma: a case study for the identification of disinvestment opportunities using horizon scanning

The Clinical Effect of Platelet–Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

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