Scientific Evidence of Platelet-Rich Plasma for Orthopedic Conditions: Basic Science to Clinical Research and Application

Wu, Peter I-Kung; Diaz, Robert; Borg‐Stein, Joanne

doi:10.1891/9781617052897.0007

Cited by 1 publication

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“…Traditional nonoperative musculoskeletal medicine, including the use of anti-inflammatories and targeted exercises, often fall short. 1 In recent years there has been a rapid increase in the use of biologics, such as platelet-rich plasma (PRP) injections, for a variety of musculoskeletal injures, including those attributed to rotator cuff injuries. 2 This interest in PRP is expected to continue, as the global market for PRP was valued at $195.2 million in 2017 and is projected to expand at a compound annual growth rate of 12% yearly reaching $543.5 million by 2026.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review and Meta‐Analysis of Nonoperative Platelet‐Rich Plasma Shoulder Injections for Rotator Cuff Pathology

Lui

Shih

Yim

et al. 2021

PM&R

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Background: Platelet-rich plasma (PRP) injections have been introduced to augment the recovery of patients with shoulder pathology. Although multiple studies have been published, no large-scale trials or meta-analyses have assessed the efficacy of nonoperative shoulder PRP injection. Objective: To assess the efficacy of nonoperative PRP shoulder injection in rotator cuff pathology for pain as measured by the visual analog scale (VAS) and range of motion (ROM). Design: Two authors independently screened the Medline and Cochrane databases to include prospective studies that reported VAS and ROM outcomes for nonoperative shoulder PRP injections for rotator cuff pathology. Study quality was assessed using the revised Cochrane Collaboration risk-of-bias tool and modified Downs and Black checklist. Subsequent meta-analysis was performed to determine the effect of nonoperative PRP injections on pain and ROM 3 to 12 months after intervention. Results: Six studies met systematic review criteria. The included studies used different PRP formulations (concentration, leukocyte count), injection protocols (approach, injection number), and varied study designs. Three studies concluded that PRP provided no significant benefit for pain and ROM when compared to physical therapy. Within-group meta-analysis of six fairly heterogeneous studies (I 2 77.8%) demonstrated a statistically significant (P < .001) improvement in pain 3 to 12 months after PRP injection. Within-group meta-analysis for four studies for shoulder flexion and abduction was found to be too heterogeneous to derive meaningful results. Conclusion:There is a limited quantity of high-quality studies that assess the efficacy of nonoperative PRP shoulder injection for pain and ROM. Systematic review of PRP injections did not demonstrate an improvement in pain or ROM compared to physical therapy. Although within-group meta-analysis of nonoperative PRP statistically showed that nonoperative PRP improved pain, the lack of adequate negative controls precludes the ability to conclude whether improvements were due to natural recovery or nonoperative PRP.

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Section: Introductionmentioning

confidence: 99%