Smoke and mirrors. Safety. Ok. Efficacy for tennis elbow and maybe OA knee.
And how is his disclosure and COI looking?
What is name of his practice? President of what? Stock options in Genzyme? Bias much?
Int J Surg. 2019 May 22. pii: S1743-9191(19)30106-2. doi: 10.1016/j.ijsu.2019.05.003. [Epub ahead of print]
Comparison of platelet rich plasma and corticosteroids in the management of lateral epicondylitis: a meta-analysis of randomized controlled trials.
Xu Q1,
Chen J1,
Cheng L2.
Author information
Abstract
OBJECTIVE:
To compare the clinical efficacy of platelet-rich plasma (PRP) injections with that of corticosteroids in patients with lateral epicondylitis (LE).
METHODS:
We searched for relevant studies on the comparison of PRP and corticosteroids in the management of lateral epicondylitis in electronic databases, including PubMed, Embase, Ovid, Cochrane Library, Web of Science, Wan Fang and China National Knowledge Internet, up to March 2019. The outcomes were pain score, elbow joint function and adverse effects after local injection. For continuous data, the weighted mean difference (WMD) and 95% confidence intervals (CIs) was used. Risk difference (RD) with a 95% CI were calculated for dichotomous outcomes. Cochrane Collaboration's tool was used to assess the risk of bias. The data were collected and input into the STATA software.
RESULTS:
A total of seven randomized controlled trials (RCTs) involving 515 patients were finally included in our study. The present meta-analysis indicated that PRP injection yielded statistically significant superior in pain scores and elbow joint function at a 6-month follow up compared with local corticosteroid injection. No significant difference was identified between two groups regarding the post-injection adverse events.
CONCLUSION:
Local PRP injections was associated with superior outcomes for reducing pain and improving elbow joint function compared with local corticosteroids treatment for LE at a follow-up of 6 months.
Copyright © 2019 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
KEYWORDS:
Lateral epicondylitis; corticosteroid; meta-analysis; pain; platelet-rich plasma
J Back Musculoskelet Rehabil. 2019 May 10. doi: 10.3233/BMR-181374. [Epub ahead of print]
Platelet rich plasma in osteoarthritis the efficiency of platelet rich plasma treatment in patients with knee osteoarthritis.
Elik H1,2,
Doğu B1,
Yılmaz F1,
Begoğlu FA1,3,
Kuran B1.
Author information
Abstract
OBJECTIVE:
The aim of this study was to determine the effects of platelet-rich plasma (PRP) treatment on pain, functionality, quality of life, and cartilage thickness in patients with knee osteoarthritis (OA).
METHODS:
Sixty patients with chronic knee pain were randomly separated into two groups. The first group was administered 4-ml PRP intra-articularly (IA) in three doses at one-week intervals, and the second group had only one dose of a 4-ml saline solution IA. The patients' pain was measured using the Visual Analogue Scale (VAS); functionality was measured using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The distal femur cartilage thickness was assessed using ultrasonography (USG).
RESULTS:
All baseline parameters were similar (p> 0.05). In the first and sixth months after the treatment, the VAS scores of the PRP group were significantly low (p< 0.001). In the same group, only the pain sub-score was low in the WOMAC assessment in the first month after treatment. However, in the sixth month, all parameters of the WOMAC score were lower than those of the placebo group (p< 0.05). Cartilage thickness measurements were similar in the two groups (p< 0.05).
CONCLUSION:
PRP treatment had positive effects on the pain, physical function, and quality of life of patients with knee OA, but it did not increase cartilage thickness.
KEYWORDS:
Osteoarthritis; cartilage thickness; platelet rich plasma (PRP)
J Orthop Surg Res. 2019 May 24;14(1):153. doi: 10.1186/s13018-019-1203-0.
Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage.
Burchard R1,2,3,
Huflage H4,
Soost C5,
Richter O6,
Bouillon B4,7,
Graw JA8,9.
Author information
Abstract
OBJECTIVES:
Osteoarthritis of the knee is common and often leads to significant physical disability. While classic conservative therapeutic approaches aim for symptoms like pain and inflammation, procedures like the intraarticular application of hyaluronic acids (HA) or platelet-rich plasma (PRP) are thought to stimulate the endogenous HA production, stop catabolism of cartilage tissue, and promote tissue regeneration. To analyse whether the positive effects of PRP injections are associated with the level of cartilage damage, patient satisfaction with the treatment was correlated with the level of knee joint osteoarthritis quantified by MRI.
METHODS:
PRP was performed with a low-leukocyte autologous conditioned plasma (ACP) system in 59 patients. A pre-treatment MRI was performed and a Whole-Organ MRI Score (WORMS) was used to score the level of knee osteoarthritis by 14 features: integrity of the cartilage, affection of the bone marrow, subcortical cysts, bone attrition, osteophytes, integrity of the menisci and ligaments, presence of synovitis, loose bodies, and periarticular cysts. A multivariate analysis with ordinary least squares regressions was used.
RESULTS:
Although pain symptoms and severity of clinical osteoarthritis symptoms decreased, regression analysis could not detect a correlation between the degree of cartilage damage measured by the WORMS score and a positive response to PRP therapy.
CONCLUSION:
This study suggests that intraarticular injection of PRP might improve osteoarthritis symptoms and reduces the pain in patients suffering from osteoarthritis of the knee joint independent from the level of cartilage damages quantified by the whole-organ MRI scoring method WORMS.
KEYWORDS:
Cartilage damage; Knee; Osteoarthritis; Platelet-rich plasma