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www.cureus.com

A Prospective Study Comparing the Efficacy of Local Injection of Platelet-Rich Plasma (PRP) vs Methylprednisolone in Plantar Fasciitis

Introduction Plantar fasciitis is a common musculoskeletal problem in Orthopaedic practice. Heel pain caused due to plantar fasciitis, if persistent, can cause distress to the patient, so the correct intervention at the right time is needed. Plantar fasciitis is also common in the rural...
www.cureus.com www.cureus.com



so here is an interesting conundrum - we espouse doing epidural injections all the time, yet we decry insufficient data that shows long term benefit (ie nothing greater than 3 months). we all know they only last 3 months.
yet we also decry steroid injections elsewhere and tout PRP injections because they apparently help longer term (but dont help short term).

is there some amount of hypocrisy in our stance? can we truly reconcile advocating so hard for epidurals knowing they only last such a short period of time? as stated, iong term all that matters, right? because if it is, for epidurals, the data is not there...

i suppose the argument to use is that there arent other alternative injections that last longer, and the only alternatives are surgery, or managing expectations regarding pain. and those are treatments we do not offer. apparently.
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Ducttape said:
here you go:

www.cureus.com

A Prospective Study Comparing the Efficacy of Local Injection of Platelet-Rich Plasma (PRP) vs Methylprednisolone in Plantar Fasciitis

Introduction Plantar fasciitis is a common musculoskeletal problem in Orthopaedic practice. Heel pain caused due to plantar fasciitis, if persistent, can cause distress to the patient, so the correct intervention at the right time is needed. Plantar fasciitis is also common in the rural...
www.cureus.com www.cureus.com



so here is an interesting conundrum - we espouse doing epidural injections all the time, yet we decry insufficient data that shows long term benefit (ie nothing greater than 3 months). we all know they only last 3 months.
yet we also decry steroid injections elsewhere and tout PRP injections because they apparently help longer term (but dont help short term).

is there some amount of hypocrisy in our stance? can we truly reconcile advocating so hard for epidurals knowing they only last such a short period of time? as stated, iong term all that matters, right? because if it is, for epidurals, the data is not there...

i suppose the argument to use is that there arent other alternative injections that last longer, and the only alternatives are surgery, or managing expectations regarding pain. and those are treatments we do not offer. apparently.
Click to expand...
Plenty of ppl get > 3m benefits from ESI.

ESI help ppl tread water, and since there's no cure for spondylosis or stenosis I think ESI up to 3x per yr is a good treatment option.
 
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so we need to show that data. and specifically we need to show data that the numbers are better than placebo effect.

because outside of someone in Padukah Ky posting, it isnt being documented in the studies that CMS is looking at.
 
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Ducttape said:
so we need to show that data. and specifically we need to show data that the numbers are better than placebo effect.

because outside of someone in Padukah Ky posting, it isnt being documented in the studies that CMS is looking at.
Click to expand...
Anecdata of course, and like everyone my mind sees what it wants, but it isn't that uncommon in my pt population to do an ESI and not see the pt again for 6 months. That isn't my expectation and I tell ppl this shot will go 1-3 months.
 
Eur J Orthop Surg Traumatol. 2022 Aug 23.
doi: 10.1007/s00590-022-03356-2. Online ahead of print.

Autologous microfragmented adipose tissue and leukocyte-poor platelet-rich plasma combined with hyaluronic acid show comparable clinical outcomes for symptomatic early knee osteoarthritis over a two-year follow-up period: a prospective randomized clinical trial​

Alberto Gobbi 1, Ignacio Dallo 1, ******** D'Ambrosi 2 3
Affiliations expand

Abstract​

Purpose: The purpose of this prospective randomized clinical trial is to compare the clinical outcomes of three injections of leucocyte-poor platelet-rich plasma (LP-PRP) and hyaluronic acid (HA) to a single dose of autologous microfragmented adipose tissue (AMAT) in patients with mild osteoarthritis at a two-year follow-up.

Methods: Eighty symptomatic knees in fifty patients (mean age: 62.38 ± 11.88 years) with Kellgren-Lawrence grade 0 to 2 osteoarthritis were non blinded, randomly allocated into two equal groups. Group 1 consisted of 40 knees that received autologous LP-PRP + HA; Group 2 consisted of 40 knees treated with a single dose of AMAT injection. The outcomes were measured by Tegner, Marx, Visual Analogue Scale (VAS) for pain, International Knee Documentation Committee, and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 (T1), 12 (T2), and 24 (T3) months. Adverse events were recorded at each follow-up timepoint. To assess score differences among subjects of the same gender and age, a subgroup analysis was performed.

Results: Both groups had significant clinical and functional improvement at 6, 12, and 24 months (p < 0.05). Comparing the two groups, the AMAT groups showed significantly higher pre-operative Marx score (3.35 ± 4.91 vs. 1.78 ± 3.91) and VAS score (5.03 ± 2.02 vs. 3.85 ± 1.68) (p < 0.05), higher VAS (3.89 ± 2.51 vs. 2.64 ± 2.00) at T2 and KOOS-ADL (79.60 ± 20.20 vs. 65.68 ± 23.62), and lower KOOS-Sports (50.30 ± 30.15 vs. 68.35 ± 30.39) at T3 (p < 0.05). No patient from either group had experienced major adverse effects. In the LP-PRP group 12 (30%) patients presented swelling, redness, and mild pain for one day after injection and two patients had synovitis for two days and required paracetamol and local ice. In AMAT group 5 (12.5%) patients had ecchymosis and bruising at the fat aspiration site for three days.

Conclusion: AMAT did not show significant superior clinical improvement compared with three LP-PRP combined with HA injections in terms of functional improvement at different follow-up points. Both procedures were safe with no major complications reporting good results at mid-term follow-up, improving knee function, pain, and quality of live regardless of age and gender.

Level of evidence: Level I-Prospective Randomized Clinical Trial.

Keywords: Hyaluronic acid; Knee; LP-PRP; Leucocyte-poor platelet-rich plasma; Microfragmented adipose tissue; Osteoarthritis.



Am J Sports Med. 2022 Aug 19;3635465221115821.

doi: 10.1177/03635465221115821. Online ahead of print.

Microfragmented Adipose Tissue Versus Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Prospective Randomized Controlled Trial at 2-Year Follow-up

Stefano Zaffagnini 1, Luca Andriolo 1, Angelo Boffa 1, Alberto Poggi 1, Annarita Cenacchi 2, Maurizio Busacca 3, Elizaveta Kon 4 5, Giuseppe Filardo 6, Alessandro Di Martino 1
Affiliations expand
PMID: 35984721 DOI: 10.1177/03635465221115821
Abstract
Background: Intra-articular microfragmented adipose tissue (MF-AT) injections have been proposed for the treatment of knee osteoarthritis (OA).

Purpose: To compare a single injection of MF-AT or platelet-rich plasma (PRP) in terms of clinical outcomes and OA progression.

Study design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 118 patients with symptomatic knee OA were randomized to receive a single intra-articular injection of MF-AT or PRP. Patients were evaluated before the injection and at 1, 3, 6, 12, and 24 months with the International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, EuroQol visual analogue scale (EQ-VAS), EuroQol 5 dimensions (EQ-5D), and visual analogue scale (VAS) for pain. Primary outcomes were the IKDC subjective score and the KOOS pain subscore at 6 months. Knees were evaluated at baseline and at 6, 12, and 24 months with radiography and high-resolution magnetic resonance imaging (MRI) using the Whole-Organ Magnetic Resonance Imaging Score (WORMS).

