Adding Regenerative medicine to your practice.

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
I can cure cancer with PRP. Step up your game.

Review. 2020 Mar 28;6(3):e03660. doi: 10.1016/j.heliyon.2020.e03660. eCollection 2020 Mar.

What is the potential use of platelet-rich-plasma (PRP) in cancer treatment? A mini review​

Angela C M Luzo 1, Wagner J Fávaro 2, Amedea B Seabra 3, Nelson Durán 2 3
Affiliations Expand

Abstract​

Platelet-rich-plasma (PRP) is an autologous human platelet concentrate extracted from plasma. PRP has been investigated in order to be used in many fields, with emphasis on the musculoskeletal field applied to sports injuries, as well as on other medical fields such as cardiac surgery, gynecology, pediatric surgery, urology, ophthalmology and plastic surgery. Cancer treatment is another important field where PRP should be investigated; thus, it is important validating PRP preparation protocols to be used in clinical research. Many protocols should be revised since, overall, most studies do not provide necessary information to allow them to be multiplied or replicated. The current review focuses on several topics about cancer, mainly on innovative studies about PRP use as a feasible therapeutic alternative to treat bladder cancer - a field where it could play a key role. Relevant aspects such as platelets' contribution to immune regulation and the supportive role they play in innate and adaptive immune functions are also addressed. Another important topic reviewed in the current study refers to inflammatory process regulation associated with cancer and thrombosis sites, which indicated that tumor-induced platelet activation could be used as an important therapeutic target in the future. New aspects concerning nitric oxide's ability to restrain platelet adhesion and aggregation in order to slow metastasis progress in cancer patients provide an important advantage in cancer treatment. Finally, the current review has pointed out perspectives and the main concerns about, and possibilities of, PRP use in cancer treatment.
Keywords: Biochemistry; Cancer; Cancer research; Cell biology; Health sciences; Immunology; Platelet-rich-plasma.



Platelet-Rich Plasma (PRP) is a concentrated mix of platelets and plasma taken from a person's blood. It's mostly used to help heal sports injuries but is now being studied for cancer treatment. PRP contains growth factors and proteins that help repair tissues, but its effects on cancer are complicated and still unclear.

Key Points from the Study:

  1. What PRP Does: PRP can speed up healing by helping cells grow and reduce inflammation. It’s used in many medical fields like heart surgery, plastic surgery, and urology.
  2. In Cancer Treatment:
    • PRP might help the immune system fight cancer by regulating inflammation and immune responses.
    • However, PRP can also promote tumor growth because it stimulates blood vessel growth (angiogenesis), which tumors need to grow and spread.
  3. Potential Uses in Cancer:
    • PRP might help in tissue healing after cancer surgery, like breast reconstruction.
    • Early studies suggest PRP combined with cancer therapies (e.g., immunotherapy for bladder cancer) might improve outcomes by boosting the immune system.
  4. Concerns:
    • PRP might unintentionally help cancer spread by creating an environment that supports tumor growth.
    • It can also protect tumor cells from the immune system, making treatment harder.
  5. Future Research Needs:
    • Understanding when PRP helps versus harms cancer patients.
    • Testing how safe and effective PRP is across different types of cancer.
    • Investigating side effects and long-term impacts of using PRP in cancer patients.
Takeaway: PRP has potential in cancer care, but it needs much more research to ensure it doesn’t cause more harm than good. Scientists are still figuring out the best ways to use it safely in cancer patients.
 

Review. 2020 Mar 28;6(3):e03660. doi: 10.1016/j.heliyon.2020.e03660. eCollection 2020 Mar.

What is the potential use of platelet-rich-plasma (PRP) in cancer treatment? A mini review​

Angela C M Luzo 1, Wagner J Fávaro 2, Amedea B Seabra 3, Nelson Durán 2 3
Affiliations Expand

Abstract​

Platelet-rich-plasma (PRP) is an autologous human platelet concentrate extracted from plasma. PRP has been investigated in order to be used in many fields, with emphasis on the musculoskeletal field applied to sports injuries, as well as on other medical fields such as cardiac surgery, gynecology, pediatric surgery, urology, ophthalmology and plastic surgery. Cancer treatment is another important field where PRP should be investigated; thus, it is important validating PRP preparation protocols to be used in clinical research. Many protocols should be revised since, overall, most studies do not provide necessary information to allow them to be multiplied or replicated. The current review focuses on several topics about cancer, mainly on innovative studies about PRP use as a feasible therapeutic alternative to treat bladder cancer - a field where it could play a key role. Relevant aspects such as platelets' contribution to immune regulation and the supportive role they play in innate and adaptive immune functions are also addressed. Another important topic reviewed in the current study refers to inflammatory process regulation associated with cancer and thrombosis sites, which indicated that tumor-induced platelet activation could be used as an important therapeutic target in the future. New aspects concerning nitric oxide's ability to restrain platelet adhesion and aggregation in order to slow metastasis progress in cancer patients provide an important advantage in cancer treatment. Finally, the current review has pointed out perspectives and the main concerns about, and possibilities of, PRP use in cancer treatment.
Keywords: Biochemistry; Cancer; Cancer research; Cell biology; Health sciences; Immunology; Platelet-rich-plasma.



Platelet-Rich Plasma (PRP) is a concentrated mix of platelets and plasma taken from a person's blood. It's mostly used to help heal sports injuries but is now being studied for cancer treatment. PRP contains growth factors and proteins that help repair tissues, but its effects on cancer are complicated and still unclear.

Key Points from the Study:

  1. What PRP Does: PRP can speed up healing by helping cells grow and reduce inflammation. It’s used in many medical fields like heart surgery, plastic surgery, and urology.
  2. In Cancer Treatment:
    • PRP might help the immune system fight cancer by regulating inflammation and immune responses.
    • However, PRP can also promote tumor growth because it stimulates blood vessel growth (angiogenesis), which tumors need to grow and spread.
  3. Potential Uses in Cancer:
    • PRP might help in tissue healing after cancer surgery, like breast reconstruction.
    • Early studies suggest PRP combined with cancer therapies (e.g., immunotherapy for bladder cancer) might improve outcomes by boosting the immune system.
  4. Concerns:
    • PRP might unintentionally help cancer spread by creating an environment that supports tumor growth.
    • It can also protect tumor cells from the immune system, making treatment harder.
  5. Future Research Needs:
    • Understanding when PRP helps versus harms cancer patients.
    • Testing how safe and effective PRP is across different types of cancer.
    • Investigating side effects and long-term impacts of using PRP in cancer patients.
Takeaway: PRP has potential in cancer care, but it needs much more research to ensure it doesn’t cause more harm than good. Scientists are still figuring out the best ways to use it safely in cancer patients.

