Friday, July 5, 2013

platelet-rich plasma - is this evidence?

Clinical and MRI Outcomes After Platelet-Rich Plasma Treatment for Knee Osteoarthritis

The stated purpose of this study was to investigate whether  platelet-rich plasma therapy for early knee osteoarthritis is associated with good clinical outcomes and a change in magnetic resonance imaging (MRI) structural appearances. 22 patients were treated with platelet-rich plasma for early osteoarthritis, confirmed with a baseline MRI. All the patients received a platelet-rich plasma injection.

At 1 year, 12 of the 15 knees available did not show MRI progression. Functional scores improved over baseline.

As the authors point out, this study is limited by the absence of a control group and the number of patients lost to followup. These limitations are important because of the high degree of variability in the clinical management of knee arthritis. It is also not clear what other treatments (medication, physical therapy, etc) these patients may have received. 

Blinding is often difficult in orthopaedic clinical research, for example when comparing operative and non-operative management. However, with a study on injection therapy, a standard randomized control trial with blinding of the observers of the outcome to the method of treatment is straightforward.

We don't find that this study provides evidence supporting the use of PRP in the management of arthritis.

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