Results: Both MF-AT and PRP provided a statistically and clinically significant improvement up to 24 months. The improvement in the IKDC subjective score from baseline to 6 months was similar in both MF-AT (41.1 ± 16.3 to 57.3 ± 18.8) and PRP (44.8 ± 17.3 to 58.4 ± 18.1) groups (P < .0005). The improvement in the KOOS pain subscore from baseline to 6 months was similar in both the MF-AT (58.4 ± 15.9 to 75.8 ± 17.4) and PRP (63.5 ± 17.8 to 75.5 ± 16.1) groups (P < .0005). Overall, no differences were found between the MF-AT and PRP groups in terms of clinical outcomes, adverse events (18.9% and 10.9%, respectively), and failures (15.1% and 25.5%, respectively). Radiographic and MRI findings did not show changes after the injection. As a secondary outcome, more patients in the MF-AT group with moderate/severe OA reached the minimal clinically important difference for the IKDC score at 6 months compared with the PRP group (75.0% vs 34.6%, respectively; P = .005).

Conclusion: A single intra-articular injection of MF-AT was not superior to PRP, with comparable low numbers of failures and adverse events and without disease progression. No differences were found in clinical and imaging results between the 2 biological approaches.

Keywords: adipose tissue; knee; mesenchymal stromal cell (MSC); microfragmented adipose tissue (MF-AT); osteoarthritis; platelet-rich plasma (PRP).
 
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Arch Phys Med Rehabil. 2022 Aug;103(8):1505-1514.

doi: 10.1016/j.apmr.2022.04.001. Epub 2022 Apr 16.

Effects of Intra-articular Coinjections of Hyaluronic Acid and Hypertonic Dextrose on Knee Osteoarthritis: A Prospective, Randomized, Double-Blind Trial
Ru-Lan Hsieh 1, Wen-Chung Lee 2
Affiliations expand
PMID: 35439521 DOI: 10.1016/j.apmr.2022.04.001

Abstract
Objective: To determine whether intra-articular coinjection with hypertonic dextrose improves the outcome of hyaluronic acid (HA) prolotherapy for knee osteoarthritis (OA).

Design: Prospective, randomized, double-blind trial.

Setting: Medical center in Taiwan.

Participants: In total, 104 participants who fulfilled the American College of Rheumatology clinical and radiographic criteria for knee OA with a Kellgren-Lawrence score of 2 or 3 were recruited (N=104).

Interventions: The participants were blocked randomized to the treatment (HA and hypertonic dextrose) or control (HA and normal saline) group. Ultrasound-guided knee intra-articular injections were administered once a week for 3 weeks.

Main outcome measures: The primary outcomes were performance-based physical function measures (regular and fastest walking speed, stair climbing time, and chair rising time), and the secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS). The outcome measures were assessed before the injections and at 1 week and 1, 3, and 6 months after the injections. The data were analyzed through repeated-measures analysis of covariance.

Results: Significant intergroup difference-in-differences favoring the treatment group were observed for improvements in stair climbing time (-1.6; 95% confidence interval, -8.56 to 4.16; P=.38) and WOMAC physical function (-21.2; 95% confidence interval, -126.05 to 103.83; P = .045) at 6 months. The group×time interaction effects favored the treatment group for regular (P=.001) and fastest walking speed (P=.001) and chair rising time (P=.038); WOMAC stiffness (P < .001) and physical function (P = .003); and KOOS for pain (P = .035), other symptoms (P=.022), and quality of life (P=.012).

Conclusions: Compared with HA plus normal saline coinjections, HA plus dextrose coinjections resulted in more significant improvements in stair climbing time and physical function at 6 months, effectively decreased pain, and improved physical function and physical functional performance from 1 week to 6 months. HA plus dextrose coinjections could be a suitable adjuvant therapy for patients with knee OA.

Trial registration: ClinicalTrials.gov NCT03238183.

Keywords: Glucose; Hyaluronic acid; Osteoarthritis, knee; Prolotherapy; Rehabilitation.
 
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this last is a good study.

meets all the criteria - blinded, prospective, randomized, against placebo injection.

you found the one (personally, i would have liked to see a noninterventional control group)
 
Growth Factors. 2022 Aug 26;1-12.
doi: 10.1080/08977194.2022.2093198. Online ahead of print.

Platelet lysate and tendon healing: comparative analysis of autologous frozen-thawed PRP and ketorolac tromethamine in the treatment of patients with rotator cuff tendinopathy​

Raha Markazi 1, Mohammad Sadegh Soltani-Zangbar 2 3 4, Majid Zamani 5, Shadi Eghbal-Fard 4, Roza Motavalli 3, Amin Kamrani 3, Sanam Dolati 1, Majid Ahmadi 3, Leili Aghebati-Maleki 6, Amir Mehdizadeh 7, Fariba Eslamian 1, Alireza Pishgahi 3, Mehdi Yousefi 3 4
Affiliations expand

Abstract​

Platelet-rich blood derivatives are being nowadays increasingly used in the treatment of tendon-related pathologies as a rich source of growth factors. We sought to ascertain if local application of platelet lysate (PL) to augment rotator cuff repair ameliorates patient outcomes compared to ketorolac tromethamine treated group.

A total of forty patients, with clinical diagnosis of Rotator Cuff Tendinopathy were randomized to receive sub acromial injections of PL every week for a total of 3 injections and two injection of ketorolac tromethamine once every two weeks.

Subjective assessments included VAS, SPADI and shoulder range of motion were assessed at baseline and at 1 and 6 months after injection. Taking both control and PL groups, it was vividly seen that the outcomes were identical at the initial state, as well as the short-term one; whereas, when considering the 6-month period, there is a seemingly remarkable superiority in PL group in all parameters.

Keywords: Platelet lysate; platelet-rich plasma; rotator cuff tendinopathy; tendon healing.

J Rehabil Med
. 2022 Jul 27;jrm00312. doi: 10.2340/jrm.v54.1434. Online ahead of print.


Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Pengfei Zhu, Zhengchao Wang, Hongmei Li, Yu Cai 1

Affiliations expand
PMID: 35892292 DOI: 10.2340/jrm.v54.1434

Abstract
Objective: Partial-thickness rotator cuff tears have a high prevalence in older people. Treatment for such tears remains controversial. Platelet-rich plasma has recently attracted attention for treating partial-thickness rotator cuff tears, due to its regenerative characteristics. However, the results of application of platelet-rich plasma in non-operative treatments are unclear. The aim of this review is to evaluate the effects on shoulder function improvement and pain relief of platelet-rich plasma injection in partial-thickness rotator cuff tears, at different follow-up times (3-6 weeks, 8-12 weeks, and more than 24 weeks after treatment) compared with placebo or corticosteroids.

Design: A systematic review and meta-analysis.

Methods: Several databases, including PubMed, EMBASE, and Cochrane, were searched. Eleven studies met the inclusion criteria for the meta-analysis. The quality of research was evaluated using the Cochrane risk-of-bias tool. The effectiveness of platelet-rich plasma was calculated as the difference between baseline measurements and post-injection outcomes. The standardized mean difference was used to compare different outcome scales or questionnaire measurements. Statistical analysis was performed using Stata 15.0.

