NYT: Stem Cell Treatments Flourish Despite Evidence

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drusso

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"At a clinic in Des Moines, her blood was drawn and spun in a centrifuge to extract platelets, the cells involved in clotting. A day later, a doctor injected so-called platelet-rich plasma into the sore spots in her joints. The fact that the procedure was covered heavily swayed her to try Regenexx. “What the heck?” she recalled thinking. “It’s on my insurance.” She believes the procedure helped her pain, although she also received several months of physical therapy. “It could have gotten worse or gotten better, and it got better,” she said. Another Iowa company, Hy-Vee, the supermarket chain, is now requiring workers in some locations to get a consultation from a doctor who offers Regenexx before being eligible for a knee replacement."

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“I believe strongly that it isn’t ethical to charge patients for unproven therapies like these and raise what are likely to be false hopes,” said Paul S. Knoepfler, a stem cell researcher at the University of California, Davis.

Magic beans.
 
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These therapies are being wildly oversold by large numbers of unscrupulous physicians across the US that are preying on the hopes of desperate patients. Many of these physicians are charlatans that really should be prosecuted for fraud since they fail to disclose that 1. there may be zero scientific data to support the proposed usage 2. the unknown consequences of such human experimentation have had disastrous results in some people receiving stem cells 3. there are many types of stem cell treatments that have been used throughout the past decade that were completely useless. On the other hand, stem cells have potential and in limited applications using specific techniques have scientifically proven to be useful. So we should not give up on stem cells, but we definitely should begin reeling in outlier and unscrupulous physicians via FDA and State Medical Board actions.
 
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Add this in there too.

New Yorker and Propublica:


Some quotes and responses:

“Providers of amniotic stem cell treatments often attribute to their products all the powers of embryonic stem cells, minus the ethical issues associated with deriving cells from early-stage embryos. That assertion is “simply not true,” said Jeanne Loring, the director of the Center for Regenerative Medicine at the Scripps Research Institute and chief scientific officer at Aspen Neuroscience. “If a stem cell from one organ is put into another, like a placenta or umbilical cord cell into a knee, it will die. It can’t become something else.”

“Their "research" most often has no control subjects, isn't blinded, & consists only of paying customers with the clinic owners doing the data analysis. What could go wrong?”

“If you stand on a joint full of stem cells, those are really pushed out of the joint because bones are pushed together due to gravity.

In a simplistic model - (i) joint surfaces need to be kept separated by an external frame until stem cells are changed into cartilage and are firmly adherent into the underlying bone, (ii) stem cells have to be combined with appropriate signalling molecule in appropriate amount for injection, (iii) something needs to be done to the firm cortical bone at the joint surface so these stem cells can hook into this bone as cartilage.

Blood is highly inflammatory substance and repeated injection of blood in the joint causes arthritis as in hemophiliacs.”
 
I think the article pointed out that the "Marketing of this is way ahead of the actual Science"

SNAKE OIL
 
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If insurances were to cover theses treatments would you offer it?

Personally I can see both sides of the argument due to a paucity of evidence for the treatments but with my n of 1 I had medial epicondylitis treated with corticosteroids a couple of times with good pain relief for about three months and had a PRP injection afterwards which has lasted about two years. Fingers crossed on its lasting effect.
 
If insurances were to cover theses treatments would you offer it?

Personally I can see both sides of the argument due to a paucity of evidence for the treatments but with my n of 1 I had medial epicondylitis treated with corticosteroids a couple of times with good pain relief for about three months and had a PRP injection afterwards which has lasted about two years. Fingers crossed on its lasting effect.

I just did a PRP elbow injection 10 minutes ago covered by insurance. No big deal.
 
Have done prp for lateral epicondylitis, hip labral pathology, partial rtc tears. Have also done epidural lysate and intra-articular facet prp with good results. Would post testimonials but don’t think a public forum is appropriate for that. My fees are very low after you consider cost of kits, but since I believe in it, I’m really not trying to make money off of it, as after I did the math, a two level tfesi would def pay me more then prp..
 
