Efficacy of adjuvant treatment for fracture nonunion/delayed union: a network meta-analysis of randomized controlled trials

Yang, Jing; Zhang, Xiangmin; Liang, Wangbo; Chen, Guo; Ma, Yanbo; Zhou, Yonghua; Rong, Fen; Jiang, Kaichang

doi:10.1186/s12891-022-05407-5

Cited by 11 publications

(4 citation statements)

References 56 publications

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“…Yang et al, (2022) 39 in a network meta-analysis of randomized-controlled studies regarding the efficacy of the various available adjuvant therapies for the treatment of delayed unions and non-unions of fractures concluded that: 1) Bone marrow aspirate in combination with PRP and autologous cancellous bone have the potential to improve the healing rate, 2) Low intensity pulsed ultrasonography intervention shorten the healing time significantly and, 3) Electromagnetic field and extracorporeal shock wave therapy are associated with high risk of adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…Researchers suggest that the inconsistent effects of PRP on fracture healing may be due to various factors, including the preparation and activation method, concentration, site of administration, and type of fracture fixation 38 . In a recent network metaanalysis of randomized-controlled studies regarding the efficacy of the various available adjuvant therapies for the treatment of delayed unions and non-unions of fractures, Yang et al (2022) 39 concluded that bone marrow aspirate in combination with PRP and autologous cancellous bone have the potential to improve the healing rate, while low intensity pulsed ultrasonography intervention can shorten the healing time significantly. On the other hand, electromagnetic field and extracorporeal shock wave therapy are associated with high risks of adverse effects.…”

Section: Discussionmentioning

confidence: 99%

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A Review of the Role of Platelet-Rich Plasma in Fracture Healing

Ntalaperas,

Nikolaou

2023

JRPMS

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Fractures are a global health concern affecting millions of people annually, with the elderly being more susceptible. Although the majority of patients with fractures recover, approximately 10% of them, particularly the elderly, encounter difficulties in the healing process. Platelet-rich plasma (PRP) is a concentrated solution of platelets that contain numerous growth factors and other bioactive molecules, which make it effective in promoting tissue repair and regeneration. Additionally, PRP injections can enhance local blood flow and stimulate angiogenesis, which can contribute to better healing outcomes in the treated area. Recent literature reviews suggest that PRP has clinical efficacy in accelerating the fracture healing process, treating delayed unions and non-unions, and serving as an adjuvant method when used alone or in combination with surgical procedures. However, the clinical heterogeneity of the available studies warrants the need for further research with high-quality randomized controlled trials involving a large number of participants to provide appropriate guidelines for PRP use. The present narrative review aims to present the recent data in relation to the effectiveness of the use of the PRP injection technique in the process of bone fracture healing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Review of the Role of Platelet-Rich Plasma in Fracture Healing

Ntalaperas,

Nikolaou

2023

JRPMS

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“…A recent systematic review and meta-analysis on 10 randomised controlled trials (RCT) with 652 patients identified PRP as being able to reduce fracture healing time, enhance bone mineral density and decrease the risk of revision surgeries [ 86 ]. Nonetheless, due to the absence of randomised controlled trials (RCTs) evaluating the effectiveness of PRP in treating fracture non-union, its incorporation into the standard surgical management of fracture non-unions has not yet been realised [ 87 ].…”

Section: Platelet-rich Plasma (Prp)mentioning

confidence: 99%

Anti-Aging Potential of Platelet Rich Plasma (PRP): Evidence from Osteoarthritis (OA) and Applications in Senescence and Inflammaging

Vun,

Iqbal,

Jones

et al. 2023

Bioengineering

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Aging and age-related changes impact the quality of life (QOL) in elderly with a decline in movement, cognitive abilities and increased vulnerability towards age-related diseases (ARDs). One of the key contributing factors is cellular senescence, which is triggered majorly by DNA damage response (DDR). Accumulated senescent cells (SCs) release senescence-associated secretory phenotype (SASP), which includes pro-inflammatory cytokines, matrix metalloproteinases (MMPs), lipids and chemokines that are detrimental to the surrounding tissues. Chronic low-grade inflammation in the elderly or inflammaging is also associated with cellular senescence and contributes to ARDs. The literature from the last decade has recorded the use of platelet rich plasma (PRP) to combat senescence and inflammation, alleviate pain as an analgesic, promote tissue regeneration and repair via angiogenesis—all of which are essential in anti-aging and tissue regeneration strategies. In the last few decades, platelet-rich plasma (PRP) has been used as an anti-aging treatment option for dermatological applications and with great interest in tissue regeneration for orthopaedic applications, especially in osteoarthritis (OA). In this exploration, we connect the intricate relationship between aging, ARDs, senescence and inflammation and delve into PRP’s properties and potential benefits. We conduct a comparative review of the current literature on PRP treatment strategies, paying particular attention to the instances strongly linked to ARDs. Finally, upon careful consideration of this interconnected information in the context of aging, we suggest a prospective role for PRP in developing anti-aging therapeutic strategies.

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“…Numerous techniques have been proposed for the treatment of femoral shaft pseudarthrosis, including electromagnetic fields [7], low-intensity ultrasound [8], extracorporeal shock wave therapy (ESWT) [9], external fixators [10] and osteosynthesis with plate and screws [11]. Moreover, several studies have reported positive results after the treatment of non-union of the femur with single or double plate fixation combined with autologous bone graft [12,13].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Femoral Shaft Pseudarthrosis, Case Series and Medico-Legal Implications

Basile

Fozzato

Petrucci

et al. 2022

JCM

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Pseudarthrosis (PSA) is a possible complication of femoral shaft fracture treatment. It is often associated with reduced bone quality and can, therefore, adversely affect quality of life. Its treatment poses a major challenge for orthopaedic surgeons. Several authors have set forth different surgical approaches for the treatment of pseudarthrosis, such as internal fixation with plate and screws, replacement of an intramedullary nail or prosthetic replacement. In cases associated with bone loss, osteopenia, or comminution of fracture fragments, autologous or homologous bone grafts may also be used. The chronic outcomes of the surgical treatment of femoral shaft pseudarthrosis, even when consolidation is achieved, are linked to disabling sequelae of clinical-functional relevance, deserving an adequate medico-legal evaluation. The purpose of this retrospective study is to analyse a clinical case series of patients treated for atrophic femoral shaft pseudarthrosis at the IRCCS Orthopaedic Institute Galeazzi, Milan, Italy, from 2014 to 2020 and their orthopaedic-traumatological and medico-legal implications.

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Efficacy of adjuvant treatment for fracture nonunion/delayed union: a network meta-analysis of randomized controlled trials

Cited by 11 publications

References 56 publications

A Review of the Role of Platelet-Rich Plasma in Fracture Healing

A Review of the Role of Platelet-Rich Plasma in Fracture Healing

Anti-Aging Potential of Platelet Rich Plasma (PRP): Evidence from Osteoarthritis (OA) and Applications in Senescence and Inflammaging

Treatment of Femoral Shaft Pseudarthrosis, Case Series and Medico-Legal Implications

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