Results: The analysis included 11 studies, with a total of 641 patients (318 treated with platelet-rich plasma and 323 controls). Compared with placebo, platelet-rich plasma exhibited significantly better effects on shoulder function improvement and pain relief at all 3 follow-up times. Compared with other conservative treatments, platelet-rich plasma exhibited significantly better effects on shoulder function and pain relief at 8-12 weeks and at more than 24 weeks after treatment.

Conclusion: This review showed positive effects on shoulder function improvement and pain relief of the use of platelet-rich plasma in treating partial-thickness rotator cuff tears, especially in relatively late stages of follow-up (more than 8 weeks) after treatment.


Cureus. 2022 Jun 7;14(6):e25727.
doi: 10.7759/cureus.25727. eCollection 2022 Jun.

Efficacy of Single Injection of Platelet-Rich Plasma in Shoulder Impingement Syndrome​

Shivam Saurav 1, Aditya N Aggarwal 1, Pratyush Shahi 1, Sushil Kamal 1, Kuldeep Bansal 1, Shubham Singla 1
Affiliations expand
Free PMC article

Abstract​

Introduction: To analyze the change in Visual Analog Scale (VAS), QuickDASH score, and the range of motion at the shoulder joint following a single injection of platelet-rich plasma (PRP) in shoulder impingement syndrome.

Methods: Twenty patients (21 shoulders) of either sex above the age of 18 years with a clinical diagnosis of shoulder impingement having a positive shoulder impingement test (positive Hawkins-Kennedy impingement test and/or positive Neer's impingement sign), ultrasonographic confirmation of shoulder impingement, and a failure to respond to standard non-operative methods for a minimum period of four weeks were included in this prospective interventional study. PRP was injected at the proposed site. At three months after the injection, the changes in the VAS, QuickDASH score, and the range of motion at the shoulder joint were analyzed.

Results: There were significant changes in the VAS, QuickDASH score, and range of motion at the shoulder joint following a single injection of PRP.

Conclusions: Platelet-rich plasma (PRP) injection results in a significant decrease in pain and improvement in the range of motion and an overall excellent functional outcome in shoulder impingement syndrome. However, future studies with a bigger sample size and longer follow-up are needed.

Keywords: platelet-rich plasma; range of motion; shoulder impingement; single injection; visual analog scale (vas).


Arthroscopy. 2022 Jul 8;S0749-8063(22)00397-8.
doi: 10.1016/j.arthro.2022.06.022. Online ahead of print.

Platelet-Rich Plasma Injection Can Be a Viable Alternative to Corticosteroid Injection for Conservative Treatment of Rotator Cuff Disease: A Meta-analysis of Randomized Controlled Trials​

Long Pang 1, Yang Xu 1, Tao Li 2, Yinghao Li 2, Jing Zhu 3, Xin Tang 4
Affiliations expand

Abstract​

Purpose: To explore whether platelet-rich plasma (PRP) injection can be a viable alternative to corticosteroid (CS) injection for conservative treatment of rotator cuff disease.

Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, EMBASE, The Cochrane Library, and Web of Science were searched from January 1, 1990, to March 20, 2022, for English-language randomized controlled trials that compared PRP and CS injections for patients with rotator cuff disease. Two evaluators independently screened the literature, extracted data, and assessed the level of evidence and methodologic quality of the enrolled studies. The meta-analysis was conducted using RevMan software (version 5.3.3).

Results: Thirteen nonsurgical randomized controlled trials with 725 patients were included. Compared with CS, PRP provided statistically worse short-term (<2 months) changes in American Shoulder and Elbow Surgeons (ASES) assessment scores, Simple Shoulder Test scores, and Disabilities of the Arm, Shoulder and Hand questionnaire scores but provided better medium-term (2-6 months) changes in Disabilities of the Arm, Shoulder and Hand scores, as well as long-term (≥6 months) changes in Constant-Murley scores, ASES scores, and Simple Shoulder Test scores. No statistically significant differences regarding pain reduction were found between the 2 groups. PRP injections led to worse short-term changes in forward flexion and internal rotation but better medium-term changes in forward flexion and external rotation. PRP showed significantly lower rates of post-injection failure (requests for subsequent injections or surgical intervention prior to 12 months) than CS. No outcome reached the minimal clinically important difference. After sensitivity analyses excluding studies with substantial clinical and/or methodologic heterogeneity, PRP showed better medium-term changes in ASES scores and visual analog scale scores and long-term changes in visual analog scale scores that reached the minimal clinically important difference.

Conclusions: Without the drawbacks of CS injection, PRP injection is not worse than CS injection in terms of pain relief and function recovery at any time point during follow-up. PRP injection may reduce rates of subsequent injection or surgery, and it might provide better improvements in pain and function in the medium to long term. PRP injection can be a viable alternative to CS injection for conservative treatment of rotator cuff disease.
Level of evidence: Meta-analysis of Level I and II studies.
 
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2 are meta-analysis.

someone used the term GIGO to describe these kinds of studies in the past.

"study" 2 is that kind of a study.

the last meta-analysis - study 4 - states No outcome reached the minimal clinically important difference.

1st study seems to compare 3 PRP injections over a 3 week time period to 2 toradol shots (?in the joint) over 2 weeks. sponsored by the Stem Cell Research Center. i cant read the full article, but clearly different modes of treatment, not sure the purpose of the stud and doesnt really prove anything.

3rd study was non-comparative, not blinded. essentially a bunch of case reports. meaningless for our purposes.
 
Ducttape said:
2 are meta-analysis.

someone used the term GIGO to describe these kinds of studies in the past.

"study" 2 is that kind of a study.

the last meta-analysis - study 4 - states No outcome reached the minimal clinically important difference.

1st study seems to compare 3 PRP injections over a 3 week time period to 2 toradol shots (?in the joint) over 2 weeks. sponsored by the Stem Cell Research Center. i cant read the full article, but clearly different modes of treatment, not sure the purpose of the stud and doesnt really prove anything.

3rd study was non-comparative, not blinded. essentially a bunch of case reports. meaningless for our purposes.
Click to expand...

What purpose?
 
lobelsteve said:
I think you meant porpoise, because it sure smells fishy.
Click to expand...

Ask, and you shall receive...

Curr Opin Obstet Gynecol. 2022 Aug 18.
doi: 10.1097/GCO.0000000000000820. Online ahead of print.

Platelet rich plasma for the management of urogynecological disorders: the current evidence​

Anastasia Prodromidou 1, Themos Grigoriadis, Stavros Athanasiou
Affiliations expand

Abstract​

Purpose of review: Our objective is to review the currently available literature on the use of platelet-rich plasma (PRP) in patients with pelvic floor disorders and to critically appraise the latest evidence on the safety and efficacy of the PRP application.
Recent findings: The evidence on the use of PRP for the treatment of stress urinary incontinence (SUI) appears promising, although limited to case series, case reports and animal studies. PRP has also been proposed to enhance the surgical outcomes of pelvic organ prolapse (POP) by native tissue repair with promising success rates. The application of PRP in other PFDs including vaginal fistulas, genitourinary syndrome of menopause (GSM), mesh exposure and lichen sclerosus has been also associated with beneficial outcomes and a favorable safety profile.
Summary: The currently available literature indicates that PRP could have a beneficial effect as a single or adjuvant treatment in patients with SUI, POP, GSM, vaginal fistula and genital lichen sclerosus with minimal adverse events. However, valid evidence is still lacking and further well-designed studies are warranted in the field to confirm the validity of the so far reported outcomes.
 
