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PRP
has been found to effectively alleviate pain and provide functional improvement
even after 12 months.
Platelet-Rich Plasma (PRP) is plasma with many more
platelets than what is normally found in blood where the concentration of
growth factors can be 5 to 10 times higher (or richer) than standard. Many
clinical studies have revealed that PRP injections have ameliorated function
and diminished pain to various ailments, like elbow, wrist, shoulder, hip,
knee, and ankle tendonosis. The researchers here have used meta-analysis mthods
to estimate the efficacy and safety of platelet-rich plasma (PRP) injections
for the treatment knee of osteoarthritis (OA).
A systematic literature search was implemented in PubMed,
Embase, Scopus, and the Cochrane database through April 2016. This was done to
reveal Level I randomized controlled trials that assessed the clinical efficacy
of PRP versus control treatments for knee OA. The primary outcomes depicted
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and
function scores. The primary outcomes were differentiated with their minimum
clinically important differences (MCID)—defined as the smallest difference recognised
as significant by the average patient.
A total of 1069 patients in 10 randomized controlled trials
were considered. As per the analysis at 6 months postinjection, PRP and
hyaluronic acid (HA) had similar effects with respect to pain relief (WOMAC pain
score) and functional advancement (WOMAC function score, WOMAC total score,
International Knee Documentation Committee score, Lequesne score). PRP was
concerned with notably better pain relief (WOMAC pain score, mean
difference −2.83, 95% confidence interval [CI] −4.26
to −1.39, P = .0001) and functional improvement (WOMAC function
score, mean difference −12.53, 95% CI −14.58 to −10.47, P < .00001;
WOMAC total score, International Knee Documentation Committee score, Lequesne
score, standardized mean difference 1.05, 95% CI 0.21-1.89, P = .01) than HA at
12 months postinjection. Also, the effect sizes of WOMAC pain and function
scores at 12 months transcended the MCID (−0.79 for WOMAC pain
and −2.85 for WOMAC function score). The PRP was more effective for pain
relief (WOMAC pain score) and functional improvement (WOMAC function score) at
6 months and 12 months postinjection, and the effect sizes of WOMAC
pain and function scores at 6 months and 12 months surpassed the MCID
as compared with saline. PRP did not escalate the risk of adverse events
compared with HA and saline.
The evidences obtained from this study specify that,
intra-articular PRP injection may have more advantage in pain relief and
functional improvement in patients with symptomatic knee OA as compared with HA
and saline at 1 year postinjection.
Arthroscopy
Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials
Yahui Grace Chiu, Christopher T. Ritchlin
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