PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials

Filardo, Giuseppe; Previtali, Davide; Napoli, Francesca; Candrian, Christian; Zaffagnini, Stefano; Grassi, Alberto

doi:10.1177/1947603520931170

Cited by 176 publications

(133 citation statements)

References 79 publications

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“…PRP has shown a very good promise as an agent of tissue repair and regeneration. Most of the studies involving the use of PRP point towards some improvement in pain and function but lack proper documentation and analysis [12][13][14][15]. Table 1.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

Rai

Singh

Somashekharappa

et al. 2021

SICOT-J

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Objective: PRP is produced by centrifugation of whole blood containing highly concentrated platelets, associated growth factors, and other bioactive agents which has been shown to provide some symptomatic relief in early knee osteoarthritis (OA). The principal objective of our study was to evaluate the effectiveness and safety of standardized intra-articular injection of autologous PRP in early osteoarthritis knee. Methods: A total of 98 eligible symptomatic patients received two injections of standardized PRP 3 weeks apart. Clinical outcomes were evaluated using the VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, 6 months, and 1 year after treatment. Secondary objectives were safety (side effects), and the effect of PRP on the different grades of knee degeneration. Results: There was a statistically significant improvement in mean VAS and WOMAC scores at 6 weeks, 3 months, 6 months, and slight loss of improvement at 1 year follow-up. There was also a correlation between the degree of degeneration and improvement in the mean scores. The decrease in mean pain score is more in grades 1 and 2 (early OA) than in grade 3. The intraarticular injection is safe, with no major complications. Conclusion: PRP is a safe and effective biological regenerative therapy for early OA Knees. It provides a significant clinical improvement in patients with some loss of improvement with time. More studies will be needed to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

Rai

Singh

Somashekharappa

et al. 2021

SICOT-J

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“…However, the use of PRP for symptomatic tendinopathy is controversial, with mixed results reported. Animal studies generally show histologic improvement following PRP infiltration for tendinopathy (181). These studies showed that mechanical loading is regenerative to tendons, and the load is synergistic with PRP injections for tendon healing.…”

Section: Combining Prp With Rehabilitationmentioning

confidence: 93%

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Everts¹,

Onishi²,

Jayaram³

et al. 2020

Preprint

163

120

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Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

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“…PRP treatment involves injecting concentrated platelets in the local tissue milieu to modulate pain and foster tissue repair [ 197 , 198 ]. The strongest clinical evidence exists in knee OA.…”

Section: Combining Platelet-rich Plasma Applications With Rehabilmentioning

confidence: 99%

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Everts

Onishi²,

Jayaram

et al. 2020

IJMS

550

319

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Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

show abstract

PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials

Cited by 176 publications

References 79 publications

Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

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