Jesus take the wheel...
 
J Orthop Surg Res. 2024 Oct 30;19(1):703.
doi: 10.1186/s13018-024-05060-9.

Autologous platelet rich plasma injection can be effective in the management of osteoarthritis of the knee: impact on IL-1 β, TNF-α, hs-CRP​

Jiajia Qiao 1, Xiaojun Guo 1, Ling Zhang 1, Hongbin Zhao 1, Xuehua He 2
Affiliations Expand

Abstract​

Objective: To analyze the clinical efficacy of autologous platelet rich plasma (PRP) injection in the treatment of knee osteoarthritis (KOA) and its influence on related biomarkers such as interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP).
Method: 150 study subjects are randomly selected from KOA patients received treatment in the Third Hospital of Bethune Hospital from January 2022 to January 2023. After enrollment, patients are randomly numbered 1-100. 75 patients with odd and even numbers are included in the control group and the observation group, respectively. The former is cured with etocoxib, while the latter is treated with autologous PRP injection based on this. The clinical efficacy, relevant biomarkers (IL-1β, TNF-α, hs-CRP), and Lysholm knee score scale and Fugl Meyer assessment (FMA) scores are compared and analyzed.
Results: The total effective rate of 94.67% (71/75) in the observation group was higher than 84.00% (63/75) in the other one group (P < 0.05). Before treatment, the comparison in IL-1β, TNF-α, hs-CRP, Lysholm knee joint score, and FMA scale score are with P > 0.05. When the treatment period is at 1 and 2 months, the IL-1β, TNF-α, hs-CRP levels within the group were lower than before treatment, while the Lysholm knee joint score and FMA scale score were higher than before treatment (P < 0.05). When the treatment period is at 1 and 2 months, the IL-1β, TNF-α, hs-CRP levels and the Lysholm knee joint and FMA scale scores in the observation group were lower and higher than those in the other one group, respectively (P < 0.05).
Conclusion: The application of autologous PRP injection therapy in KOA patients can significantly improve their levels of related biomarkers, effectively improve knee joint function and motor function, and have good clinical efficacy.
Keywords: Autologous PRP injection; Biomarkers; Knee joint function; Knee osteoarthritis; Motor function.
 
We use the same kit.

Question is there no issue with PRP efficacy if mixed with a local anesthetic?

Regarding PRP epidurals-
I just cured a guy last week who had epidural fibrosis with years of chronic radicular pain. He failed 10 different ESI by other docs. He is now 98% better six weeks after a single PRP epidural, and thrilled with his new life.
As I’ve posted previously I’ve also had good success treating symptomatic annular tears with PRP. Only provides a sustained benefit in 70% of patients but those 70% of patients are damn happy.
Mitchell i have same concerns as bedrock. I thought local and contrast change up the pH of PRP. Glad you're having success.

To bedrock. How much prp r u using into epidural? 3mL? Do you worry about the anticoagulant in the PrP going into the epidural? I worry as it's an anticoagulant...
 
Fountain of youth? Already being done in California study and results seem like rejuvenating effect of 20 years younger.

 


Randomized Controlled Trial

J Shoulder Elbow Surg. 2024 Dec;33(12):2563-2571.
doi: 10.1016/j.jse.2024.06.012. Epub 2024 Aug 3.

Subacromial injection of platelet-rich plasma provides greater improvement in pain and functional outcomes compared to corticosteroids at 1-year follow-up: a double-blinded randomized controlled trial​

Luciano Andrés Rossi 1, Rodrigo Brandariz 2, Tomás Gorodischer 2, Pablo Camino 3, Nicolás Piuzzi 4, Ignacio Tanoira 2, Maximiliano Ranalletta 2
Affiliations Expand

Abstract​

Background: Studies evaluating the results of platelet-rich plasma (PRP) for the treatment of rotator cuff tendinopathy have demonstrated conflicting results and have been confounded by small patient samples, the absence of a control group, the combined analysis of isolated tendinopathies and rotator cuff tears, and insufficient reporting of PRP preparations. The purpose of this study was to perform a randomized controlled trial (RCT) comparing PRP with standard corticosteroid injections in providing pain relief and improved function in patients with rotator cuff tendinopathy.
Methods: This was a double-blind RCT at a single center. We evaluated patients between 18 and 50 years old who had both a clinical and magnetic resonance imaging diagnosis of supraspinatus tendinopathy refractory to conservative treatment. A total of 50 patients received PRP treatment, whereas 50 patients received a corticosteroid, as a control group. Patients completed patient-reported outcome assessments at baseline and at 1, 3, 6 and 12 months after injection. The primary outcome was improvement in the visual analog scale (VAS) score for pain. Secondary outcomes included changes in American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and the Pittsburgh Sleep Quality Index (PSQI). Treatment failure was defined as persistent pain at 3 months that required a subsequent injection.
Results: The mean age was 27.7 years (±7.4). All the patients completed 12 months of clinical follow-up. At 12 months, patients in the PRP group showed a significantly greater improvement in the VAS score than patients in the corticosteroid group: 1.68 (0.6) vs. 2.3 (1.0) (P < .001). As well, at the 12-month follow-up, the 3 scores evaluated were significantly higher in patients treated with PRP than in patients treated with corticosteroid: ASES, 89.8 (6.3) vs. 78.0 (8.6) (P < .001); SANE, 89.2 (6.3) vs. 80.5 (9.6) (P < .001); and PSQI, 2.72 (0.6) vs. 4.02 (1.7) (P < .001). The overall failure rate was significantly higher in the corticosteroid group (30%) than in the PRP group (12%) (P < .01).
Conclusion: One subacromial PRP injection in patients with rotator cuff tendinopathy showed significantly superior and sustained pain-relieving and functional improvements compared with one corticosteroid subacromial injection assessed by 4 patient-reported outcome scales at the 12-month follow-up. Moreover, the overall failure rate was significantly higher in the corticosteroid group than in the PRP group.