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drusso said:
Ask, and you shall receive...

Curr Opin Obstet Gynecol. 2022 Aug 18.
doi: 10.1097/GCO.0000000000000820. Online ahead of print.

Platelet rich plasma for the management of urogynecological disorders: the current evidence​

Anastasia Prodromidou 1, Themos Grigoriadis, Stavros Athanasiou
Affiliations expand

Abstract​

Purpose of review: Our objective is to review the currently available literature on the use of platelet-rich plasma (PRP) in patients with pelvic floor disorders and to critically appraise the latest evidence on the safety and efficacy of the PRP application.
Recent findings: The evidence on the use of PRP for the treatment of stress urinary incontinence (SUI) appears promising, although limited to case series, case reports and animal studies. PRP has also been proposed to enhance the surgical outcomes of pelvic organ prolapse (POP) by native tissue repair with promising success rates. The application of PRP in other PFDs including vaginal fistulas, genitourinary syndrome of menopause (GSM), mesh exposure and lichen sclerosus has been also associated with beneficial outcomes and a favorable safety profile.
Summary: The currently available literature indicates that PRP could have a beneficial effect as a single or adjuvant treatment in patients with SUI, POP, GSM, vaginal fistula and genital lichen sclerosus with minimal adverse events. However, valid evidence is still lacking and further well-designed studies are warranted in the field to confirm the validity of the so far reported outcomes.
Click to expand...


:sick::sick::sick::sick::hungover::hungover::hungover:🤢🤢🤢:vomit::vomit::vomit:



But:
You could have gone here.


www.frontiersin.org

Frontiers | Zebrafish for Personalized Regenerative Medicine; A More Predictive Humanized Model of Endocrine Disease

Regenerative medicine is a multidisciplinary field that aims to determine different factors and develop various methods to regenerate impaired tissues, organ...
www.frontiersin.org www.frontiersin.org
 
drusso said:
Ask, and you shall receive...

Curr Opin Obstet Gynecol. 2022 Aug 18.
doi: 10.1097/GCO.0000000000000820. Online ahead of print.

Platelet rich plasma for the management of urogynecological disorders: the current evidence​

Anastasia Prodromidou 1, Themos Grigoriadis, Stavros Athanasiou
Affiliations expand

Abstract​

Purpose of review: Our objective is to review the currently available literature on the use of platelet-rich plasma (PRP) in patients with pelvic floor disorders and to critically appraise the latest evidence on the safety and efficacy of the PRP application.
Recent findings: The evidence on the use of PRP for the treatment of stress urinary incontinence (SUI) appears promising, although limited to case series, case reports and animal studies. PRP has also been proposed to enhance the surgical outcomes of pelvic organ prolapse (POP) by native tissue repair with promising success rates. The application of PRP in other PFDs including vaginal fistulas, genitourinary syndrome of menopause (GSM), mesh exposure and lichen sclerosus has been also associated with beneficial outcomes and a favorable safety profile.
Summary: The currently available literature indicates that PRP could have a beneficial effect as a single or adjuvant treatment in patients with SUI, POP, GSM, vaginal fistula and genital lichen sclerosus with minimal adverse events. However, valid evidence is still lacking and further well-designed studies are warranted in the field to confirm the validity of the so far reported outcomes.
Click to expand...
I now know who to refer vaginal fistulas to. Thanks!
 
Ducttape said:
this last is a good study.

meets all the criteria - blinded, prospective, randomized, against placebo injection.

you found the one (personally, i would have liked to see a noninterventional control group)
Click to expand...

Serial Platelet-Rich Plasma Intra-articular Injections in Kellgren and Lawrence Grade IV Knee Joint Osteoarthritis: A Prospective Blinded Placebo-Controlled Interventional Study​

Indian Journal of Orthopaedics (2022)Cite this article

Abstract​

Purpose​

The purpose of this study was to evaluate whether serial intra-articular (IA) Platelet-Rich Plasma (PRP) injections improve pain and function in patients of Kellgren–Lawrence (K–L) Grade IV primary knee osteoarthritis (KOA), not willing for arthroplasty or having relative contraindications to surgery.

Methods​

90 patients (84 available at final follow-up) of Grade IV KOA were given 3 PRP or Normal Saline injections at 1-month interval. Pain and functional assessment was done with Visual analog scale (VAS) and Western Ontario and McMaster universities osteoarthritis index (WOMAC) respectively, at baseline and then at three and six months of follow-up. Both groups were homogenous with similar baseline characteristics.

Results​

Both groups showed statistically significant improvements in the outcome scores, but only PRP showed minimal clinically important difference (25% in WOMAC and > 2 cm difference of mean in VAS at follow-up). For inter-group comparison, PRP showed better results as there was statistically significant difference in WOMAC at 3 months (Difference =  − 9.220, 95% CI =  − 13.1945 to − 5.2455, P < 0.0001) and at 6 months (Difference =  − 10.360, 95% CI =  − 14.5358 to − 6.1842, P < 0.0001). Similar results were seen for VAS also (Difference =  − 0.580, 95% CI =  − 1.1412 to − 0.0188, P = 0.04 at 3 months, Difference =  − 0.870, 95% CI − 1.3993 to − 0.3407, P = 0.001 at 6 months). Outcome scores significantly correlated with age and sex but not with body mass index (BMI).

Conclusion​

Serial Intra-articular Injections of autologous PRP mildly improve short-term subjective pain and knee function scores in patients of Grade IV KOA without any major complications.
 
cant read the actual study - ie not going to pay $39.99 to subscribe.

from what is reported above, looks like a decent study. in this study, they comment about statistically significant difference but then they say "mildly imporve short term subjective pain and knee function scores." seems like the data is more impressive than their conclusions, but there may be something in the article...

i dont remember if you posted this one:

www.ncbi.nlm.nih.gov

Intra-Articular Injection of Platelet-Rich Plasma Is More Effective than Hyaluronic Acid or Steroid Injection in the Treatment of Mild to Moderate Knee Osteoarthritis: A Prospective, Randomized, Triple-Parallel Clinical Trial

Purpose: To prospectively compare the efficacy and safety of intra-articular injections of platelet-rich plasma (PRP) with hyaluronic acid (HA) and glucocorticosteroid (CS) control groups for knee osteoarthritis (KOA) in a randomized, triple-parallel, ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
Biomedicines. 2022 May; 10(5): 991.
Published online 2022 Apr 25. doi: 10.3390/biomedicines10050991
PMCID: PMC9138252
PMID: 35625728

Intra-Articular Injection of Platelet-Rich Plasma Is More Effective than Hyaluronic Acid or Steroid Injection in the Treatment of Mild to Moderate Knee Osteoarthritis: A Prospective, Randomized, Triple-Parallel Clinical Trial​

Dawid Szwedowski,1,2,* Ali Mobasheri,3,4,5,6 Andrzej Moniuszko,7 Jan Zabrzyński,8 and Sławomir Jeka9
JaiHong Cheng, Academic Editor
Author information Article notes Copyright and License information Disclaimer

Associated Data​

Supplementary MaterialsData Availability Statement
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Abstract​