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Of course PRP injections have nothing to do with stem cells unless they are fraudulently marketed as stem cells (which I have seen on multiple occasions)
 
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if it were myself, and i paid $500 for PRP vs an ESI for $50....

knowing myself, im pretty sure that the PRP would work 10 x better than the ESI.
 
if it were myself, and i paid $500 for PRP vs an ESI for $50....

knowing myself, im pretty sure that the PRP would work 10 x better than the ESI.
So you’re saying human mentality is flawed and that is our problem and we should try to work around that flaw. I’m not forcing my patients to tell me they are better from prp. That is their choice. If they are not better they can see one of the 100 practices around me for multiple opinions on their condition and write ****ty reviews about me on the internet about how much of a money grubbing charlatan I am...
 
Add this in there too.

New Yorker and Propublica:


Some quotes and responses:

“Providers of amniotic stem cell treatments often attribute to their products all the powers of embryonic stem cells, minus the ethical issues associated with deriving cells from early-stage embryos. That assertion is “simply not true,” said Jeanne Loring, the director of the Center for Regenerative Medicine at the Scripps Research Institute and chief scientific officer at Aspen Neuroscience. “If a stem cell from one organ is put into another, like a placenta or umbilical cord cell into a knee, it will die. It can’t become something else.”

“Their "research" most often has no control subjects, isn't blinded, & consists only of paying customers with the clinic owners doing the data analysis. What could go wrong?”

“If you stand on a joint full of stem cells, those are really pushed out of the joint because bones are pushed together due to gravity.

In a simplistic model - (i) joint surfaces need to be kept separated by an external frame until stem cells are changed into cartilage and are firmly adherent into the underlying bone, (ii) stem cells have to be combined with appropriate signalling molecule in appropriate amount for injection, (iii) something needs to be done to the firm cortical bone at the joint surface so these stem cells can hook into this bone as cartilage.

Blood is highly inflammatory substance and repeated injection of blood in the joint causes arthritis as in hemophiliacs.”

If you are injecting bloody prp you’re doing it wrong
 
im saying, and i have been saying all along, that we should have some good level of non-biased evidence that our treatments benefitted someone in some situation.

if you are doing treatment that does not have sufficient level and amount of evidence, then you are deceiving them.


PRP for soft tissue injuries, sports injuries? well, you guys posted some evidence that suggests benefit over steroid injections. I'm almost convinced, but the placebo effect can be strong...
 
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im saying, and i have been saying all along, that we should have some good level of non-biased evidence that our treatments benefitted someone in some situation.

if you are doing treatment that does not have sufficient level and amount of evidence, then you are deceiving them.


PRP for soft tissue injuries, sports injuries? well, you guys posted some evidence that suggests benefit over steroid injections. I'm almost convinced, but the placebo effect can be strong...

Last year I injected a high school pitcher's UCL and saved him a Tommy John's surgery. He's now on an athletic scholarship for college. He's happy I was willing to think outside the box.

 
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Last year I injected a high school pitcher's UCL and saved him a Tommy John's surgery. He's now on an athletic scholarship for college. He's happy I was willing to think outside the box.


What if you did not inject him and he still improved without surgery? Or is that not conceivable for a HS kid to heal?
 
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Last year I injected a high school pitcher's UCL and saved him a Tommy John's surgery. He's now on an athletic scholarship for college. He's happy I was willing to think outside the box.


thats pretty awesome if what you did indeed saved the kid a scholarship

a year out, however, he may still need tommy john surgery, and we dont know how he would have done without it. that being said: kudos. PRP for soft tissue situations like this is definitely reasonable. lets just no go overboard with regenerative medicine quite yet
 
What if you did not inject him and he still improved without surgery? Or is that not conceivable for a HS kid to heal?

Possible. But, that wasn't his clinical trajectory. And, I couldn't live with myself if I withheld a possibly useful treatment that would preserve his scholarship. Cash price for PRP injection versus 4 years of out-of-state tuition for a working-class farm family? I'd roll the dice on that if I were in his shoes.

Primum Non Nocere.

