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The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis

OBJECTIVE: To assess the effect of PRP on knee articular cartilage content (thickness/volume) and examine the correlation between cartilage changes and clinical outcomes in patients with knee OA. METHOD: A systematic literature search was performed using the Cochrane methodology in four online datab...

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Autores principales: Prodromidis, Apostolos D., Charalambous, Charalambos P., Moran, Emma, Venkatesh, Ram, Pandit, Hemant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9718182/
https://www.ncbi.nlm.nih.gov/pubmed/36474791
http://dx.doi.org/10.1016/j.ocarto.2022.100318
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author Prodromidis, Apostolos D.
Charalambous, Charalambos P.
Moran, Emma
Venkatesh, Ram
Pandit, Hemant
author_facet Prodromidis, Apostolos D.
Charalambous, Charalambos P.
Moran, Emma
Venkatesh, Ram
Pandit, Hemant
author_sort Prodromidis, Apostolos D.
collection PubMed
description OBJECTIVE: To assess the effect of PRP on knee articular cartilage content (thickness/volume) and examine the correlation between cartilage changes and clinical outcomes in patients with knee OA. METHOD: A systematic literature search was performed using the Cochrane methodology in four online databases. Studies were included if they reported on cartilage content with cross-sectional imaging pre- and post-injection. A random-effects model meta-analysis was performed. Correlation with clinical outcomes was evaluated. RESULTS: 14 studies (n ​= ​1099 patients) from 1452 records met the inclusion criteria: seven RCTs (n ​= ​688), one prospective (n ​= ​50), one retrospective (n ​= ​68), and four case-series (n ​= ​224). The PRP preparation process and treatment protocol varied widely (follow-up 6–12 months). In meta-analysis, PRP treatment was not associated with a significant increase in cartilage thickness (4 studies, n ​= ​187, standardized mean difference: Hedges g: 0.079; 95%CI: 0.358 - 0.516; p ​= ​0.723). Meta-analysis of 3 RCTs (n ​= ​112) showed no significant difference in the change of overall knee cartilage content with PRP injections compared with no PRP (Hedges’ g: 0.217; 95%CI: 0.177 – 0.611; P ​= ​0.281). CONCLUSION: The current literature does not support the PRP as chondrogenic in treatment of knee OA. However, there is substantial heterogeneity in the evaluated studies which limits the robustness of any conclusion. An adequately powered RCT, with a standardized PRP regime and standardized high-resolution MRI is needed to definitely define any effect of PRP on knee cartilage content and its relation to clinical outcomes. Until such high-quality evidence becomes available, we recommend that PRP is not administered with the intention of promoting chondrogenesis.
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spelling pubmed-97181822022-12-05 The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis Prodromidis, Apostolos D. Charalambous, Charalambos P. Moran, Emma Venkatesh, Ram Pandit, Hemant Osteoarthr Cartil Open REVIEW(S) OBJECTIVE: To assess the effect of PRP on knee articular cartilage content (thickness/volume) and examine the correlation between cartilage changes and clinical outcomes in patients with knee OA. METHOD: A systematic literature search was performed using the Cochrane methodology in four online databases. Studies were included if they reported on cartilage content with cross-sectional imaging pre- and post-injection. A random-effects model meta-analysis was performed. Correlation with clinical outcomes was evaluated. RESULTS: 14 studies (n ​= ​1099 patients) from 1452 records met the inclusion criteria: seven RCTs (n ​= ​688), one prospective (n ​= ​50), one retrospective (n ​= ​68), and four case-series (n ​= ​224). The PRP preparation process and treatment protocol varied widely (follow-up 6–12 months). In meta-analysis, PRP treatment was not associated with a significant increase in cartilage thickness (4 studies, n ​= ​187, standardized mean difference: Hedges g: 0.079; 95%CI: 0.358 - 0.516; p ​= ​0.723). Meta-analysis of 3 RCTs (n ​= ​112) showed no significant difference in the change of overall knee cartilage content with PRP injections compared with no PRP (Hedges’ g: 0.217; 95%CI: 0.177 – 0.611; P ​= ​0.281). CONCLUSION: The current literature does not support the PRP as chondrogenic in treatment of knee OA. However, there is substantial heterogeneity in the evaluated studies which limits the robustness of any conclusion. An adequately powered RCT, with a standardized PRP regime and standardized high-resolution MRI is needed to definitely define any effect of PRP on knee cartilage content and its relation to clinical outcomes. Until such high-quality evidence becomes available, we recommend that PRP is not administered with the intention of promoting chondrogenesis. Elsevier 2022-11-05 /pmc/articles/PMC9718182/ /pubmed/36474791 http://dx.doi.org/10.1016/j.ocarto.2022.100318 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle REVIEW(S)
Prodromidis, Apostolos D.
Charalambous, Charalambos P.
Moran, Emma
Venkatesh, Ram
Pandit, Hemant
The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title_full The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title_fullStr The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title_full_unstemmed The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title_short The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis
title_sort role of platelet-rich plasma (prp) intraarticular injections in restoring articular cartilage of osteoarthritic knees. a systematic review and meta-analysis
topic REVIEW(S)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9718182/
https://www.ncbi.nlm.nih.gov/pubmed/36474791
http://dx.doi.org/10.1016/j.ocarto.2022.100318
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