Purpose: To prospectively compare the efficacy and safety of intra-articular injections of platelet-rich plasma (PRP) with hyaluronic acid (HA) and glucocorticosteroid (CS) control groups for knee osteoarthritis (KOA) in a randomized, triple-parallel, single-center clinical trial. Methods: A total of 75 patients were randomly assigned to one of three groups receiving a single injection of either leukocyte-poor platelet-rich plasma (25 knees), hyaluronic acid (25 knees), or glucocorticosteroid (25 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was collected at baseline and 6, 12, and 26 weeks after treatment. Results: After 6 weeks of PRP administration, a decrease in the mean WOMAC value was observed in all three study groups. Three months after administration, the greatest decrease in the mean WOMAC value was obtained in the PRP group. The results in the HA and CS groups were similar (p = 0.681). In the one-way analysis of variance and post hoc analysis using the HSD Tukey test, a significantly greater improvement was shown by comparing the PRP and CS groups (p = 0.001), and the PRP and HA groups (p = 0.010). After intra-articular injection of CS, the reduction in pain was greatest 6 weeks after administration, and the mean value was the lowest among all groups. During subsequent visits, the value of the pain subscale increased, and after 6 months, it was the highest among the studied groups. Using the Wilcoxon paired test, no PRP effect was found to reduce stiffness at the 6-month follow-up (p = 0.908). Functional improvement was achieved in all groups, i.e., a decrease in the value of this subscale 6 months after administration. The largest decrease was seen in the group that received PRP (p < 0.001) and then in the HA group. The smallest decrease among the investigated methods was shown in the CS group. Conclusions: Intra-articular injections of PRP can provide clinically significant functional improvement for at least 6 months in patients with mild to moderate KOA which is superior to HA or CS injections.
Click to expand...
 
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drusso said:
I don't know. PRP still seems pretty "experimental" to me...
Click to expand...

follow the money right? no one selling "big blood" people complaining about an expensive prp kit if they choose to use one to save time, but take big pharma and big stim at face value for the cost of everything else.

oscar wilde quote about knowing the price of everything but not value...
 
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oreosandsake said:
follow the money right? no one selling "big blood" people complaining about an expensive prp kit if they choose to use one to save time, but take big pharma and big stim at face value for the cost of everything else.

oscar wilde quote about knowing the price of everything but not value...
Click to expand...

If I were a steroid KOL or Big Triamcinolone, I'd be pissed.
 
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Right.

There is no steroid KOL because of lack of money, which is why there are 3 1/2 x more hits on Oreos search.

it isn't about the science as much as it is about the Benjamin's.
 
Ducttape said:
Right.

There is no steroid KOL because of lack of money, which is why there are 3 1/2 x more hits on Oreos search.

it isn't about the science as much as it is about the Benjamin's.
Click to expand...

You're not a Z player...


1662555968370.png
 
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Gels. 2021 Nov 19;7(4):222. doi: 10.3390/gels7040222.

Short- and Midterm Comparison of Platelet-Rich Plasma with Hyaluronic Acid versus Leucocyte and Platelet-Rich Plasma on Pain and Function to Treat Hip Osteoarthritis. A Retrospective Study

Michelangelo Palco 1, Paolo Rizzo 1, Giorgio Carmelo Basile 2, Angelo Alito 3, Daniele Bruschetta 2, Maria Accorinti 3, Roberto Restuccia 3, Danilo Leonetti 1
Affiliations expand
PMID: 34842700 PMCID: PMC8628741 DOI: 10.3390/gels7040222
Free PMC article
Abstract
Hip osteoarthritis (HOA) leads to pain and reduced function. The use of intra-articular injections based on corticosteroids, platelet-rich plasma (PRP), or hyaluronic acid (HA) is becoming a common symptomatic therapy for HOA. For the first time, we compare the effectiveness of plasma with a high concentration of platelets and leukocytes (L-PRP) with PRP+HA in patients with mild to moderate HOA. A total of 26 patients in each group were administered with either L-PRP or PRP+HA. Outcomes were evaluated at baseline, 3 months, and 1 year after the injection. The mean visual analog scale (VAS) and Harris hip score (HHS) within and between groups among different time points were compared using repeated measures ANCOVA (age set as a covariate). Both treatments were effective in reducing VAS, but not in significantly increasing HHS. In the group treated with L-PRP, VAS showed interaction between time and treatment (in favor of L-PRP). Pairwise comparison for treatment and time point evidenced a significant difference at 1-year follow-up between L-PRP and PRP-HA. Outcomes support the idea that both treatments may be effective in reducing pain, with maximal pain reduction achieved after 3 months. L-PRP showed better results in reducing VAS over time. Both treatments are effective at reducing pain in the short to medium term. L-PRP could be the treatment of choice due to a more marked effect over time. Nevertheless, further research is needed to better describe the clinical outcome of these formulations.

Keywords: L-PRP; PRP; cartilage; degeneration; gel; hyaluronic acid; osteoarthritis; pain.


JBJS. 2021 Nov 17;103(22):2070-2079.
doi: 10.2106/JBJS.20.02155.

Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip​

Kanu Okike 1, Ryan K King 2, Jason C Merchant 3, Eugene A Toney 1, Gregory Y Lee 1, Hyo-Chun Yoon 3
Affiliations expand

Abstract​

Background: While recent reports have suggested that hip corticosteroid injections can hasten joint degeneration, there are few published data on the topic. The purpose of the present study was to evaluate for an association between corticosteroid injection and rapidly destructive hip disease (RDHD) and to determine the rate of, and risk factors for, occurrence.
Methods: This study was conducted in 2 parts. First, to assess for a potential association between hip corticosteroid injection and RDHD, a case-control analysis was performed. Patients who developed RDHD between 2013 and 2016 served as cases, whereas those who underwent total hip arthroplasty for diagnoses other than RDHD during the same period served as controls, and the exposure of interest was prior intra-articular hip corticosteroid injection. Second, in a retrospective cohort analysis, we analyzed all patients who received a fluoroscopically guided intra-articular hip corticosteroid injection at our institution from 2013 to 2016. The rate of post-injection RDHD was determined, and logistic regression was used to identify risk factors for occurrence.
Results: In the case-control analysis, hip corticosteroid injection was associated with the development of RDHD (adjusted odds ratio, 8.56 [95% confidence interval, 3.29 to 22.3], p < 0.0001). There was evidence of a dose-response curve, with the risk of RDHD increasing with injection dosage as well as with the number of injections received. In the retrospective cohort analysis, the rate of post-injection RDHD was 5.4% (37 of 688). Cases of post-injection RDHD were diagnosed at an average of 5.1 months following injection and were characterized by rapidly progressive joint-space narrowing, osteolysis, and collapse of the femoral head.
Conclusions: This study documents an association between hip corticosteroid injection and RDHD. While the risk of RDHD following a single low-dose (≤40 mg) triamcinolone injection is low, the risk is higher following high-dose (≥80 mg) injection and multiple injections. These findings provide information that can be used to counsel patients about the risks associated with this common procedure. In addition, caution should be taken with intra-articular hip injections utilizing ≥80 mg of corticosteroid and multiple injections.
Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.
 
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retrospective studies.

first study says nothing about whether PRP really helps. 2 variables and none compared to a placebo - or standard of care.

second study just basically shows in a rather poor manner what we all know, that multiple steroid injections are probably not good. again, retrospective, so data can be cherry picked to show what you want.
 
