Should Platelet-Rich Plasma or Stem Cell Therapy Be Used to Treat Osteoarthritis?

Rashid, Hani; Kwoh, C. Kent

doi:10.1016/j.rdc.2019.04.010

Cited by 14 publications

(7 citation statements)

References 49 publications

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“…Meanwhile, the treatment of osteoarthritis is also one of the important research directions. In the treatment of osteoarthritis, platelet-rich plasma has the advantages of minimal invasion, economy, less complications, and less pain compared with surgical treatment [ 15 , 16 ]. Platelet-rich plasma, rich in various growth factors and cytokines, plays a crucial part in the normal expression of cartilage cells and is an important treatment measure to regulate the dynamic balance between synthetic cytokines and catabolic cytokines.…”

Section: Discussionmentioning

confidence: 99%

Effects of Different Nonsteroidal Anti-Inflammatory Drugs Combined with Platelet-Rich Plasma on Inflammatory Factor Levels in Patients with Osteoarthritis

Jiang

Zhang

Huang³

et al. 2022

Journal of Healthcare Engineering

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Objective. To investigate the effects of different nonsteroidal anti-inflammatory drugs combined with platelet-rich plasma on inflammatory factor levels in patients with osteoarthritis. Methods. The clinic data of 120 patients with osteoarthritis who were treated in our hospital (June 2019-June 2021) were retrospectively reviewed. All the patients were given platelet-rich plasma. According to the different nonsteroidal anti-inflammatory drugs the patients received, they were equalized into diclofenac sodium group, celecoxib group, and iguratimod group, with 40 cases in each group. After treatment, the patients’ clinical efficacy was compared and analyzed. Results. After treatment, the pain degrees of the patients in the three groups were gradually reduced. After 4 weeks and 8 weeks of treatment, the statistical differences in the scores of Visual Analogue Scale (VAS) were found among the three groups. Specifically, compared with the other two groups, the iguratimod group had remarkably lower VAS scores ( P < 0.05 ) and the celecoxib group had signally lower VAS scores compared with the diclofenac sodium group ( P < 0.05 ). After treatment, the inflammatory factor levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) in the diclofenac sodium group were observably higher compared with the celecoxib group ( P < 0.05 ), and the inflammatory factor levels in the celecoxib group were remarkably higher compared with the iguratimod group ( P < 0.05 ). Before treatment, no notable difference in the Lysholm scores was found among the three groups, and the patients’ knee joint function was gradually improved after treatment. To be specific, after 4 and 8 weeks of treatment, the iguratimod group had observably higher Lysholm scores compared with the other two groups ( P < 0.05 ), and the celecoxib group had signally higher Lysholm scores compared with the diclofenac sodium group ( P < 0.05 ). The iguratimod group got markedly lower Western Ontario and McMaster Universities (WOMAC) score compared with the celecoxib group ( P < 0.05 ); Compared with the diclofenac sodium group, the celecoxib group got remarkably lower WOMAC score ( P < 0.05 ). During treatment, few patients suffered from mild gastrointestinal discomfort and hepatic dysfunction in the three groups, and no other severe adverse reactions were found. No statistical difference in the total incidence of adverse reactions among the three groups was observed ( P > 0.05 ). Conclusion. The combination of nonsteroidal anti-inflammatory drugs with platelet-rich plasma can further reduce the inflammatory reactions of the patients with osteoarthritis and improve their knee joint function. Significantly, the iguratimod, with high safety, has observably better effects on inhibiting inflammatory factors and improving knee joint function compared with diclofenac sodium and celecoxib.

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Section: Discussionmentioning

confidence: 99%

Effects of Different Nonsteroidal Anti-Inflammatory Drugs Combined with Platelet-Rich Plasma on Inflammatory Factor Levels in Patients with Osteoarthritis

Jiang

Zhang

Huang³

et al. 2022

Journal of Healthcare Engineering

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“…Reproducible protocols of chondrogenesis by SC do not exist [164]. The latest review did not recommend SC therapies for knee osteoarthritis for lack of high-quality evidence [165]. Admittedly, many papers report the efficiency and relative safety of cell therapies [166,167], which is generally the case for substances with unproven effects discussed in this review.…”