Keywords: Rotator cuff tendinopathy; corticosteroids; image guided; platelet rich plasma; randomized controlled trial; subacromial injections.
Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
 


Randomized Controlled Trial

J Shoulder Elbow Surg. 2024 Dec;33(12):2563-2571.
doi: 10.1016/j.jse.2024.06.012. Epub 2024 Aug 3.

Subacromial injection of platelet-rich plasma provides greater improvement in pain and functional outcomes compared to corticosteroids at 1-year follow-up: a double-blinded randomized controlled trial​

Luciano Andrés Rossi 1, Rodrigo Brandariz 2, Tomás Gorodischer 2, Pablo Camino 3, Nicolás Piuzzi 4, Ignacio Tanoira 2, Maximiliano Ranalletta 2
Affiliations Expand

Abstract​

Background: Studies evaluating the results of platelet-rich plasma (PRP) for the treatment of rotator cuff tendinopathy have demonstrated conflicting results and have been confounded by small patient samples, the absence of a control group, the combined analysis of isolated tendinopathies and rotator cuff tears, and insufficient reporting of PRP preparations. The purpose of this study was to perform a randomized controlled trial (RCT) comparing PRP with standard corticosteroid injections in providing pain relief and improved function in patients with rotator cuff tendinopathy.
Methods: This was a double-blind RCT at a single center. We evaluated patients between 18 and 50 years old who had both a clinical and magnetic resonance imaging diagnosis of supraspinatus tendinopathy refractory to conservative treatment. A total of 50 patients received PRP treatment, whereas 50 patients received a corticosteroid, as a control group. Patients completed patient-reported outcome assessments at baseline and at 1, 3, 6 and 12 months after injection. The primary outcome was improvement in the visual analog scale (VAS) score for pain. Secondary outcomes included changes in American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and the Pittsburgh Sleep Quality Index (PSQI). Treatment failure was defined as persistent pain at 3 months that required a subsequent injection.
Results: The mean age was 27.7 years (±7.4). All the patients completed 12 months of clinical follow-up. At 12 months, patients in the PRP group showed a significantly greater improvement in the VAS score than patients in the corticosteroid group: 1.68 (0.6) vs. 2.3 (1.0) (P < .001). As well, at the 12-month follow-up, the 3 scores evaluated were significantly higher in patients treated with PRP than in patients treated with corticosteroid: ASES, 89.8 (6.3) vs. 78.0 (8.6) (P < .001); SANE, 89.2 (6.3) vs. 80.5 (9.6) (P < .001); and PSQI, 2.72 (0.6) vs. 4.02 (1.7) (P < .001). The overall failure rate was significantly higher in the corticosteroid group (30%) than in the PRP group (12%) (P < .01).
Conclusion: One subacromial PRP injection in patients with rotator cuff tendinopathy showed significantly superior and sustained pain-relieving and functional improvements compared with one corticosteroid subacromial injection assessed by 4 patient-reported outcome scales at the 12-month follow-up. Moreover, the overall failure rate was significantly higher in the corticosteroid group than in the PRP group.

Keywords: Rotator cuff tendinopathy; corticosteroids; image guided; platelet rich plasma; randomized controlled trial; subacromial injections.
Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Why would one do either of these treatments for a rotator cuff tendinopathy? Wouldn’t an injection directly into the region of the tendinopathy make more sense with PRP? Is the thought process that subacromial is close enough?
 
Why would one do either of these treatments for a rotator cuff tendinopathy? Wouldn’t an injection directly into the region of the tendinopathy make more sense with PRP? Is the thought process that subacromial is close enough?
agree.. think they wanted to compare two injectates administered same way

fwiw, rotator cuff tear often causes connection between joint/joint fluid and the tear. bursa does not connect and cover entire interface between the muscles and the bursa is not always patent... so you can get connections between them all. same corollary that if you inject enough fluid through the biceps tendon sheath it will track up the tendon to the GH joint. so if you have fluid around the biceps tendon it doesn't mean you have biceps tendon pathology, because gravity will drag joint fluid down
 

Comparing the efficacy of intra-articular injection of Platelet Rich Plasma (PRP) with corticosteroids (CS) in patients with chronic zygapophyseal joint low back pain confirmed by double intra-articular diagnostic blocks: A triple-blinded randomized multicentric controlled trial with a 6-month follow-up​


Author links open overlay panelAnne-Marie Cauchon a, Christopher Mares b, Xin Yi Fan c, Marie-Claude Bois b, Nicola Hagemeister d, Nicolas Noiseux e, André Roy f

RedirectingGet rights and content
Under a Creative Commons license
open access

Highlights​


  • First triple-blinded RCT comparing PRP to corticosteroid in Z-joint OA mediated LBP.

  • PRP was superior to corticosteroid to improve function and reduce pain at 6 months.

  • PRP group kept improving throughout the 6 months follow-up.

  • Corticosteroid group deteriorated after the first month of follow-up.

  • Intra-articular lumbar Z-joint PRP and corticosteroid injections were safe.

Abstract​

Objective​

To compare the safety and effectiveness in improving function and reducing pain of autologous PRP to corticosteroid (CS) zygapophyseal (Z-joint) intra-articular (IA) injections at six months for patients with chronic osteoarthritis Z-joint mediated low back pain (LBP).

Design​

Prospective triple-blinded multicentric randomized controlled trial.

Methods​

Fifty participants with radiological signs of Z-joint OA and chronic Z-joint mediated LBP confirmed by a ≥80 % pain improvement after two IA local anesthetic injections were randomized into PRP and CS groups, using a 1:1 ratio. Participants completed questionnaires at baseline, and at 1-, 3- and 6-month post-treatment, with adverse effect data collected at 1 month. Function (Oswestry disability index (ODI)), pain (Numeric Rating Scale (NRS)), treatment satisfaction (modified MacNab criteria), and quality of life (Short Form survey 36 (SF-36)) were assessed at each follow-up. The primary outcome was the percentage of participants improving their function (ODI score) above the minimal clinically important difference (MCID) of 17 points. The secondary outcomes were the percentage of participants with a >50 % NRS improvement, satisfaction to treatment and mean score improvement. Proportions were compared between groups using a chi-square test. Mean scores were compared using a two-way ANOVA or the nonparametric Brunner & Langer test.