Ducttape said:
retrospective studies.

first study says nothing about whether PRP really helps. 2 variables and none compared to a placebo - or standard of care.

second study just basically shows in a rather poor manner what we all know, that multiple steroid injections are probably not good. again, retrospective, so data can be cherry picked to show what you want.
Click to expand...

goal of first study was to see if there was a difference between PRP and PRP + HA.

HA studies for hip already didn't show benefit, so it's not really a great thing to look at. PRP studies for hip aren't great either, so that's been done.


there are over dozen PRCT for knee OA with PRP showing benefit.
 
oreosandsake said:
goal of first study was to see if there was a difference between PRP and PRP + HA.

HA studies for hip already didn't show benefit, so it's not really a great thing to look at. PRP studies for hip aren't great either, so that's been done.


there are over dozen PRCT for knee OA with PRP showing benefit.
Click to expand...
BMC Musculoskelet Disord. 2022 Sep 12;23(1):856. doi: 10.1186/s12891-022-05787-8.

Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial

Farshad Nouri 1, Marzieh Babaee 2, Parya Peydayesh 3, Hadi Esmaily 4, Seyed Ahmad Raeissadat 5
Affiliations expand

PMID: 36096771 DOI: 10.1186/s12891-022-05787-8

Abstract
Background: Intra articular (IA) injection of platelet-rich plasma (PRP) and hyaluronic acid (HA) are of the new methods in the management of hip osteoarthritis (OA). The aim of this study was to compare the effectiveness of IA injections of PRP, HA and their combination in patients with hip OA. HA and PRP are two IA interventions that can be used in OA in the preoperative stages. Due to the different mechanisms of action, these two are proposed to have a synergistic effect by combining.

Methods: This is a randomized clinical trial with three parallel groups. In this study, patients with grade 2 and 3 hip OA were included, and were randomly divided into three injection groups: PRP, HA and PRP + HA. In either group, two injections with 2 weeks' interval were performed into the hip joint under ultrasound guidance. Patients were assessed before the intervention, 2 months and 6 months after the second injection, using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne questionnaires.

Results: One hundred five patients were enrolled randomly in HA, PRP and PRP + HA groups. All three groups showed significant improvement in WOMAC, VAS, and Lequesne at 2 months and 6 months compared with baseline. Comparison of the 3 groups demonstrated significant differences regarding WOMAC and Lequesne total scores and the activities of daily living (ADL) subscale of Lequesne (P = 0.041, 0.001 and 0.002, respectively), in which the observed improvement at 6th month was significantly higher in the PRP + HA and PRP groups compared to the HA group.

Conclusion: Although all 3 interventions were associated with improvement of pain and function in patients with hip OA, the therapeutic effects of PRP and PRP + HA injections lasted longer (6 months), and the effects of these two interventions on patients' performance, disability, and ADL were superior to HA in the long run. Moreover, the addition of HA to PRP was not associated with a significant increase in the therapeutic results.

Trial registration: The study was registered at Iranian Registry of Clinical Trials (IRCT) website IRCT , a WHO Primary Register setup, with the registration number of IRCT20130523013442N30 on 29/11/2019.

Keywords: Hip osteoarthritis; Hyaluronic acid; Intra-articular injections; Platelet-rich plasma; Ultrasound guided injection.
 
drusso said:
BMC Musculoskelet Disord. 2022 Sep 12;23(1):856. doi: 10.1186/s12891-022-05787-8.

Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial

Farshad Nouri 1, Marzieh Babaee 2, Parya Peydayesh 3, Hadi Esmaily 4, Seyed Ahmad Raeissadat 5
Affiliations expand

PMID: 36096771 DOI: 10.1186/s12891-022-05787-8

Abstract
Background: Intra articular (IA) injection of platelet-rich plasma (PRP) and hyaluronic acid (HA) are of the new methods in the management of hip osteoarthritis (OA). The aim of this study was to compare the effectiveness of IA injections of PRP, HA and their combination in patients with hip OA. HA and PRP are two IA interventions that can be used in OA in the preoperative stages. Due to the different mechanisms of action, these two are proposed to have a synergistic effect by combining.

Methods: This is a randomized clinical trial with three parallel groups. In this study, patients with grade 2 and 3 hip OA were included, and were randomly divided into three injection groups: PRP, HA and PRP + HA. In either group, two injections with 2 weeks' interval were performed into the hip joint under ultrasound guidance. Patients were assessed before the intervention, 2 months and 6 months after the second injection, using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne questionnaires.

Results: One hundred five patients were enrolled randomly in HA, PRP and PRP + HA groups. All three groups showed significant improvement in WOMAC, VAS, and Lequesne at 2 months and 6 months compared with baseline. Comparison of the 3 groups demonstrated significant differences regarding WOMAC and Lequesne total scores and the activities of daily living (ADL) subscale of Lequesne (P = 0.041, 0.001 and 0.002, respectively), in which the observed improvement at 6th month was significantly higher in the PRP + HA and PRP groups compared to the HA group.

Conclusion: Although all 3 interventions were associated with improvement of pain and function in patients with hip OA, the therapeutic effects of PRP and PRP + HA injections lasted longer (6 months), and the effects of these two interventions on patients' performance, disability, and ADL were superior to HA in the long run. Moreover, the addition of HA to PRP was not associated with a significant increase in the therapeutic results.

Trial registration: The study was registered at Iranian Registry of Clinical Trials (IRCT) website IRCT , a WHO Primary Register setup, with the registration number of IRCT20130523013442N30 on 29/11/2019.

Keywords: Hip osteoarthritis; Hyaluronic acid; Intra-articular injections; Platelet-rich plasma; Ultrasound guided injection.
Click to expand...
The hip OA studies for HA didn’t pan out. They would have loved that indication.

3 or 4 other hip OA PRP studies showed modest benefits.


IMO Not enough fine tuning the diagnosis and fine tuning the prp in most of these studies.
 
oreosandsake said:
The hip OA studies for HA didn’t pan out. They would have loved that indication.

3 or 4 other hip OA PRP studies showed modest benefits.


IMO Not enough fine tuning the diagnosis and fine tuning the prp in most of these studies.
Click to expand...
Please describe your prp protocol for hip. What’s in your secret sauce?
 
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lobelsteve said:
Please describe your prp protocol for hip. What’s in your secret sauce?
Click to expand...
It’s 🤫

Actually it’s not secret

L rich for tendons and ligaments

Poor for the joint
Pre and post protocols you’ll need to sign up for a conference 😜
It’s more than a hip it’s more than a knee.

Hip pain is not a diagnosis. Anterior lateral posterior changes the diagnosis and injection targets
 
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oreosandsake said:
It’s 🤫

Actually it’s not secret

L rich for tendons and ligaments

Poor for the joint
Pre and post protocols you’ll need to sign up for a conference 😜
It’s more than a hip it’s more than a knee.

Hip pain is not a diagnosis. Anterior lateral posterior changes the diagnosis and injection targets
Click to expand...
Fine I’ll just let Russo inject me
 
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Biomedicines.
2022 Apr 25;10(5):991. doi: 10.3390/biomedicines10050991.