Here's the clinic telephone log:


6/1/17 pt scheduled for 6/2/17 an

6/2/17 Right elbow PRP with Dr. Drusso

6/27/17 Patient reports thru dad that he has no pain. Dad reports hard to hold patient back. Has been dribbling and shooting a basketball and doing some swimming. They are anxious to start training for baseball. August is an important month for elite baseball playing, performing in front of college scouts. Per Dr. Drusso, should start participating in formal PT, and can "play light catch" with baseball, but absolutely no pitching until August. Information relayed to Dad. cf

8/17/17 11 week f/u; phone message left. Cf

8/30/17 follow-up email sent an

8/31/17 Spoke with dad, Shane is throwing and batting, with no pain. Coach impressed. Starts fall season in two weeks. Back to all regular activities. They are very happy and pleased with the results. cf

8/1/18 1 yr f/u. Patient doing well. Had a good year. Ended the season with an 8-1 record, 0.59 ERA, 129 strikeouts and only 10 walks. an
 
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My mom recently asked me about stem cells and "if they work." I told her that their use for chronic pain is still investigational and not proven to work at this time, for the most part. She told me that the guy doing the presentation (some ortho chump in FL) told her right then and there that they don't have any evidence that any of it works. I then asked her how much money they want for it. She said, $5,000.

My response, "Seems like a lot of cash for something the guy told you he had no proof would do anything other than separate you from your money."

My Dad, "I told her it's a scam!"

Lol
 
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Possible. But, that wasn't his clinical trajectory. And, I couldn't live with myself if I withheld a possibly useful treatment that would preserve his scholarship. Cash price for PRP injection versus 4 years of out-of-state tuition for a working-class farm family? I'd roll the dice on that if I were in his shoes.

Primum Non Nocere.

Here's the clinic telephone log:


6/1/17 pt scheduled for 6/2/17 an

6/2/17 Right elbow PRP with Dr. Drusso

6/27/17 Patient reports thru dad that he has no pain. Dad reports hard to hold patient back. Has been dribbling and shooting a basketball and doing some swimming. They are anxious to start training for baseball. August is an important month for elite baseball playing, performing in front of college scouts. Per Dr. Drusso, should start participating in formal PT, and can "play light catch" with baseball, but absolutely no pitching until August. Information relayed to Dad. cf

8/17/17 11 week f/u; phone message left. Cf

8/30/17 follow-up email sent an

8/31/17 Spoke with dad, Shane is throwing and batting, with no pain. Coach impressed. Starts fall season in two weeks. Back to all regular activities. They are very happy and pleased with the results. cf

8/1/18 1 yr f/u. Patient doing well. Had a good year. Ended the season with an 8-1 record, 0.59 ERA, 129 strikeouts and only 10 walks. an

the three month layoff didnt have any effect?
 
Not really. Find 100 folks with the dx. Randomly place in prp vs usual care groups. Blind doc and pt from prp vs plasma or other not felt to be active injection.

You would be way over-powered with 1000 people. You'd detect clinically meaningless changes...my practice is informed by evidence even if level 1 evidence is lacking.

Am J Orthop (Belle Mead NJ). 2016 Jul-Aug;45(5):296-300.
Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High-Level Throwers.
Dines JS, Williams PN1, ElAttrache N, Conte S, Tomczyk T, Osbahr DC, Dines DM, Bradley J, Ahmad CS.
Author information