Results​

Both groups were similar at baseline, no major adverse effects occurred, and no participants were lost at follow-up. The proportion of participants improving their ODI scores above the MCID, the proportion of participants with a >50 % NRS improvement, and mean ODI scores were significantly different between groups in favor of PRP at 6 months. Modified MacNab satisfaction scale, NRS and SF36 mean scores were not statistically different between groups, but all followed the same pattern: the CS groups had a greater improvement a one month, both groups were equivalent at three months and the PRP group had a greater improvement at six months.

Conclusion​

This first triple-blinded multicentric RCT demonstrates the safety of PRP IA Z-joint injections and its superiority in improving pain and function at six months post-treatment compared to CS for patients with chronic OA Z-joint mediated LBP. To perform a blinded control study, two intra-articular treatments were compared. However, knowing that radiofrequency neurotomy (RFN) of the medial branch diagnosed by branch blocks has been standard of care for pain originating from Z-joints, further studies comparing PRP to RFN are still needed.

Clinicaltrials gov registry number​

NCT05188820.
 

Comparing the efficacy of intra-articular injection of Platelet Rich Plasma (PRP) with corticosteroids (CS) in patients with chronic zygapophyseal joint low back pain confirmed by double intra-articular diagnostic blocks: A triple-blinded randomized multicentric controlled trial with a 6-month follow-up​


Author links open overlay panelAnne-Marie Cauchon a, Christopher Mares b, Xin Yi Fan c, Marie-Claude Bois b, Nicola Hagemeister d, Nicolas Noiseux e, André Roy f

RedirectingGet rights and content
Under a Creative Commons license
open access

Highlights​


  • First triple-blinded RCT comparing PRP to corticosteroid in Z-joint OA mediated LBP.

  • PRP was superior to corticosteroid to improve function and reduce pain at 6 months.

  • PRP group kept improving throughout the 6 months follow-up.

  • Corticosteroid group deteriorated after the first month of follow-up.

  • Intra-articular lumbar Z-joint PRP and corticosteroid injections were safe.

Abstract​

Objective​

To compare the safety and effectiveness in improving function and reducing pain of autologous PRP to corticosteroid (CS) zygapophyseal (Z-joint) intra-articular (IA) injections at six months for patients with chronic osteoarthritis Z-joint mediated low back pain (LBP).

Design​

Prospective triple-blinded multicentric randomized controlled trial.

Methods​

Fifty participants with radiological signs of Z-joint OA and chronic Z-joint mediated LBP confirmed by a ≥80 % pain improvement after two IA local anesthetic injections were randomized into PRP and CS groups, using a 1:1 ratio. Participants completed questionnaires at baseline, and at 1-, 3- and 6-month post-treatment, with adverse effect data collected at 1 month. Function (Oswestry disability index (ODI)), pain (Numeric Rating Scale (NRS)), treatment satisfaction (modified MacNab criteria), and quality of life (Short Form survey 36 (SF-36)) were assessed at each follow-up. The primary outcome was the percentage of participants improving their function (ODI score) above the minimal clinically important difference (MCID) of 17 points. The secondary outcomes were the percentage of participants with a >50 % NRS improvement, satisfaction to treatment and mean score improvement. Proportions were compared between groups using a chi-square test. Mean scores were compared using a two-way ANOVA or the nonparametric Brunner & Langer test.

Results​

Both groups were similar at baseline, no major adverse effects occurred, and no participants were lost at follow-up. The proportion of participants improving their ODI scores above the MCID, the proportion of participants with a >50 % NRS improvement, and mean ODI scores were significantly different between groups in favor of PRP at 6 months. Modified MacNab satisfaction scale, NRS and SF36 mean scores were not statistically different between groups, but all followed the same pattern: the CS groups had a greater improvement a one month, both groups were equivalent at three months and the PRP group had a greater improvement at six months.

Conclusion​

This first triple-blinded multicentric RCT demonstrates the safety of PRP IA Z-joint injections and its superiority in improving pain and function at six months post-treatment compared to CS for patients with chronic OA Z-joint mediated LBP. To perform a blinded control study, two intra-articular treatments were compared. However, knowing that radiofrequency neurotomy (RFN) of the medial branch diagnosed by branch blocks has been standard of care for pain originating from Z-joints, further studies comparing PRP to RFN are still needed.

Clinicaltrials gov registry number​

NCT05188820.
Garbage in, garbage period.

MBB is gold standard and IA injections are not diagnostic. Tell Frenchies to redo study using DDMBB then randomize to RF vs IA PRP.
 
who here - besides for the random young patient after MVC - is doing intraarticular joint injections?

all these studies show the exact same thing - steroids relieve pain better for 3 months, PRP is better for 6 months, if 1 injection is given.

agree with steve - the study that should be done is PRP vs RFA. but that would be technically difficult to blind.


at least compare PRP to CS in the expected duration of the medications that are used.



arent we are being hypocritical if we adamantly defend epidural steroid injections as only lasting 3 months and to expect only that, all while decrying joint steroid injections for only lasting 3 months.
 
who here - besides for the random young patient after MVC - is doing intraarticular joint injections?

all these studies show the exact same thing - steroids relieve pain better for 3 months, PRP is better for 6 months, if 1 injection is given.

agree with steve - the study that should be done is PRP vs RFA. but that would be technically difficult to blind.


at least compare PRP to CS in the expected duration of the medications that are used.



arent we are being hypocritical if we adamantly defend epidural steroid injections as only lasting 3 months and to expect only that, all while decrying joint steroid injections for only lasting 3 months.

Huh. I wonder why no one checks with you first before submitting their grant proposals and study designs.
 
I think it’s a good study abstract. Blinded. Reasonable endpoint. Thanks for sharing.

I have lots of patients who don’t want steroids or nerves burned.
 
Last edited:
i didnt bother doing a deep dive because there seems little reason to do so when the article is comparing PRP with a procedure that is just not done.
 
because medicare only covers with preconditions, and prior studies have shown RFA to be superior to intraarticular facet injections.

