Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma

Evans, Adam; Ibrahim, Maryo M.; Pope, Rand W.; Mwangi, James M.; Botros, Mina; Johnson, Shepard P.; Kassis, Salam Al

doi:10.1016/j.jor.2020.01.037

Cited by 15 publications

(9 citation statements)

References 67 publications

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“…PRP is an autologous blood product derived by centrifugation of the whole blood and characterized by a high concentration of platelets above the normal levels ( Marx, 2001 ). Many protocols for preparing PRP exist; one possibility is to include the leukocyte-containing buffy coat obtaining the so-called leukocyte-rich PRP, while another one is to exclude leukocytes resulting in the so-called leukocyte-poor PRP which is the standard PRP preparation for OA ( Evans et al, 2020 ). Its use for the treatment of OA of large joints, particularly knee and hip OA, has emerged since the first decade of twenty-first century.…”

Section: Resultsmentioning

confidence: 99%

New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going?

et al. 2021

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Thumb-base osteoarthritis (TBOA) is a common condition, mostly affecting post-menopausal women, often inducing a significant impact on quality of life and hand functionality. Despite its high prevalence and disability, the therapeutic options in TBOA are still limited and few have been investigated. Among the pharmacological strategies for TBOA management, it would be worthwhile to mention the injection-based therapy. Unfortunately, its efficacy is still the subject of debate. Indeed, the 2018 update of the European League Against Rheumatism (EULAR) recommendations for the management of hand osteoarthritis (OA) stated that intra-articular (IA) injections of glucocorticoids should not generally be used, but may be considered in patients with painful interphalangeal joints, without any specific mention to the TBOA localization and to other widely used injections agents, such as hyaluronic acid (HA) and platelet-rich plasma (PRP). Even American College of Rheumatology (ACR) experts conditionally recommended against IA HA injections in patients with TBOA, while they conditionally encouraged IA glucocorticoids. However, the recommendations from international scientific societies don’t often reflect the clinical practice of physicians who routinely take care of TBOA patients; indeed, corticosteroid injections are a mainstay of therapy in OA, especially for patients with pain refractory to oral treatments and HA is considered as a safe and effective treatment. The discrepancy with the literature data is due to the great heterogeneity of the clinical trials published in this field: indeed, the studies differ for methodology and protocol design, outcome measures, treatment (different formulations of HA, steroids, PRP, and schedules) and times of follow-up. For these reasons, the current review will provide deep insight into the injection-based therapy for TBOA, with particular attention to the different employed agents, the variety of the schedule treatments, the most common injection techniques, and the obtained results in terms of efficacy and safety. In depth, we will discuss the available literature on corticosteroids and HA injections for TBOA and the emerging role of PRP and other injection agents for this condition. We will consider in our analysis not only randomized controlled trials (RCTs) but also recent pilot or retrospective studies trying to step forward to identify satisfactory management strategies for TBOA.

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Section: Resultsmentioning

confidence: 99%

New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going?

et al. 2021

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“…These outcomes may be affected by publication bias and the designs of the included studies (randomized, blinded) is not representative for the studies registered in clintrials.gov ( Table 3 ). Finally, few studies for the efficacy of PRP treatment of OA in joints other than knees have been performed, precluding conclusions on its efficacy there [ 75 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

“…Clearly this field is upcoming, but the applied preparation, dose, and dose interval vary, precluding conclusions on effectiveness. Consequently, the efficacy of PRP in OA is yet to be confirmed in high-quality, long-term follow-up studies [ 73 , 75 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

Challenges and opportunities of pharmacological interventions for osteoarthritis: A review of current clinical trials and developments

Vrouwe

Burggraaf

Kloppenburg

et al. 2021

Osteoarthritis and Cartilage Open

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“…In recent years, there has been significant interest in exploiting PRP in regenerative medicine. Particular attention has been paid to musculoskeletal ( Scully et al , 2019 , 2020 ), oral-maxillofacial ( Xu et al , 2020 ) and osteoarthritis ( Evans et al , 2020 ) applications to name but a few. For a more comprehensive account, the reader is referred to a review ( Scully et al , 2018 ).…”

Section: Platelets and Platelet-rich Plasmamentioning

confidence: 99%

Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon?

2021

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The prospect of ovarian rejuvenation offers the tantalising prospect of treating age-related declines in fertility or in pathological conditions such as premature ovarian failure. The concept of ovarian rejuvenation was invigorated by the indication of the existence of oogonial stem cells (OSCs), which have been shown experimentally to have the ability to differentiate into functional follicles and generate oocytes; however, their clinical potential remains unknown.  Furthermore, there is now growing interest in performing ovarian rejuvenation in situ.  One proposed approach involves injecting the ovary with platelet rich plasma (PRP). PRP is a component of blood that remains after the in vitro removal of red and white blood cells.  It contains blood platelets, tiny anucleate cells of the blood, which are responsible for forming a thrombus to prevent bleeding.  In addition, PRP contains an array of cytokines and growth factors, as well as a number of small molecules.  The utility of PRP has been investigated in a range of regenerative medicine approaches and has been shown to induce differentiation of a range of cell types, presumably through the action of cytokines.  A handful of case reports have described the use of PRP injections into the ovary in the human, and while these clinical data report promising results, knowledge on the mechanisms and safety of PRP injections into the ovary remain limited.  In this article, we summarise some of the physiological detail of platelets and PRP, before reviewing the existing emerging literature in this area. We then propose potential mechanisms by which PRP may be eliciting any effects before reflecting on some considerations for future studies in the area. Importantly, on the basis of our existing knowledge, we suggest that immediate use of PRP in clinical applications is perhaps premature and further fundamental and clinical research on the nature of ovarian insufficiency, as well as the mechanism by which PRP may act on the ovary, is needed to fully understand this promising development.

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Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma

Cited by 15 publications

References 67 publications

New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going?

New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going?

Challenges and opportunities of pharmacological interventions for osteoarthritis: A review of current clinical trials and developments

Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon?

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