Abstract

We conducted a study to evaluate the effect of platelet-rich plasma (PRP) injections on partial ulnar collateral ligament (UCL) tears in high-level throwing athletes. We retrospectively reviewed the cases of 44 baseball players (6 professional, 14 college, 24 high school) treated with PRP injections for partial-thickness UCL tears. All tears were diagnosed by physical examination and confirmed by magnetic resonance imaging (MRI). Sixteen patients had 1 injection, 6 had 2, and 22 had 3. Once patients became asymptomatic after injection, they were started on an interval throwing program. Physical examination findings at final follow-up were classified according to a modified version of the Conway Scale. Mean age was 17.3 years (range, 16-28 years). All patients were available for follow-up after injection (mean, 11 months). Of the 44 patients, 15 (34%) had an excellent outcome, 17 had a good outcome, 2 had a fair outcome, and 10 had a poor outcome. After injection, 4 (67%) of the 6 professional players returned to professional play. Twenty-two patients had proximally based partial-thickness tears, 7 had distally based partial tears, and 15 had diffuse signal without partial tear on MRI. Mean time from injection to return to throwing was 5 weeks; mean time to return to competition was 12 weeks (range, 5-24 weeks). There were no injection-related complications. Our use of PRP in the treatment of UCL insufficiency produced outcomes much better than earlier reported outcomes of conservative treatment of these injuries. PRP injections may be particularly beneficial in young athletes who have sustained acute damage to an isolated part of the ligament and in athletes unwilling or unable to undergo the extended rehabilitation required after surgical reconstruction of the ligament.
 
That is a review. 32/44 had good or excellent outcomes. What is the outcome if offered usual care over same time period? How much did they rake in?
 
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steve is right, retrospective review with some benefit. no control. a start.

what scares me is this line:
in athletes unwilling... to undergo the extended rehabilitation

I understand some of these are pro ball players, but there shouldn't be any rushing back to the mound....
 
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your dad is right.

Chondrotoxic Effects of Local Anesthetics on Human Knee Articular Cartilage: A Systematic Review.
Jayaram P, et al. PM R. 2019.

Authors
Jayaram P1, Kennedy DJ2, Yeh P3, Dragoo J4.

Author information
1H. Ben Dept. Physical Medicine & Rehabilitation, Dept of Orthopedic Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX.2Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN.3H. Ben Dept. Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX.4Department of Orthopedic Surgery, Stanford University Medical Center, Stanford, CA.

Citation
PM R. 2019 Apr;11(4):379-400. doi: 10.1002/pmrj.12007. Epub 2019 Mar 15.

Abstract

OBJECTIVE: To review the current literature on the effects of intraarticular local anesthetics on human knee articular cartilage.

LITERATURE SURVEY: PubMed; MEDLINE; SCOPUS; PEDro; CINAHL databases (1/1990-06/1/2018) were searched for local anesthetic effects on human knee articular cartilage.

METHODOLOGY: Sixteen studies met the inclusion criteria, with outcome measures assessing chondrocyte viability, morphology, and histology. A systematic review was performed using PRISMA guidelines.

SYNTHESIS: Seven studies were identified evaluating lidocaine, with five of them demonstrating statistically significant chondrotoxic effects. Fourteen studies examined bupivacaine, with all but one study demonstrating a chondrotoxic effect. Eight studies examined ropivacaine and found a dose-dependent chondrotoxicity starting at 0.75%. Two studies evaluated levobupivacaine showing chondrotoxicity, with one study showing it to be more chondrotoxic than bupivacaine. One study looked at mepivacaine and showed it to have more chondrotoxicity than ropivacaine. When studied the chondrotoxicity was found to be both dose and time dependent. Also, the addition of corticosteroids appeared to worsen the chondrotoxic effects.

CONCLUSIONS: Lidocaine, bupivacaine, ropivacaine, levobupivacaine, and mepivacaine were reported to have dose- and time-dependent deleterious effects on chondrocytes that appeared to be made worse by the coadministration of corticosteroids. Ropivacaine at concentrations of 0.5% or less was found to be the least chondrotoxic anesthetic.

LEVEL OF EVIDENCE: I.

© 2018 American Academy of Physical Medicine and Rehabilitation.
 
diversionary. no where has anyone recommended local anesthetic injections as primary treatment.

and, as you have noted previously, meta-analysis. GIGO? (and primary author seems to be pro-regenerative medicine, fwiw)
 
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diversionary. no where has anyone recommended local anesthetic injections as primary treatment.

and, as you have noted previously, meta-analysis. GIGO? (and primary author seems to be pro-regenerative medicine, fwiw)

"...dose- and time-dependent deleterious effects on chondrocytes that appeared to be made worse by the coadministration of corticosteroids."