B. Therapeutic Facet Joint Procedures (IA or MBB):

Therapeutic facet joint injections are considered medically reasonable and necessary for patients who meet ALL the following criteria:

  1. The patient has had two (2) medically reasonable and necessary diagnostic facet joint procedures with each one providing a consistent minimum of 80% relief of primary (index) pain (with the duration of relief being consistent with the agent used); AND
  2. Subsequent therapeutic facet joint procedures at the same anatomic site results in at least consistent 50% pain relief for at least three (3) months from the prior therapeutic procedure or at least 50% consistent improvement in the ability to perform previously painful movements and ADLs as compared to baseline measurement using the same scale; AND
  3. Documentation of why the patient is not a candidate for radiofrequency ablation (such as established spinal pseudarthrosis, implanted electrical device)
 
because medicare only covers with preconditions, and prior studies have shown RFA to be superior to intraarticular facet injections.

B. Therapeutic Facet Joint Procedures (IA or MBB):

Therapeutic facet joint injections are considered medically reasonable and necessary for patients who meet ALL the following criteria:

  1. The patient has had two (2) medically reasonable and necessary diagnostic facet joint procedures with each one providing a consistent minimum of 80% relief of primary (index) pain (with the duration of relief being consistent with the agent used); AND
  2. Subsequent therapeutic facet joint procedures at the same anatomic site results in at least consistent 50% pain relief for at least three (3) months from the prior therapeutic procedure or at least 50% consistent improvement in the ability to perform previously painful movements and ADLs as compared to baseline measurement using the same scale; AND
  3. Documentation of why the patient is not a candidate for radiofrequency ablation (such as established spinal pseudarthrosis, implanted electrical device)

*THAT's* why you think no one does them?
 
*THAT's* why you think no one does them?
stop being obtuse.

its a pretty crappy procedure that is performed relatively rarely. i dont it only on young patients after an MVA or patietns where there is a language/comprehension barried where they just dont understand the rationale behind an MBB. comparisons should be made to the SOC, which is MBB/RF
 
stop being obtuse.

its a pretty crappy procedure that is performed relatively rarely. i dont it only on young patients after an MVA or patietns where there is a language/comprehension barried where they just dont understand the rationale behind an MBB. comparisons should be made to the SOC, which is MBB/RF

What about elderly folks with some cognitive impairment?
How about facet cysts?
What about younger patients who don't WANT an RFA?
...or people living in jurisdictions not subject to Medicare LCD's?
 
What about elderly folks with some cognitive impairment? Burn away
How about facet cysts? Rupture and wait for them to go back. Neither IA or RF is treating them.
What about younger patients who don't WANT an RFA?
...or people living in jurisdictions not subject to Medicare LCD's? patients do not dictate procedures.
 
What about elderly folks with some cognitive impairment?
How about facet cysts?
What about younger patients who don't WANT an RFA?
...or people living in jurisdictions not subject to Medicare LCD's?
stop being obtuse.

its a pretty crappy procedure that is performed relatively rarely. i dont it only on young patients after an MVA or patients where there is a language/comprehension barried where they just dont understand the rationale behind an MBB. comparisons should be made to the SOC, which is MBB/RF
 
Knee Surg Relat Res. 2024 Dec 17;36(1):47.
doi: 10.1186/s43019-024-00252-3.

A comparative analysis of platelet-rich plasma alone versus combined with extracorporeal shockwave therapy in athletes with patellar tendinopathy and knee pain: a randomized controlled trial​

Shun-Wun Jhan 1 2, Kuan-Ting Wu 1 2, Wen-Yi Chou 1 2, Po-Cheng Chen 3, Ching-Jen Wang 1 2, Wen-Chiung Huang 2, Jai-Hong Cheng 4
Affiliations Expand
Free article

Abstract​

Background: Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic, and serum cytokine markers in patellar tendinopathy of athletes following platelet-rich plasma (PRP) or PRP with extracorporeal shockwave therapy (ESWT) treatments. Our aims to investigate and compare therapeutic effects of PRP versus a combination of PRP with ESWT for treating patellar tendinopathy.
Methods: A total of 33 athletes with patellar tendinopathy were randomized into two groups. PRP + Sham (PS) group received intraarticular injection of autologous PRP (5 mL) once and sham ESWT. PRP + ESWT (PE) group received intraarticular injection of autologous PRP once and after 1 week ESWT (0.2 mJ/mm2 energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for 1 year.
Results: Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the 1-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of interleukin (IL)-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments.
Conclusions: The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study. Trial registration Research registry and the registration number is researchregistry9518. Registered 14 September 2023.

Browse the Registry - Research Registry .

The level of evidence is level II.

Keywords: Combination therapy; Extracorporeal shockwave therapy; Functional improvement; Patellar tendinopathy; Platelet-rich plasma.
 
What about elderly folks with some cognitive impairment?
How about facet cysts?
What about younger patients who don't WANT an RFA?
...or people living in jurisdictions not subject to Medicare LCD's?
The government doesn't dictate care but it does pay for them and insurances follow its lead for most part.


You want to give frail elderly patients with cognitive impairment steroids? Or try to convince them that PRP is effective so poke someone twice?

Which jurisdictions are not subject to Medicare lcds that you work in?

Argue the science. Did the study compare PRP to the treatment most commonly done for facet arthropathy, not what you want to do, that the patient will pay out of pocket for?
 
Knee Surg Relat Res. 2024 Dec 17;36(1):47.
doi: 10.1186/s43019-024-00252-3.

A comparative analysis of platelet-rich plasma alone versus combined with extracorporeal shockwave therapy in athletes with patellar tendinopathy and knee pain: a randomized controlled trial​

Shun-Wun Jhan 1 2, Kuan-Ting Wu 1 2, Wen-Yi Chou 1 2, Po-Cheng Chen 3, Ching-Jen Wang 1 2, Wen-Chiung Huang 2, Jai-Hong Cheng 4
Affiliations Expand
Free article

Abstract​

Background: Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic, and serum cytokine markers in patellar tendinopathy of athletes following platelet-rich plasma (PRP) or PRP with extracorporeal shockwave therapy (ESWT) treatments. Our aims to investigate and compare therapeutic effects of PRP versus a combination of PRP with ESWT for treating patellar tendinopathy.
Methods: A total of 33 athletes with patellar tendinopathy were randomized into two groups. PRP + Sham (PS) group received intraarticular injection of autologous PRP (5 mL) once and sham ESWT. PRP + ESWT (PE) group received intraarticular injection of autologous PRP once and after 1 week ESWT (0.2 mJ/mm2 energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for 1 year.
Results: Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the 1-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of interleukin (IL)-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments.
Conclusions: The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study. Trial registration Research registry and the registration number is researchregistry9518. Registered 14 September 2023.

