Platelet-rich plasma in osteoarthritis treatment: review of current evidence
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Platelet-rich plasma in osteoarthritis treatment: review of current evidenceAuthor(s)
Date
2019-02-19Citation
Gato-Calvo L, Magalhaes J, Ruiz-Romero C, Blanco FJ, Burguera EF. Platelet-rich plasma in osteoarthritis treatment: review of current evidence. Ther Adv Chronic Dis. 2019 Feb 19;10:2040622319825567.
Abstract
[Abstract] Platelet-rich plasma (PRP) is defined as a volume of plasma with a platelet concentration higher than the average in peripheral blood. Many basic, preclinical and even clinical case studies and trials report PRP’s ability to improve musculoskeletal conditions including osteoarthritis, but paradoxically, just as many conclude it has no effect. The purpose of this narrative review is to discuss the available relevant evidence that supports the clinical use of PRP in osteoarthritis, highlighting those variables we perceive as critical. Here, recent systematic reviews and meta-analyses were used to identify the latest randomized controlled trials (RCTs) testing a PRP product as an intra-articular treatment for knee osteoarthritis, compared with an intra-articular control (mostly hyaluronic acid). Conclusions in the identified RCTs are examined and compared. In total, five recent meta-analyses and systematic reviews were found meeting the above criteria. A total of 19 individual trials were identified in the five reviews but only 9 were level of evidence I RCTs, and many had moderate or high risks of bias. At present, results from these RCTs seem to favor PRP use over other intra-articular treatments to improve pain scales in the short and medium term (6–12 months), but the overall level of evidence is low. As a result, clinical effectiveness of PRP for knee osteoarthritis treatment is still under debate. This is, prominently, the result of a lack of standardization of PRP products, scarceness of high quality RCTs not showing high risks of bias, and poor patient stratification for inclusion in the RCTs.
Keywords
Allogenic products
Anti-inflammatory intra-articular therapies
Clinical evidence
Clinical trials
Knee osteoarthritis
Patient stratification
Platelet rich plasma
Anti-inflammatory intra-articular therapies
Clinical evidence
Clinical trials
Knee osteoarthritis
Patient stratification
Platelet rich plasma
Description
Review
Editor version
Rights
Creative Commons Attribution-NonCommercial 4.0 International License (CC-BY-NC 4.0)
ISSN
2040-6223