Intra-Articular Injection of Platelet-Rich Plasma Is More Effective than Hyaluronic Acid or Steroid Injection in the Treatment of Mild to Moderate Knee Osteoarthritis: A Prospective, Randomized, Triple-Parallel Clinical Trial​

Dawid Szwedowski 1 2, Ali Mobasheri 3 4 5 6, Andrzej Moniuszko 7, Jan Zabrzyński 8, Sławomir Jeka 9
Affiliations expand
Free PMC article

Abstract​

Purpose: To prospectively compare the efficacy and safety of intra-articular injections of platelet-rich plasma (PRP) with hyaluronic acid (HA) and glucocorticosteroid (CS) control groups for knee osteoarthritis (KOA) in a randomized, triple-parallel, single-center clinical trial.

Methods: A total of 75 patients were randomly assigned to one of three groups receiving a single injection of either leukocyte-poor platelet-rich plasma (25 knees), hyaluronic acid (25 knees), or glucocorticosteroid (25 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was collected at baseline and 6, 12, and 26 weeks after treatment.

Results: After 6 weeks of PRP administration, a decrease in the mean WOMAC value was observed in all three study groups. Three months after administration, the greatest decrease in the mean WOMAC value was obtained in the PRP group. The results in the HA and CS groups were similar (p = 0.681). In the one-way analysis of variance and post hoc analysis using the HSD Tukey test, a significantly greater improvement was shown by comparing the PRP and CS groups (p = 0.001), and the PRP and HA groups (p = 0.010). After intra-articular injection of CS, the reduction in pain was greatest 6 weeks after administration, and the mean value was the lowest among all groups. During subsequent visits, the value of the pain subscale increased, and after 6 months, it was the highest among the studied groups. Using the Wilcoxon paired test, no PRP effect was found to reduce stiffness at the 6-month follow-up (p = 0.908). Functional improvement was achieved in all groups, i.e., a decrease in the value of this subscale 6 months after administration. The largest decrease was seen in the group that received PRP (p &lt; 0.001) and then in the HA group. The smallest decrease among the investigated methods was shown in the CS group.

Conclusions: Intra-articular injections of PRP can provide clinically significant functional improvement for at least 6 months in patients with mild to moderate KOA which is superior to HA or CS injections.

Keywords: glucocorticosteroids; injections; intra-articular; knee osteoarthritis; osteoarthritis; platelet-rich plasma; viscosupplementation.
 
A devasting blow and terrible news for Big Steroid and steroid KOLs. If I were doing a bunch of steroid injections into joints, I'd be pissed...


Osteoarthritis Cartilage. 2022 Sep 12;S1063-4584(22)00838-X. doi: 10.1016/j.joca.2022.07.011. Online ahead of print.

Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at three months and beyond: a systematic review and meta-analysis in comparison to other injectables

Richard L Donovan 1, Tomos A Edwards 2, Andrew Judge 3, Ashley W Blom 4, Setor K Kunutsor 5, Michael R Whitehouse 6
Affiliations expand
PMID: 36108937 DOI: 10.1016/j.joca.2022.07.011

Abstract
Objective: Intra-articular corticosteroid injections (IACIs) provide temporary symptom relief in osteoarthritis (OA). This meta-analysis investigated the effects of recurrent IACIs at three months and beyond.

Design: We searched Medline, Embase and Cochrane from inception to January 2021 for randomised controlled trials (RCTs) of patients with OA who received recurrent IACIs compared with other injectables, placebo or no treatment (primary outcomes: pain, function). Mean differences (MDs) with 95% confidence intervals were reported.

Results: Ten RCTs were included (eight knee OA (n=763), two trapeziometacarpal OA (n=121)). Patients received between 2 and 8 injections, varying by trial. Trials compared recurrent IACIs with hyaluronic acid (HA), platelet-rich plasma (PRP), saline or orgotein (follow-up 3-24 months). Greater improvements in pain, function and QoL at 3-24 months were noted for the comparators than with IACIs, with comparators demonstrating an equal or superior effect, or the intervention effect attenuating over follow-up. Recurrent IACIs demonstrated no benefits in pain or function over placebo at 12-24 months. No serious adverse events were recorded. No studies reported on time-to-future interventions, risk of future prosthetic joint infection or other adverse events associated with subsequent joint replacement.

Conclusions: Recurrent IACIs often provide inferior (or non-superior) symptom relief compared with other injectables (including placebo). Other injectables (HA, PRP) often yielded greater improvements in pain and function up to 24 months post-injection. Existing RCTs on recurrent IACIs lack sufficient follow-up data to assess disease progression, time-to-future interventions and complications following these.

Keywords: Injections; Intra-Articular; Meta-Analysis; Osteoarthritis; Patient Reported Outcome Measures; Steroids; Systematic Review.

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
 
1. GIGO
2. im still trying to find a steroid KOL. let me know if you ever find one
3. if they dont work in joints - might they not work at other sites?

be careful what you wish for...
 

JOHN C RICHMOND​

Listed Specialty: Orthopaedic Surgery​

830 BOYLSTON ST, SUITE 107, CHESTNUT HILL, MA, 02467-2503​

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Yearly Payment Breakdown: 2013 2014 2015 2016 2017 2018​

2018 Payments At a Glance​

68​

PAYMENTS​

$92,001​

PAYMENT TOTAL​

3​

COMPANIES PAID THIS DOCTOR​


Payment Calendar in 2018​

This doctor received a payment on 22 days in 2018.
Each box below represents a single day during the disclosure period. A gray box indicates no payments. The darker the color, the more payments a doctor received that day.

2018​



Types of Payments in 2018​

CATEGORYPAYMENTSPAYMENT VALUE

CONSULTING​

20$78,100

TRAVEL AND LODGING​

30$8,406

PROMOTIONAL SPEAKING/OTHER​

1$4,000

FOOD AND BEVERAGE​

17$1,495

Drugs & Devices in 2018​

Totals listed below account for all payments from that mention this product. Beginning in 2016, the government began classifying products as drugs, devices, biologics or medical supplies. Below, you will see drugs (drugs and biologics) and devices (devices and medical supplies). If a payment record mentions more than one product, the entire value will be included in each of those products. When no products are listed, they are not included in the list below.
PRODUCT NAMEPRODUCT TYPEPAYMENTS†

ZILRETTA​

Drug$87,853

COBLATION WANDS​

Device$4,000

BLUEPRINT PSI SYSTEM​

Device$149
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PAUL M SETHI

Listed Specialty: Orthopaedic Surgery​

6 GREENWICH OFFICE PARK, GREENWICH, CT, 06831-5151​

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161​

PAYMENTS​

$226,449​

PAYMENT TOTAL​

10​

COMPANIES PAID THIS DOCTOR​


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This doctor received a payment on 74 days in 2018.
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2018​



Types of Payments in 2018​

CATEGORYPAYMENTSPAYMENT VALUE

PROMOTIONAL SPEAKING/OTHER​

19$102K

CONSULTING​

28$97,981

TRAVEL AND LODGING​

64$22,538

FOOD AND BEVERAGE​

46$4,324

ROYALTY OR LICENSE​

4$50

Drugs & Devices in 2018​

Totals listed below account for all payments from that mention this product. Beginning in 2016, the government began classifying products as drugs, devices, biologics or medical supplies. Below, you will see drugs (drugs and biologics) and devices (devices and medical supplies). If a payment record mentions more than one product, the entire value will be included in each of those products. When no products are listed, they are not included in the list below.
PRODUCT NAMEPRODUCT TYPEPAYMENTS†