Browse the Registry - Research Registry .

The level of evidence is level II.

Keywords: Combination therapy; Extracorporeal shockwave therapy; Functional improvement; Patellar tendinopathy; Platelet-rich plasma.
Hmmm so ESWT works for patellar tendinopathy....

😛
 
arent we are being hypocritical if we adamantly defend epidural steroid injections as only lasting 3 months and to expect only that, all while decrying joint steroid injections for only lasting 3 months.
Epidural isnt treating articular cartilage, so please help me make sense of this
 
neither were their injections.

what was the patient complaint?

"my articular cartilage is acting up", or "my knee hurts"?

and if you say that this was a group of athletes that was primarily concerned about fixing the tendinopathy, id ask again why pain relief was the primary endpoint of the study, not some functional scale or return to full activities or the like.


those who favor PRP are purposely trying to justify its use when pretty much every study shows that pain reduction is greater at 3 months with steroid injection. its a reasonable approach but compare apples to apples. dont compare a clementine to a watermelon and expect to get the same amount of fruit with both.


we have this problem with epidurals. all these anti-epidural groups routinely point out the 3 month duration of epidurals as having no role or use. we always counter "but they are supposed to last only 3 months"!
 
neither were their injections.

what was the patient complaint?

"my articular cartilage is acting up", or "my knee hurts"?

and if you say that this was a group of athletes that was primarily concerned about fixing the tendinopathy, id ask again why pain relief was the primary endpoint of the study, not some functional scale or return to full activities or the like.


those who favor PRP are purposely trying to justify its use when pretty much every study shows that pain reduction is greater at 3 months with steroid injection. its a reasonable approach but compare apples to apples. dont compare a clementine to a watermelon and expect to get the same amount of fruit with both.


we have this problem with epidurals. all these anti-epidural groups routinely point out the 3 month duration of epidurals as having no role or use. we always counter "but they are supposed to last only 3 months"!
You failed at making sense of that.
 
Randomized Controlled Trial

Am J Phys Med Rehabil. 2024 Dec 1;103(12):1081-1087.
doi: 10.1097/PHM.0000000000002509.

Dry Needling Plus Cervical Interlaminar Epidural Steroid Injections: Do We Have More Favorable Results in Cervical Disc Herniation? A Randomized Sham-Controlled Clinical Study​

Günay Yolcu 1, Canan Sanal Toprak, Savas Sencan, Osman Hakan Gunduz
Affiliations Expand

Abstract​

Objective: Trigger point-related myofascial pain commonly accompanies cervical disc herniation. The aim of the study is to investigate the effect of dry needling for accompanying trigger points on cervical interlaminar epidural steroid injection treatment outcomes.
Design: Among the patients scheduled for interlaminar epidural steroid injection for cervical disc herniation, those with active trigger points were randomly divided into three groups: interlaminar epidural steroid injection + dry needling, interlaminar epidural steroid injection + sham dry needling, and only interlaminar epidural steroid injection group. Outcome measures were determined as the change in Numeric Rating Scale, number of active trigger points, and the pressure-pain threshold measurement.
Results: A total of 66 patients, 22 per group, were included in the final evaluation. While significant decrease in Numeric Rating Scale scores was observed in all three groups at 3rd week and 3rd month, this decrease was significantly more pronounced in the interlaminar epidural steroid injection + dry needling group (P < 0.001). There was a significant decrease in the number of active trigger points in all three groups (P < 0.001). While a significant increase was observed in the pressure-pain threshold value only in the interlaminar epidural steroid injection + dry needling group at the 3rd week, this increase was found to be significant in all three groups at the 3rd month (P < 0.001).
Conclusions: Combination therapy with dry needling has superiority to interlaminar epidural steroid injection + sham dry needling and only interlaminar epidural steroid injection groups in reducing pain and increasing pressure-pain threshold values.
Trial registration: ClinicalTrials.gov NCT04914637.
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
 
My lady wanted to ask this forum this question. I told her they may not know.

Is anyone doing and or familiar with literature on PRP injections for bags under eyes and crows feet?

Relative efficacy?
 
My lady wanted to ask this forum this question. I told her they may not know.

Is anyone doing and or familiar with literature on PRP injections for bags under eyes and crows feet?

Relative efficacy?
I don’t know if there is any literature, but prp has been used on the face for a long time. Definitely easy to try.
 
Seems like a good alternative to botox, but there isn't much immediate change. It's a harder sell to play the long game hoping to avoid the bags/crows feet. There's a session on it at a conference I'm doing in Feb. I'll relay any new info.
 
It's past time that we stop politicizing platelets.




Expert Opin Biol Ther. 2025 Mar 3.
doi: 10.1080/14712598.2025.2465833. Online ahead of print.

Corticosteroids, hyaluronic acid, platelet-rich plasma, and cell-based therapies for knee osteoarthritis - literature trends are shifting in the injectable treatments' evidence: a systematic review and expert opinion​

Alessandro Bensa 1 2, Luca Bianco Prevot 3 4, Giacomo Moraca 1, Alessandro Sangiorgio 1, Angelo Boffa 5, Giuseppe Filardo 1 2

Affiliations Expand
PMID: 40028854 DOI: 10.1080/14712598.2025.2465833

Abstract​

Introduction: The aim of this systematic review was to quantify the data available on corticosteroids (CS), hyaluronic acid, (HA), platelet-rich plasma (PRP), and cell-based therapies for knee osteoarthritis (OA) treatment.

Methods: A literature search was conducted on PubMed, Cochrane, WebofScience according to the PRISMA guidelines. Inclusion criteria: clinical studies of any level of evidence, written in English, evaluating the intra-articular use of CS, HA, PRP, or cell-based therapies for knee OA treatment.

