NDLI: Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review.

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Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review.

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Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Meheux, Carlos J. McCulloch, Patrick C. Lintner, David M. Varner, Kevin E. Harris, Joshua D.
Description	Country affiliation: United States Author Affiliation: Meheux CJ ( Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.); McCulloch PC ( Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.); Lintner DM ( Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.); Varner KE ( Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.); Harris JD ( Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.. Electronic address: joshuaharrismd@gmail.com.)
Abstract	PURPOSE: To determine (1) whether platelet-rich plasma (PRP) injection significantly improves validated patient-reported outcomes in patients with symptomatic knee osteoarthritis (OA) at 6 and 12 months postinjection, (2) differences in outcomes between PRP and corticosteroid injections or viscosupplementation or placebo injections at 6 and 12 months postinjection, and (3) similarities and differences in outcomes based on the PRP formulations used in the analyzed studies. METHODS: PubMed, Cochrane Central Register of Controlled Trials, SCOPUS, and Sport Discus were searched for English-language, level I evidence, human in vivo studies on the treatment of symptomatic knee OA with intra-articular PRP compared with other options, with a minimum of 6 months of follow-up. A quality assessment of all articles was performed using the Modified Coleman Methodology Score (average, 83.3/100), and outcomes were analyzed using 2-proportion z-tests. RESULTS: Six articles (739 patients, 817 knees, 39% males, mean age of 59.9 years, with 38 weeks average follow-up) were analyzed. All studies met minimal clinical important difference criteria and showed significant improvements in statistical and clinical outcomes, including pain, physical function, and stiffness, with PRP. All but one study showed significant differences in clinical outcomes between PRP and hyaluronic acid (HA) or PRP and placebo in pain and function. Average pretreatment Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 52.36 and 52.05 for the PRP and HA groups, respectively (P = .420). Mean post-treatment WOMAC scores for PRP were significantly better than for HA at 3 to 6 months (28.5 and 43.4, respectively; P = .0008) and at 6 to 12 months (22.8 and 38.1, respectively; P = .0062). None of the included studies used corticosteroids. CONCLUSIONS: In patients with symptomatic knee OA, PRP injection results in significant clinical improvements up to 12 months postinjection. Clinical outcomes and WOMAC scores are significantly better after PRP versus HA at 3 to 12 months postinjection. There is limited evidence for comparing leukocyte-rich versus leukocyte-poor PRP or PRP versus steroids in this study. LEVEL OF EVIDENCE: Level I, systematic review of Level I studies.
File Format	HTM / HTML
ISSN	07498063
Issue Number	3
Journal	Arthroscopy: The Journal of Arthroscopic & Related Surgery
Volume Number	32
e-ISSN	15263231
Language	English
Publisher	Elsevier
Publisher Date	2016-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Therapy Platelet-rich Plasma Knee Joint Humans Osteoarthritis, Knee Injections, Intra-articular Review Discipline Orthopedic Surgery Journal Article
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Sports Science

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