Injectable orthobiologics in professional football (soccer) players: a systematic review

Fermín, Theodorakys Marín; Papakostas, Emmanouil; Macchiarola, Luca; Zampeli, Frantzeska; Kalifis, Georgios; Zikria, Bashir A.; KHOURY, Miguel; D’Hooghe, Pieter

doi:10.1016/j.jcjp.2022.100050

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…2,3 Our team conducted a systematic review on injectable orthobiologics in professional football players, revealing that less than 10% of the studies reported platelet-rich plasma characteristics. 4 In that sense, our commitment to the scientific community was to ensure adequate reporting of our platelet-rich plasma (as a control group) and adipose-derived stromal cells preparation and treatment following the DOSES guidelines 5 and allowing adequate reproducibility of our study and outcomes. In fact, we are promoting adherence to these reporting guidelines as part of manuscript submissions by editors and reviewers to improve the overall quality of the studies.…”

Section: Dear Editor and Colleaguesmentioning

confidence: 99%

Response to Comments by Zhao et al. Regarding “Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma”

Khoury,

Chamari,

Tabben

et al. 2023

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Section: Dear Editor and Colleaguesmentioning

confidence: 99%

Response to Comments by Zhao et al. Regarding “Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma”

Khoury,

Chamari,

Tabben

et al. 2023

CARTILAGE

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“…9,10 Several systematic reviews have shown that less than 10% of orthobiologics studies adequately report the implemented platelet-rich plasma preparation protocol, limiting their reproducibility and compromising their scientific value. 2,3,7 Thus, journals and editors can play a critical role in evidence quality improvement by requesting mandatory adherence to reporting guidelines in the submission and reviewing process. 8 The orthopaedic scientific community still faces wide heterogeneity in platelet-rich plasma products, and building high-quality evidence from new studies is paramount.…”

mentioning

confidence: 99%

Improving Injectable Orthobiologics Reporting Guidelines Adherence: Letter to the Editor

Fermín,

Laupheimer,

Khoury

2023

Am J Sports Med

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We have read with great interest the article ''Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis'' by Paget et al,12 published in the American Journal of Sports Medicine.The authors have made a remarkable effort in conducting a randomized controlled trial on the use of platelet-rich plasma in ankle osteoarthritis in 98 patients, finding no improvement in ankle symptoms and function over 52 weeks compared with placebo injections.The body of evidence on platelet-rich plasma and other injectable orthobiologics is still growing. However, the reporting quality of these interventions remains poor despite the many guidelines developed by experts. 9,10 Several systematic reviews have shown that less than 10% of orthobiologics studies adequately report the implemented platelet-rich plasma preparation protocol, limiting their reproducibility and compromising their scientific value. 2,3,7 Thus, journals and editors can play a critical role in evidence quality improvement by requesting mandatory adherence to reporting guidelines in the submission and reviewing process. 8 The orthopaedic scientific community still faces wide heterogeneity in platelet-rich plasma products, and building high-quality evidence from new studies is paramount. 5 In that sense, quantifying absolute platelet and leukocyte dose seems to be a key factor in improving patient-reported outcomes. 1,4,6 Given this wide heterogeneity of platelet-rich plasma, claiming it does not work seems unfair in this context. Furthermore, for the flawless methodological quality of the present study, we kindly ask the authors for adequate reporting of the injected platelet-rich plasma product using the available guidelines. This information will contribute to abandoning this specific product, system, and protocol, which has been proven ineffective. 11,12 The present study is fundamental in moving the research toward other platelet-rich plasma products with different platelet doses and protocols rather than discouraging platelet-rich plasma implementation.

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Platelet‐rich plasma intra‐articular knee injections from open preparation techniques do not pose a higher risk of joint infection: A systematic review of 91 randomized controlled trials and 5914 injections

Alazzeh,

Naseh,

Vasiliadis

et al. 2024

J. exp. orthop.

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PurposeTo compare the infection rate of intraarticular platelet‐rich plasma (PRP) knee injections between open and closed techniques in randomized controlled trials (RCTs) published in the last decade.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, PubMed, Scopus and Virtual Health Library were accessed in October 2022 using the terms ‘platelet‐rich plasma’, ‘PRP’, ‘knee’ and ‘tibiofemoral’ alone and in combination with Boolean operators AND/OR. RCTs published during the last 10 years evaluating PRP intra‐articular knee injections were considered eligible. Studies were excluded if the kit/preparation technique was not described. Data were presented using individual studies' absolute values, totals, and pooled percentages. Publication bias was assessed using the ROBIS tool.ResultsNinety‐one studies met the predetermined eligibility criteria. Forty‐one implemented a closed technique, while 50 were open. All studies implementing a closed technique disclosed their commercial kits. Only 16 studies (17.58%) failed to report joint infections. Among the studies reporting joint infections as outcomes, 30 implemented a closed technique with 1195 patients, 1921 intra‐articular knee injections and 95.44% of patient follow‐up. On the other hand, 45 of them implemented an open technique with 2290 patients, 3993 intra‐articular knee injections and 97.07% of patient follow‐up. No patient had a joint infection among the included studies. Thirty‐three studies prepared their PRP in controlled environments (36.26%). Most studies did not report where the preparation occurred (48.35%). Only twelve studies disclosed using laminar flow during preparation (13.19%). The infection rate for both techniques was 0 per 1000 knee injections.ConclusionOpen PRP preparation techniques do not pose a higher risk of joint infection and can lower manufacturing costs when appropriate facilities are available. However, PRP preparation setting and laminar flow implementation data are deficient, and minimal requirements for good manufacturing practices demand further studies while adhering to local and regional regulations.Level of EvidenceLevel I, systematic review of RCTs.

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Injectable orthobiologics in professional football (soccer) players: a systematic review

Cited by 5 publications

References 38 publications

Response to Comments by Zhao et al. Regarding “Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma”

Response to Comments by Zhao et al. Regarding “Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma”

Improving Injectable Orthobiologics Reporting Guidelines Adherence: Letter to the Editor

Platelet‐rich plasma intra‐articular knee injections from open preparation techniques do not pose a higher risk of joint infection: A systematic review of 91 randomized controlled trials and 5914 injections

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