Your hair should be on fire. This issue is just like opioids for fibromyalgia: We have evidence of harm to hyaline cartilage by LA and CS without clear evidence of sustained benefit. You are complicit in harming people's hyaline cartilage. And, there is ample evidence that Big Ortho has pushed LA&CS by hiring pain doctors to do their joint injections. They're just arthroplasty pushers.

PRP is an effective harm-reduction tool even if it is ineffective treatment per se: Most state Medicaid programs and commercial insurance already pay for and promote a variety of ineffective treatments designed to steer patients away from unnecessary opioid therapy. Should have the same policy for unnecessary orthopedic surgery.

263235
 
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i have plenty of patients who failed conservative treatment for YEARS before a regenerative treatment helped.
 
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I personally think the biggest racket is lubricants for knee oa. Pretty big placebo affect there. Just kicking that can down the road until patients get their BMI in check or are old enough to not need a revision in their lifetime. It’s a nice little ancillary revenue builder for surgical practices..and I would know..
 
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I personally think the biggest racket is lubricants for knee oa. Pretty big placebo affect there. Just kicking that can down the road until patients get their BMI in check or are old enough to not need a revision in their lifetime. It’s a nice little ancillary revenue builder for surgical practices..and I would know..

Thanks for the insight. How is it a revenue builder? I loose money on lubricants...price way higher than reimbursement. How do you guys get the product at a reasonable ROI?
 
Thanks for the insight. How is it a revenue builder? I loose money on lubricants...price way higher than reimbursement. How do you guys get the product at a reasonable ROI?
Do a series instead of mono..contracts maybe..I don’t know for sure but I think a lot has to do with multiple injections instead of single shot..the art becomes trying to explain WHY a series is necessary. Where’s the unskewded data on that one? I wish I had the persoral financial situation or balls to go out on my own......
 
Do a series instead of mono..contracts maybe..I don’t know for sure but I think a lot has to do with multiple injections instead of single shot..the art becomes trying to explain WHY a series is necessary. Where’s the unskewded data on that one? I wish I had the persoral financial situation or balls to go out on my own......

this

euflexxa only
 
"...dose- and time-dependent deleterious effects on chondrocytes that appeared to be made worse by the coadministration of corticosteroids."

Your hair should be on fire. This issue is just like opioids for fibromyalgia: We have evidence of harm to hyaline cartilage by LA and CS without clear evidence of sustained benefit. You are complicit in harming people's hyaline cartilage. And, there is ample evidence that Big Ortho has pushed LA&CS by hiring pain doctors to do their joint injections. They're just arthroplasty pushers.

PRP is an effective harm-reduction tool even if it is ineffective treatment per se: Most state Medicaid programs and commercial insurance already pay for and promote a variety of ineffective treatments designed to steer patients away from unnecessary opioid therapy. Should have the same policy for unnecessary orthopedic surgery.

View attachment 263235
except.... i dont do intra-articular joint injections...
 
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Of course PRP injections have nothing to do with stem cells unless they are fraudulently marketed as stem cells (which I have seen on multiple occasions)

Canada says your cells are drugs: Who can imagine the future of cellular therapy if the Democratic Socialists, Bernie, Ilhan Omar, and AOC pass single-payer, Canadian-style health care?


"All cell therapies are considered drugs under the Food and Drugs Act. This means that they must be authorized by Health Canada to ensure that they are safe and effective before they can be offered to Canadians," Health Canada said in a news release.

 
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Last year I injected a high school pitcher's UCL and saved him a Tommy John's surgery. He's now on an athletic scholarship for college. He's happy I was willing to think outside the box.

Then he truly did not need Tommy John surgery, overzealous Orthopod
 
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?
 
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Say what you want but he has a point regarding the state of orthopedics right now.
 
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he identifies the problem fairly quickly in the article:
Unfortunately, this scientific evidence of efficacy has been hijacked by unscrupulous clinicians using less than adequate technique with a few centers providing treatment that amounts to medical malpractice.
 
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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
 
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