Results: The initial search identified 17,415 records. A total of 766 studies from 1959 were included. Of these, 401 were randomized controlled trials, 110 comparative studies, and 255 case series, for a total of 75,834 patients. (11,245 treated with CS 40,862 with HA 16,174 with PRP, 7,553 with cell-based therapies).

Conclusions: The evidence on injective knee OA treatments is increasing at different speeds with a more rapidly growing literature focusing on orthobiologics. Currently, HA has the largest evidence, followed by PRP that recently surpassed the number of studies evaluating CS. Cell-based therapies are also growing rapidly, although the number of studies is still lower. The rapid literature shift toward orthobiologics urges an update in societies' guidelines to align with the new body of evidence on knee OA treatments.

Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42024592972.

Keywords: Intra-articular; cell-based therapies; corticosteroids; hyaluronic acid; knee; osteoarthritis; platelet-rich plasma.
 

Regen Med. 2025 Mar 3:1-10. doi: 10.1080/17460751.2025.2472589. Online ahead of print.

Quality of life changes in patients suffering from knee osteoarthritis treated with bone marrow aspirate concentrate, platelet-rich plasma and hyaluronic acid injections

Oliver Dulic 1, Dzihan Abazovic 2, Sara Matijevic 3, Predrag Rasovic 1, Mirko Obradovic 1, Mile Bjelobrk 1, Milan Tosic 1, Ivica Lalic 4, Branko Baljak 1, Milan Milinkov 1
Affiliations Expand
PMID: 40028743 DOI: 10.1080/17460751.2025.2472589
Abstract
Background: This study aimed to compare the effects of different treatments on quality of life in knee osteoarthritis patients. It focused on three therapies: bone marrow aspirate concentrate (BMAC), platelet-rich plasma (PRP), and hyaluronic acid (HA).

Methodology: The trial was conducted at a single center with 175 patients over a 12-month period with the knee OA, KL grade II-IV. Outcomes were measured using the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36 scales, which assess physical and emotional well-being. Linear mixed models (LMMs) were used to analyze which treatment had the most positive impact on quality of life.

Results: Patients treated with BMAC showed the most substantial improvement, particularly in physical health and mobility (p ≤ 0,001). PRP outperformed HA in some aspects, but BMAC consistently led to greater gains. The most notable enhancements were seen in areas like role limitations due to physical health and overall physical functioning.

Conclusions: The study suggested that BMAC treatment may contribute to improved quality of life in patients with knee osteoarthritis, particularly in terms of physical function. The correlation between WOMAC and SF-36 scores supports these findings, indicating a potential role for BMAC in enhancing mobility.

Clinical trial registration: NCT03825133 (ClinicalTrials.gov).

Keywords: Bone marrow aspirate concentrate; hyaluronic acid; knee osteoarthritis; platelet rich plasma; quality of life; regenerative orthopedics.

 

J Anaesthesiol Clin Pharmacol. 2025 Apr-Jun;41(2):265-269.
doi: 10.4103/joacp.joacp_28_24. Epub 2024 Aug 16.

Comparison of intra-articular injection of platelet-rich plasma with combination of bupivacaine and corticosteroid in osteoarthritis knee​


Abstract​

Background and aims: The use of intra-articular injection has been widely accepted as a therapy for pain due to osteoarthritis of the knee. We aimed to compare the efficacy of intra-articular injection of platelet-rich plasma (PRP) with a combination of bupivacaine and corticosteroid in osteoarthritis of the knee.

Material and methods: Fifty patients (aged more than 50 years) with pain pattern consistent with osteoarthritis of the knee who did not respond to conservative treatment were included in the study. They were randomly divided into two groups of 25 each: group I (n = 25) patients were administered fluoroscope-guided intra-articular knee injection of bupivacaine and steroid, and group II (n = 25) patients were administered intra-articular knee injection of PRP. In group I, patients were administered 9 ml of drug solution comprising 8 ml of 0.5% bupivacaine and 1 ml of triamcinolone (40 mg). In group II, patients were administered 6 ml of PRP. Pain, patient satisfaction, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were assessed at different time intervals before and after the procedure for up to 12 months.

Results: Pain score and WOMAC were both clinically and statistically better at 2 weeks and 1 month after injection in group I (P < 0.05). But results were better clinically in group II compared to group I at 2, 3, 6, and 12 months after the procedure. More than 50% of patients in both groups had excellent satisfaction.

Conclusions: Both techniques were effective in providing good analgesia. Pain relief and improvement in disability were clinically higher with PRP for longer duration.

Keywords: Intra-articular injection; PRP; osteoarthritis of the knee.
Copyright: © 2024 Journal of Anaesthesiology Clinical Pharmacology.

1745258194708.png
 
where is the statistical significance between group 1 and 2 at 12 months?


fyi, i believe many physicians might offer second steroid injection after 6 months. was that factored in to the final analysis?
 
Lobel Research?

you're going to have to post more details than just that chart Steve!
This chart is from the study. I wrote the numbers in the study on the top and bottom of the chart. Clinical significance PGIC Womack was not met except twice and that’s once for each group so their conclusion is a bunch of nonsense.
 
This chart is from the study. I wrote the numbers in the study on the top and bottom of the chart. Clinical significance PGIC Womack was not met except twice and that’s once for each group so their conclusion is a bunch of nonsense.
i realized it afterwards and deleted my post.
 


$tem Cell$$...

A single infusion of a stem cell-based treatment may have cured 10 out of 12 people with the most severe form of type 1 diabetes. One year later, these 10 patients no longer need insulin. The other two patients need much lower doses.

The experimental treatment, called zimislecel and made by Vertex Pharmaceuticals of Boston, involves stem cells that scientists prodded to turn into pancreatic islet cells, which regulate blood glucose levels. The new islet cells were infused and reached the pancreas, where they took up residence.

The study was presented Friday evening at the annual meeting of the American Diabetes Association and published online by The New England Journal of Medicine.

