Platelet-activated serum might have a therapeutic effect on damaged articular cartilage

Yokoyama, Munetaka; Sato, Masato; Tani, Yoshiki; Yokoyama, Miyuki; Kokubo, Mami; Yamato, Masayuki; Okano, Teruo; Mochida, Joji

doi:10.1002/term.2238

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…PRP, a concentrated platelet obtained by centrifugation of peripheral blood, consists mainly of platelet-associated leukocyte aggregation, high-density fibrous network structures, platelet-derived growth factors, transforming growth factor-beta, insulin-like growth factor, epidermal growth factor and vascular endothelial growth factor. [ 34 , 35 ] PRP releases a large number of growth factors to promote cell proliferation and regulate cell behavior and antiinflammatory factors to reduce local inflammation. [ 36 ] In recent years, its role in cartilage injury repair has drew increasing attention.…”

Section: Discussionmentioning

confidence: 99%

Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials

et al. 2022

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Background: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Therefore, a meta-analysis was conducted to determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury.Methods: PubMed, EMBASE, Cochrane Library Databases, clinicaltrials.gov, and the CNKI Database were searched from their inception till December 1, 2020. The RCTs reporting the outcomes of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events were included. The risk of bias was assessed using Cochrane collaborative tools. The simulated results were expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed.Results: The meta-analysis included 8 RCTs and 431 participants. Compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P = .002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 3.06, P < .0001, 95%CI: 1.70-4.42) of meniscus injury, but the PRP showed no benefit in improving the healing rate of meniscus repair (RR: 1.22, P = .06, 95%CI: 0.99-1.51). No serious adverse events were reported in any study.Conclusions: PRP is safe and effective in improving the effect of meniscus repair as augment. High quality RCTs with long follow-up and definitive results are needed in the future to confirm the use and efficacy of PRP in meniscus tears.

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Section: Discussionmentioning

confidence: 99%

Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials

et al. 2022

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“…PRP mainly includes platelet-related leukocyte aggregates, high-density fibrous network structure, platelet-derived growth factor, transforming growth factor-β, insulin-like growth factor, epidermal growth factor, and vascular endothelial growth factor. 41–42 PRP can release a large number of anti-inflammatory factors to reduce local inflammation and can release a variety of growth factors to promote cell proliferation and regulate cell behavior. 43 In vitro studies have shown that chondrocytes and PRP exhibit a significant dose- and time-dependent increase in cell number and metabolic cell activity.…”

Section: Discussionmentioning

confidence: 99%

Can platelet-rich plasma enhance the effect of meniscus repair? A meta-analysis of randomized controlled trials Platelet-rich plasma and meniscus repair

Xie

Xing

Wang

et al. 2022

J Orthop Surg (Hong Kong)

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Background Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Purpose To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. Methods By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov , and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), the pain of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, the International Knee Documentation Committee (IKDC), healing rate, and adverse events. The risk of bias is assessed using Cochrane’s collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity were performed. Results The meta-analysis included 9 RCTs and 345 patients. In general, compared with the control group, used of PRP during meniscus surgery significantly improved the pain (SMD: -0.95, p < 0.00001,95% CI: -1.22 to -0.69, I2 = 42%) and knee joint function (SMD: 1.00, p = 0.01.95% CI: 0.22 to 1.79, I2 = 89%) of patients with meniscus injury at 6 months after treatment. However, both PRP and non-PRP showed improvements in the pain and knee joint function, with no significant difference between the groups at 1 months and beyond 12 months. The PRP enhancement technique showed benefit in improving the cure rate of meniscus repair (RR:1.44; p < 0.0001, 95% CI: 1.20–1.73). No serious adverse events were reported in any study. Conclusion As an enhancement program for meniscus repair, PRP is worthy of further consideration in improving the function and pain of patients during the mid-term follow-up after surgery, and PRP can further improve the healing rate of meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.

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“…Upon activation, platelet alpha-granules secrete high concentrations of GFs, such as transforming growth factor β (TGF-β) and platelet-derived growth factor (PDGF). 55 TGF-β serves as one of the most important GFs involved in cartilage regeneration by increasing chondrocyte phenotype expression and matrix deposition, 10,47 promoting MSC chondrogenic differentiation, 37 and counteracting the suppressive effects of inflammatory mediators on cartilage-specific macromolecule synthesis. 40 PDGF favors the maintenance of hyaline-like chondrogenic phenotype, increases chondrocyte proliferation and the synthesis of proteoglycans, and is a potent chemotactic factor for all cells of mesenchymal origin.…”

Section: Discussionmentioning

confidence: 99%

Platelet-Rich Plasma Augmentation to Microfracture Provides a Limited Benefit for the Treatment of Cartilage Lesions: A Meta-analysis

Boffa

Previtali

Altamura

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Microfracture is the most common first-line option for the treatment of small chondral lesions, although increasing evidence shows that the clinical benefit of microfracture decreases over time. Platelet-rich plasma (PRP) has been suggested as an effective biological augmentation to improve clinical outcomes after microfracture. Purpose: To evaluate the clinical evidence regarding the application of PRP, documenting safety and efficacy of this augmentation technique to improve microfracture for the treatment of cartilage lesions. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed in PubMed, EBSCOhost database, and the Cochrane Library to identify comparative studies evaluating the clinical efficacy of PRP augmentation to microfracture. A meta-analysis was performed on articles that reported results for visual analog scale (VAS) for pain, International Knee Documentation Committee (IKDC), and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Risk of bias was documented through use of the Cochrane Collaboration Risk of Bias 2.0 and Risk of Bias in Non-randomized Studies of Interventions assessment tools. The quality assessment was performed according to the Grading of Recommendations Assessment, Development and Evaluation guidelines. Results: A total of 7 studies met the inclusion criteria and were included in the meta-analysis: 4 randomized controlled trials, 2 prospective comparative studies, and 1 retrospective comparative study, for a total of 234 patients. Of the 7 studies included, 4 studies evaluated the effects of PRP treatment in the knee, and 3 studies evaluated effects in the ankle. The analysis of all scores showed a difference favoring PRP treatment in knees (VAS, P = .002 and P < .001 at 12 and 24 months, respectively; IKDC, P < .001 at both follow-up points) and ankles (both VAS and AOFAS, P < .001 at 12 months). The improvement offered by PRP did not reach the minimal clinically important difference (MCID). Conclusion: PRP provided an improvement to microfracture in knees and ankles at short-term follow-up. However, this improvement did not reach the MCID, and thus it was not clinically perceivable by the patients. Moreover, the overall low evidence and the paucity of high-level studies indicate further research is needed to confirm the potential of PRP augmentation to microfracture for the treatment of cartilage lesions.

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Platelet-activated serum might have a therapeutic effect on damaged articular cartilage

Cited by 10 publications

References 40 publications

Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials

Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials

Can platelet-rich plasma enhance the effect of meniscus repair? A meta-analysis of randomized controlled trials Platelet-rich plasma and meniscus repair

Platelet-Rich Plasma Augmentation to Microfracture Provides a Limited Benefit for the Treatment of Cartilage Lesions: A Meta-analysis

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