Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewThe Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis
Section snippets
Inclusion and Exclusion Criteria
All published randomized controlled trials (RCTs) or prospective cohort studies (PCSs) that evaluated the clinical efficacy of intra-articular PRP (or similarly defined preparations—autologous platelet concentrate, autologous conditioned plasma, or platelet-rich growth factors) against either HA or placebo (defined as normal saline solution [NS]) in the treatment of knee OA in humans were eligible for inclusion. It was decided a priori that only RCTs (deemed Level I studies) or prospective
Baseline Demographics
The results of our literature search are depicted in the study selection log (Fig 1). After the search, review, and assessment, 4 Level I randomized trials17, 36, 41, 42 and 2 Level II PCSs with comparative control groups22, 43 were included. All studies were published in peer-reviewed journals. Of the 6 studies, 5 were written in English17, 22, 36, 41, 43 and one required translation (Chinese to English) by a bilingual Chinese-English orthopaedic researcher.42 Two studies included patients
Discussion
The main findings of this systematic review were that multiple sequential intra-articular PRP knee injections (range of 2 to 4 injections) improved functional outcome scores (WOMAC and IKDC) at a minimum of 24 weeks. However, no benefit of PRP over control treatment was found for other pain measures (VAS) or overall patient satisfaction scores. Pooled comparisons using other common outcomes measures (e.g., Tegner scale,41 Knee Injury and Osteoarthritis Outcome Score,41 and an 11-point pain
Conclusions
As compared with HA or NS injection, multiple sequential intra-articular PRP injections may have beneficial effects in the treatment of adult patients with mild to moderate knee OA at approximately 6 months. There appears to be an increased incidence of nonspecific AEs among patients treated with PRP.
Acknowledgment
The authors thank Peggy Law, B.Sc., M.Sc., for her help with the Chinese-English translation.
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The authors report the following potential conflict of interest or source of funding: T.L. and D.L. receive support from grants pending from Physicians Services Foundation Inc as Principal Investigator and grants received from Orthopaedic Trauma Association as both Principal Investigator and a co-investigator. J.T. receives support from Zimmer, Linvatec, and Smith & Nephew. R.G. receives support from Smith & Nephew.