“It’s trailblazing work,” said Dr. Mark Anderson, professor and director of the diabetes center at the University of California in San Francisco. “Being free of insulin is life changing,” added Dr. Anderson, who was not involved in the study.
 
prelim case reports.

more than "just a" stem cell injection.


lets see if it pans out.

these patients do have to take immunosuppressants for the rest of their lives, so it is not a completely benign treatment.
 
prelim case reports.

more than "just a" stem cell injection.


lets see if it pans out.

these patients do have to take immunosuppressants for the rest of their lives, so it is not a completely benign treatment.
I was thinking more along the lines of hard objective data and not subjective complaints.
 
Eur J Orthop Surg Traumatol. 2025 Jun 19;35(1):259.
doi: 10.1007/s00590-025-04377-3.

Efficacy of platelet-rich plasma in grade 2 hamstring muscle injuries: results from a randomized controlled trial​


Abstract​

Purpose: Hamstring injuries are a major cause of time-loss in athletes, often leading to prolonged recovery and high recurrence rates. This randomized controlled trial evaluated the efficacy of ultrasound-guided platelet-rich plasma (PRP) injections in accelerating return to play (RTP) and enhancing radiological healing in grade 2 hamstring injuries.

Methods: Sixty athletes with MRI-confirmed grade 2 hamstring injuries were randomized into two groups: PRP plus standard therapy (n = 30) and standard therapy alone (n = 30). All followed a standardized rehabilitation protocol. Primary outcome was time to return to play (TTRTP). Secondary outcomes included MRI healing at 21 days, re-injury rates, and adverse events, with a 2-year follow-up.

Results: The PRP group showed significantly faster RTP (26.4 ± 4.5 vs. 34.2 ± 5.7 days; p < 0.001) and greater MRI healing at 21 days (70% vs. 36.7%; p = 0.003). Re-injury rates were lower in the PRP group (3.3% vs. 16.7%), though not statistically significant (p = 0.09). No adverse events were reported.

Conclusion: Ultrasound-guided PRP injection with standard rehabilitation accelerates return to play and improves radiological healing in acute grade 2 hamstring injuries, representing a safe and promising adjunct in sports injury management.
Keywords: Hamstring injury; Platelet-rich plasma; Rehabilitation; Return to play; Sports medicine.

© 2025. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
 
so people who got an injection and were told that it would help got better faster than people who did not get an injection. apparently randomized. controlled.

they were very close. repeat that study and have 1 group get trigger point injection/saline injection.
 
Arthroscopy. 2025 Jul 16:S0749-8063(25)00484-0.
doi: 10.1016/j.arthro.2025.06.033. Online ahead of print.

Platelet-Rich Plasma Is More Effective Than Hyaluronic Acid Injections for Osteoarthritis of the Knee: A Meta-Analysis Based on Randomized, Double-blinded, Controlled Clinical Trials​

PMID: 40681006

Abstract​

Purpose: To evaluate the difference in clinical efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA).

Methods: This study conducted a comprehensive search of the the Cochrane Library, Web of Science, PubMed, CNKI, Wanfang Data, and VIP databases. Eligible studies underwent rigorous quality assessment using the Cochrane Handbook 8.2 Risk of Bias 2 (RoB 2) criteria. A meta-analysis of efficacy-related indicators was performed using RevMan 5.4 software.

Results: Fifteen double-blind randomized controlled trials comprising 1,632 patients with KOA ranging from I to III on the Kellgren-Lawrence grading scale were included. Meta-analysis revealed that the PRP group exhibited significantly lower Western Ontario and McMaster Universities Osteoarthritis Index pain scores and total scores from baseline compared to the HA group at 12 months [MD = -1.14, 95% CI (-2.09, -0.20), P = 0.02; MD = -7.33, 95% CI (-12.81, -1.85), P = 0.009, respectively], both of which reached minimal clinical difference. Visual Analog Scale scores were also significantly reduced in the PRP group at 12 months [MD = -0.35, 95% CI (-0.59, -0.10), P = 0.005, respectively]. Improved International Knee Documentation Committee scores were observed in the PRP group at 1 months [MD = 3.13, 95% CI (1.34, 4.93), P = 0.0006, respectively].

Conclusions: 12 months, there were statistically significant differences in WOMAC pain, total, and minimal clinically important differences, with PRP being superior to HA in the treatment of KOA.

Level of evidence: Level Ⅱ, meta-analysis of Level Ⅰ and Ⅱ studies.
 
Arthroscopy. 2025 Jul 16:S0749-8063(25)00484-0.
doi: 10.1016/j.arthro.2025.06.033. Online ahead of print.

Platelet-Rich Plasma Is More Effective Than Hyaluronic Acid Injections for Osteoarthritis of the Knee: A Meta-Analysis Based on Randomized, Double-blinded, Controlled Clinical Trials​

PMID: 40681006

Abstract​

Purpose: To evaluate the difference in clinical efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA).

Methods: This study conducted a comprehensive search of the the Cochrane Library, Web of Science, PubMed, CNKI, Wanfang Data, and VIP databases. Eligible studies underwent rigorous quality assessment using the Cochrane Handbook 8.2 Risk of Bias 2 (RoB 2) criteria. A meta-analysis of efficacy-related indicators was performed using RevMan 5.4 software.

Results: Fifteen double-blind randomized controlled trials comprising 1,632 patients with KOA ranging from I to III on the Kellgren-Lawrence grading scale were included. Meta-analysis revealed that the PRP group exhibited significantly lower Western Ontario and McMaster Universities Osteoarthritis Index pain scores and total scores from baseline compared to the HA group at 12 months [MD = -1.14, 95% CI (-2.09, -0.20), P = 0.02; MD = -7.33, 95% CI (-12.81, -1.85), P = 0.009, respectively], both of which reached minimal clinical difference. Visual Analog Scale scores were also significantly reduced in the PRP group at 12 months [MD = -0.35, 95% CI (-0.59, -0.10), P = 0.005, respectively]. Improved International Knee Documentation Committee scores were observed in the PRP group at 1 months [MD = 3.13, 95% CI (1.34, 4.93), P = 0.0006, respectively].

Conclusions: 12 months, there were statistically significant differences in WOMAC pain, total, and minimal clinically important differences, with PRP being superior to HA in the treatment of KOA.

Level of evidence: Level Ⅱ, meta-analysis of Level Ⅰ and Ⅱ studies.
Purpose: To preselect data to show the difference in clinical efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA).

GIGO.

Fixed it for you.
 
Top