Release kinetic of pro- and anti-inflammatory biomolecules from platelet-rich plasma and functional study on osteoarthritis synovial fibroblasts

Mariani, Erminia; Roffi, Alice; Cattini, Luca; Pulsatelli, Lia; Assirelli, Elisa; Krishnakumar, Gopal Shankar; Cenacchi, Annarita; Kon, Elizaveta; Filardo, Giuseppe

doi:10.1016/j.jcyt.2020.02.006

Cited by 21 publications

(19 citation statements)

References 54 publications

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“…Indeed, several studies showed an anabolic effect of PRP on cartilage tissue [ 16 , 30 ] and chondrocyte metabolism [ 30 , 57 , 71 ]. The role of PRP on synoviocyte metabolism appeared more complex with both pro- and anti-inflammatory effects depending in part of PRP characteristics [ 4 , 7 , 64 , 92 ] although in vivo studies brought out rather an anti-inflammatory effect of PRP on synovial tissue [ 16 , 50 ]. Some preliminary studies in humans also seem to show beneficial homeostatic effects of PRP injections on joint tissues [ 3 , 29 , 79 ].…”

Section: Resultsmentioning

confidence: 99%

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Intra-articular injections of platelet-rich plasma in symptomatic knee osteoarthritis: a consensus statement from French-speaking experts

Eymard

Ornetti

Maillet

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose There has been much debate regarding the use of intra-articular injections of platelet-rich plasma (PRP) as symptomatic treatment for knee osteoarthritis. The objective of this consensus was to develop guidelines for PRP injections in knee osteoarthritis according to the French National Authority for Health recommendations. Methods Fifteen physicians from different French-speaking countries (10 rheumatologists, 4 specialists in rehabilitation and sports medicine and 1 radiologist) were selected for their expertise in the areas of PRP and osteoarthritis. A comprehensive literature review was conducted on Medline including all published therapeutic trials, open studies, meta-analysis and systematic reviews focusing on the effects of PRP in knee OA, as well as fundamental studies concerning the characteristics of the various types of PRP and their mechanisms, indexed before April 2019. Using the method recommended by the French National Authority for Health inspired by the Delphi consensus process, 25 recommendations were finally retained and evaluated. The recommendations were classified as appropriate or not appropriate, with strong or relative agreement, or uncertain if a consensus was not achieved. Results Among the 25 recommendations selected, the main ones are the following: (1) Intra-articular injections of PRP are an effective symptomatic treatment for early to moderate knee osteoarthritis. This recommendation was considered appropriate with a relative agreement (Median = 8; rank = 6–9). Level of evidence 1A. (2) A PRP treatment sequence in knee osteoarthritis may include 1–3 injections. This recommendation was considered appropriate with a strong agreement (Median = 9; rank = 7–9). Level of evidence 1A. (3) Leucocytes-poor PRP should be preferred in knee osteoarthritis. This recommendation was considered appropriate with a relative agreement (Median = 8; rank = 5–9). Level of evidence 5. (4) Intra-articular PRP knee injections should be performed under ultrasound or fluoroscopic guidance. This recommendation was considered uncertain with no consensus (Median = 8; rank = 3–9). Level of evidence 5. (5) PRP should not be mixed with an anesthetic or intra-articular corticosteroid. This recommendation was considered appropriate with a relative agreement (Median = 9; rank = 6–9). Level of evidence 5 Conclusion Those 25 recommendations should standardize and facilitate the use of IA PRP injections, which are considered by experts as an effective treatment especially in early or moderate knee OA. Although a strong or relative agreement from the experts was obtained for most of the recommendations, many of them had a very low level of evidence (Level 5) and were principally based on the clinical experience of the experts.

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Section: Resultsmentioning

confidence: 99%

“…that may contribute to the therapeutic effects. Preclinical studies have shown that the granule secretions have mainly a homeostatic effect with anabolic and anti-inflammatory impacts on joint tissues and cells [ 16 , 30 , 50 , 57 , 64 , 71 , 92 ].…”

Section: Introductionmentioning

confidence: 99%

Intra-articular injections of platelet-rich plasma in symptomatic knee osteoarthritis: a consensus statement from French-speaking experts

Eymard

Ornetti

Maillet

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Moreover, there is an increasing awareness on the complexity of PRP itself in light of its heterogeneity according to the preparation and application modalities, and the most suitable protocol to exploit PRP potential by concentrating the most effective cluster of growth factors to help meniscal healing remains to be defined. 8,39 Thus, the oversimplified nature of the current meta-analysis has to be recognized, and future studies need to better investigate what kind of augmentation could provide the best results and how to deliver it to the lesions. This will eventually lead to obtaining a standardization of meniscal repair augmentation procedures.…”

Section: Discussionmentioning

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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“…Beside showing an overall safety of intra-articular injections, the meta-analysis could not investigate its superiority versus placebo, and results were limited to an indirect comparison between PRP and HA which was not able to detect differences. Moreover, the complexity of the PRP field would require more studies to investigate many different features, which could affect the final outcome, such as the concentration of platelets, the presence of leukocytes, as well as the possibility of cryopreserving PRP or using it fresh, the choice of activation method, and so on [69][70][71][72][73]. Thus, further high-quality studies are needed to support the benefit of PRP in ankle OA patients, to clearly understand potential and indication compared with the other available injective options.…”

Section: Discussionmentioning

confidence: 99%

Evidence on ankle injections for osteochondral lesions and osteoarthritis: a systematic review and meta-analysis

Boffa

Previtali

Frattura

et al. 2020

International Orthopaedics (SICOT)

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Purpose To evaluate the evidence supporting safety and effectiveness of intra-articular injective treatments for ankle lesions ranging from osteochondral lesions of the talus (OLT) to osteoarthritis (OA). Methods A systematic review and a meta-analysis were performed on PubMed, Embase, and Cochrane Library in March 2020. Safety was evaluated through the reported side effects and effectiveness through the scores used. The quality of the studies was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool and the Downs and Black checklist. For each outcome, the quality of evidence was graded according to GRADE guidelines. Results Twenty-four studies (21 for OA, 3 for OLT) were included on hyaluronic acid (HA), platelet-rich plasma (PRP), saline, methylprednisolone, botulinum toxin type A (BoNT-A), mesenchymal stem cells (MSCs), and prolotherapy. No severe adverse events were reported. For OLT, a comparison was possible between HA and PRP showing no significant difference. For ankle OA, a significant difference favouring HA versus saline was documented at six months (p < 0.001). The GRADE level of evidence was very low. Conclusion This meta-analysis supports the safety of intra-articular treatment for ankle OA and OLT, while only a very low evidence supports the efficacy of HA in terms of better results versus placebo for the treatment of ankle OA, and other conclusions are hindered by the scarcity of the available literature. This urges further and stronger trials to specifically investigate potential and limitations of these different injective approaches for the treatment of OLT and ankle OA.Keywords Ankle . Intra-articular . Osteoarthritis . Osteochondral lesions of the talus (OLT) . Hyaluronic acid (HA) . Platelet-rich plasma (PRP)

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Release kinetic of pro- and anti-inflammatory biomolecules from platelet-rich plasma and functional study on osteoarthritis synovial fibroblasts

Cited by 21 publications

References 54 publications

Intra-articular injections of platelet-rich plasma in symptomatic knee osteoarthritis: a consensus statement from French-speaking experts

Intra-articular injections of platelet-rich plasma in symptomatic knee osteoarthritis: a consensus statement from French-speaking experts

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

Evidence on ankle injections for osteochondral lesions and osteoarthritis: a systematic review and meta-analysis

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