Section: Stem Cells and Cell Therapiesmentioning

confidence: 96%

Scientific Papers and Patents on Substances with Unproven Effects. Part 2

Jargin

2020

DDF

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: Several examples are discussed in this review, where substances without proven effects were proposed for practical use within the scope of evidence-based medicines. The following is discussed here: generalizations of the hormesis concept and its use in support of homeopathy; phytoestrogens and soy products potentially having feminizing effects; glycosaminoglycans for the treatment of osteoarthritis and possibilities of their replacement by diet modifications; flavonoids recommended for the treatment of chronic venous insufficiency and varicose veins; acetylcysteine as a mucolytic agent and its questionable efficiency especially by an oral intake; stem cells and cell therapies. In conclusion, placebo therapies can be beneficial and ethically justifiable but it is not a sufficient reason to publish biased information. Importantly, placebo must be devoid of adverse effects, otherwise, it is named pseudo-placebo. Therapeutic methods with unproven effects should be tested in high-quality research shielded from the funding bias. Some issues discussed in this review are not entirely clear, and the arguments provided here can initiate a constructive discussion.

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“…Estos mecanismos biológicos y moleculares han demostrado ser eficientes clínicamente al aplicarse en diversas enfermedades articulares agudas y crónicas, tal es el caso del manejo de dolor e inflamación en la osteoartritis en general (Andia & Maffulli, 2013;Rashid & Kwoh, 2019), de la rodilla (Ghai et al, 2019;Glynn et al, 2018), fascitis plantar (Tiwari & Bhargava, 2013), tendinopatías degenerativas (Wesner et al, 2016), daño colateral de ligamentos (Zou et al, 2020), o su liberación (Trull-Ahuir et al, 2020) y gonartrosis (Yaradilmis et al, 2020) en particular. Es de resaltar que, en algunos casos, los tratamientos con PRP son inferiores a los tratamientos convencionales como cuando se utiliza cortisona (Tabrizi et al, 2020) (Tabla 3).…”

Section: Reumatología Traumatología Y Medicina Deportivaunclassified

Plasma rico en plaquetas como terapia autóloga en la medicina regenerativa: Revisión narrativa

Aguilar¹,

Cáceres²

2020

CTS

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En las últimas décadas, la terapia de plasma rico en plaquetas (PRP) ha despertado mucha atención en el área de la medicina regenerativa, siendo aplicada a diferentes patologías sistémicas y localizadas. El PRP proporciona diversos factores de crecimiento y proteínas que pueden estimular al proceso de regeneración celular, representa un factor importante para su uso clínico generalizado, en diferentes tejidos en donde el suministro de sangre es lento o limitado y apoya la recuperación, cicatrización, activación biológica de células de defensa, estabilización en la regeneración celular y tisular, teniendo uso clínico en casi todas las especialidades médicas. Esta revisión tiene como objetivo presentar las bases teóricas para la potencial aplicación del PRP y sus factores de crecimiento en tratamientos que buscan una terapia regenerativa por bioestimulación de la aplicación autóloga, en patologías para las cuales aún no existe tratamiento específico. Se revisaron artículos de los últimos 10 años en los buscadores y bases de datos Google Scholar, PubMed y Scopus y se seleccionaron aquellos que pueden ayudar a entender la aplicación de PRP en diversos procesos de regeneración, con miras a utilizarse como un tratamiento alternativo y complementario a pacientes con COVID-19. Se encontró abundante literatura experimental y clínica en el uso de PRP autóloga, en diversos procesos de regeneración, inclusive en neumología e infectología, por lo que amerita comprobar su efecto con protocolos establecidos, en patologías respiratorias severas como apoyo biológico autólogo para activar la respuesta biológica innata de tipo celular.

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Should Platelet-Rich Plasma or Stem Cell Therapy Be Used to Treat Osteoarthritis?

Cited by 14 publications

References 49 publications

Effects of Different Nonsteroidal Anti-Inflammatory Drugs Combined with Platelet-Rich Plasma on Inflammatory Factor Levels in Patients with Osteoarthritis

Effects of Different Nonsteroidal Anti-Inflammatory Drugs Combined with Platelet-Rich Plasma on Inflammatory Factor Levels in Patients with Osteoarthritis

Scientific Papers and Patents on Substances with Unproven Effects. Part 2

Plasma rico en plaquetas como terapia autóloga en la medicina regenerativa: Revisión narrativa

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