PAYMENTS WITH NO LISTED PRODUCT​

N/A$114K

EXPAREL​

Drug$80,704

ZILRETTA​

Drug$20,085

SHOULDER IMPLANTS OTHER CLAVICLE FRACTURE​

Device$4,378

HEALIX​

Device$3,461

DISTAL EXTREMITIES IMPLANTS FOREFOOT PLATES & SCREWS MTP​

Device$1,740

ATTUNE​

Device$1,546

BONE MARROW ASPIRATE CONCENTRATE SYSTEM​

Device$212

SMARTPREP MULTICELLULAR PROCESSING SYSTEM​

Device$212

ALLOGRAFT​

Device$125

DENOVO​

Device$125

SCP BONE SUBSTITUTE​

Device$125

RIGIDLOOP​

Device$120

TRUESPAN​

Device$120

VAPR​

Device$120

EUFLEXXA​

Device$64

KNEE & HIP INSTRUMENTS ACLPCL DISPOSABLES OTHER​

Device$50

UROLIFT​

Device$42

SHOULDER IMPLANTS BICEPS REPAIR BUTTON FIXATION​

Device$38

ON-Q PUMP AND ACCESSORIES​

Device$34
† May not add up to dollar total at top of page, since a payment record may not be associated with any product or can be associated with several products.
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SCOTT A SIGMAN​

Listed Specialty: Orthopaedic Surgery​

14 RESEARCH PL, NORTH CHELMSFORD, MA, 01863-2412​

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Yearly Payment Breakdown: 2013 2014 2015 2016 2017 2018​

2018 Payments At a Glance​

288​

PAYMENTS​

$303,708​

PAYMENT TOTAL​

11​

COMPANIES PAID THIS DOCTOR​


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This doctor received a payment on 105 days in 2018.
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2018​



Types of Payments in 2018​

CATEGORYPAYMENTSPAYMENT VALUE

CONSULTING​

72$230K

PROMOTIONAL SPEAKING/OTHER​

11$35,479

TRAVEL AND LODGING​

119$31,623

FOOD AND BEVERAGE​

86$6,200

Drugs & Devices in 2018​

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PRODUCT NAMEPRODUCT TYPEPAYMENTS†

HEALIX​

Device$91,267

ORTHOCORD​

Device$89,539

ZILRETTA​

Drug$71,586

EXPAREL​

Drug$40,009

REGENETEN​

Device$35,712

FMS​

Device$19,757

ACCUFILL​

Device$18,017

ATTUNE​

Device$15,615

ORTHOVISC​

Device$14,173

CAPITAL EQUIPMENT CART​

Device$14,151

PAYMENTS WITH NO LISTED PRODUCT​

N/A$12,285

MI-EYE​

Device$3,150

GRYPHON​

Device$2,745

RIGIDLOOP​

Device$2,598

GLENOJET​

Device$2,000

Q-FIX​

Device$1,411

TFN ADVANCED​

Device$1,337

GLOBAL​

Device$900

SUTUREFIX​

Device$411

LATARJET SYSTEM​

Device$301

LATARJET EXPERIENCE​

Device$288

REGRANEX​

Drug$268

BRISTOW-LATARJET​

Device$262

TRUESPAN​

Device$177

TWISTR​

Device$144
Click to expand...
 
Richmond does pretty much only consulting right now. at least i think. he did my ACL 30 years ago. i have severe OA, but we'll just skip over that part.

nice guy. tried to enroll my in a study about different types of orthopedic screws. i said no thanks
 
Non-industry sponsored RCT of adipose vs. PRP for knee OA.

Orthop J Sports Med.
2022 Sep 16;10(9):23259671221120678. doi: 10.1177/23259671221120678. eCollection 2022 Sep.

Platelet-Rich Plasma Versus Microfragmented Adipose Tissue for Knee Osteoarthritis: A Randomized Controlled Trial

Michael Baria 1, Angela Pedroza 2, Christopher Kaeding 3, Sushmitha Durgam 4, Robert Duerr 3, David Flanigan 3, James Borchers 5, Robert Magnussen 3

Affiliations expand
PMID: 36147791 PMCID: PMC9486262 DOI: 10.1177/23259671221120678
Free PMC article

Abstract
Background: Platelet-rich plasma (PRP) has been established as safe and effective for knee osteoarthritis (OA). Another orthobiologic therapy, microfragmented adipose tissue (MFAT), has gained attention because of its heterogeneous cell population (including mesenchymal stem cells). However, prospective comparative data on MFAT are lacking. Because of the safety, efficacy, and simplicity of PRP, new therapeutics such as MFAT should be compared directly with PRP.

Purpose: To compare patient-reported outcomes of a single injection of PRP versus MFAT for knee OA.

Study design: Randomized controlled trial; Level of evidence, 2.

Methods: A total of 58 patients with symptomatic knee OA (Kellgren-Lawrence grades 1-4) were randomized to receive a single injection of either leukocyte-rich PRP or MFAT under ultrasound guidance. PRP was created by processing 156 mL of whole blood. MFAT was created by harvesting 30 mL of adipose tissue via standard lipoaspiration. Scores for the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and visual analog scale for pain with Activities of Daily Living (VAS-ADL) were recorded at baseline and at 1, 3, and 6 months after the injection. The primary outcome was the KOOS-Pain subscore at 6 months after the injection.

Results: The PRP group (n = 30) had a mean volume of 5.12 ± 1.12 mL injected. This consisted of a mean platelet count of 2673.72 ± 1139.04 × 103/µL and mean leukocyte count of 25.36 ± 13.27 × 103/µL (67.81% lymphocytes, 18.66% monocytes, and 12.33% neutrophils). The MFAT group (n = 28) had a mean volume of 7.92 ± 3.87 mL injected. The mean total nucleated cell count was 3.56 ± 4.62 million/mL. In both groups, KOOS subscale and VAS-ADL scores improved from baseline, and there was no significant difference between the PRP and MFAT groups in the final KOOS-Pain subscore (80.38 ± 16.07 vs 81.61 ± 16.37, respectively; P = .67) or any other outcome score.

Conclusion: A single injection of either PRP or MFAT resulted in a clinically meaningful improvement for patients with knee OA at 6 months, with no difference between treatment groups.

Registration: NCT04351087 (ClinicalTrials.gov identifier).

Keywords: knee osteoarthritis; mesenchymal stem cell; microfragmented adipose tissue; platelet-rich plasma.


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"Numerous randomized trials and meta-analyses support the use of PRP for knee OA compared with placebo, steroid, and viscosupplement. These data have established PRP as the gold standard of orthobiologic interventions. Therefore, from a pragmatic clinical perspective, new orthobiologics should be compared with PRP as benchmark to compare efficacy and determine if the increased cost and invasiveness are justified. The distinct cell populations in MFAT, including mesenchymal stem cells, may pique the interest of patients and clinicians. Additionally, the processing methods used to create MFAT are technically more complex than PRP, which could lead to the assumption that this technique is more advanced. However, this present study demonstrated that PRP is equally effectivecompared with MFAT at 6 months. This is important because the PRP procedure is simpler to perform, does not require additional training (including lipoaspiration), is less expensive, and is easier to repeat as needed."
 
Fat injection into knee? Sure, why not. But why not choose a placebo arm or a visco arm or a steroid arm. You know, the stuff that is kind of standard of care treatment.
 
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