Reporting in clinical studies on platelet-rich plasma therapy among all medical specialties: A systematic review of Level I and II studies

Abstract

Background The clinical practice of platelet-rich plasma (PRP) therapy has grown significantly in recent years in multiple medical specialties. However, comparisons of PRP studies across medical fields remain challenging because of inconsistent reporting of protocols and characterization of the PRP being administered. The purpose of this systematic review was to determine the quantity of level I/II studies within each medical specialty and compare the level of study reporting across medical fields. Methods The Cochrane Database, PubMed, and EMBASE databases were queried for level I/II clinical studies on PRP injections across all medical specialties. From these studies, data including condition treated, PRP processing and characterization, delivery, control group, and assessed outcomes were collected. Results A total of 132 studies met the inclusion and exclusion criteria and involved 28 different conditions across 8 specialties (cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK), neurology, oral maxillofacial surgery, ophthalmology, and plastic surgery). Studies on PRP for MSK injuries made up the majority of the studies (74%), with knee osteoarthritis and tendinopathy being most commonly studied. Of the 132 studies, only 44 (33%) characterized the composition of PRP used, and only 23 (17%) reported the leukocyte component. MSK studies were more likely to use patient-reported outcome measures to assess outcomes, while studies from other specialties were more likely to use clinician- or imaging-based objective outcomes. Overall, 61% of the studies found PRP to be favorable over control treatment, with no difference in favorable reporting between MSK and other medical specialties. Conclusions The majority of level I/II clinical studies investigating PRP therapy across all medical specialties have been conducted for MSK injuries with knee osteoarthritis and tendinopathy being the most commonly studied conditions. Inconsistent reporting of PRP composition exists among all studies in medicine. Rigorous reporting in human clinical studies across all medical specialties is crucial for evaluating the effects of PRP and moving towards disease-specific and individualized treatment.

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

“…The exact mechanism of PRP action remains unclear and is even sometimes questioned [ 61 , 62 ]. It is speculated that PRP enhances wound healing because of the presence of various cytokines, including growth factors.…”

“…PRP also presents hemostatic properties. Moreover, it may indirectly activate macrophages via serotonin and histamine release, which increase the capillary permeability, consequently leading to the inflammatory cells’ access [ 56 , 61 , 62 ]. Finally, PRP in in vitro studies has been found to stimulate the chondrocytes to engineer the cartilage and the biosynthesis of collagen and proteoglycans [ 63 ].…”

“…PRP has been used in various medical specialties, including oral and maxillofacial surgery, dermatology, ophthalmology, cardiothoracic surgery and plastic surgery, but also in the treatment of musculoskeletal disorders, including TMJ OA [ 61 , 64 , 65 ].…”

The Combined Use of Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells Promotes Healing. A Review of Experimental Models and Future Perspectives

“…PRP has been the subject of extensive research in the medical fields of orthopaedics, plastic surgery, and maxillofacial surgery, where it has multiple clinical applications [16]. Recent research focuses on neural regeneration and chronic pain [17].…”

The Non-Haemostatic Response of Platelets to Stress: An Actor of the Inflammatory Environment on Regenerative Medicine?

“…Recently, Jaron Nazaroff et al published ( 12 ) a systematic review and Meta-Analysis (Cochrane Database, PubMed, and EMBASE databases) for level I/II clinical studies on PRP injections across all medical specialties [cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK), neurology, oral maxillofacial surgery, ophthalmology, and plastic surgery]. Generally, 61% of the studies found PRP to be favorable over control treatment, with no difference across medical specialties.…”