Regenerative Research Roundup - April 2023
Welcome to the Regenerative Research Roundup, where we look through recently published research and bring you the best of the best in a quick-to-read digest.
This month, we have a few studies looking at PRP + HA; Facet PRP for whiplash disorder; and PRP for plantar fasciitis.
Let's dive in!
Platelet Rich Plasma is similar to Platelet Rich Plasma Plus Hyaluronic Acid for the Treatment of Knee Osteoarthritis at 2 Years: A Randomized Controlled Trial
Journal of Cart. & Joint Preservation // LOE: ll
The application of PRP with HA has been the subject of much discussion in recent years. Evidence is suggestive of some benefit in combination, but it must be weighed against the significant cost increase of including both treatment options at once.
In this RCT, authors hypothesized that HA injected at the same time as PRP would improve the efficacy of treatment compared to PRP alone in the treatment of symptomatic knee osteoarthritis with a long-term follow up of 24 months. 64 patients were divided into two treatment groups, receiving 3 IA injections of either a) PRP + HA, or b) PRP alone. The PRP product used was LP-PRP with a baseline increase of 2x, much lower than the current standard for PRP treatment.
With that said, it appears that the addition of HA to the treatment did not improve results over the follow-up period. However, it did improve results over the initial 3 month follow up period before the PRP was able to kick into gear. This suggests that HA may help provide immediate pain relief in symptomatic patients while PRP provides more long-term benefit.
ACCESS HERE: https://doi.org/10.1016/j.jcjp.2023.100129
Cervical facet joint platelet-rich plasma in people with chronic whiplash-associated disorders: A prospective case series of longer term 6- and 12- month outcomes
Interventional Pain Medicine // LOE: lll
This prospective case series was published by Canadian orthobiologics practitioner Dr. Rob Burnham, Ashley Smith, and other collaborators out of Calgary, AB. They sought to explore the 6- and 12-month effectiveness of a single autologous injection of platelet-rich plasma (PRP) in cervical facet joints of people with chronic WAD and facet-mediated pain. PRP was characterized at 4.2x baseline.
44 consecutive people underwent cervical facet joint PRP ( ± adjunct physiotherapy) between 2019 and 2021, selected for PRP based on 80% relief following single diagnostic medial branch blocks or 50% relief and a significant improvement in performing a previously limited activity of daily living.
Among the 35 patients that reported 12-month data, thirty-seven percent of people reported greater than 50% relief of pain 12-months post-cervical facet joint PRP. There was significant improvement in pain and disability following PRP (and possibly adjunct physiotherapy) received during this time period.
ACCESS HERE: https://doi.org/10.1186/s40798-023-00556-w
Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial
BMC Musculoskeletal Disorders // LOE: ll
This study was a single-center, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in plantar fasciitis between August 2020 and March 2022. A total of 90 randomly selected participants aged 18 to 60 years suffering from plantar fasciitis with failed conservative treatment were intervened. The PRP product was not characterized, however, a double-spin approach utilizing 30ml of whole blood was employed, suggesting a theoretical X factor of 4.
Overall, the PRP injection showed a better outcome than the steroid injection in six months follow-up. Additionally, there was also a significant reduction of plantar fascia thickness in the PRP group compared to that of the steroid group. It is worth noting that a 6-month follow up is generall insufficient to determine maximal benefit of PRP injections and I speculate that PRP would have continued to exceed the steroid group in outcomes if the follow-up period was extended to 12-months.
ACCESS HERE: https://doi.org/10.1186/s12891-023-06277-1
Musculoskeletal Ultrasound Changes in Chronic Plantar Fascia after Treatment with Platelet Rich Plasma Compared to Steroid
Muscles, Ligaments and Tendons Journal // LOE: l
This is another study that highlights the structural changes that occur in chronic soft-tissue injuries treated with PRP compared to steroids. It's been long understood that steroid injections contribute to the breakdown of tissue and increase the likelihood of future injury, despite the immediate improvements in pain and possibly function.
In this study, 98 patients with PF were assigned to receive either PRP or corticosteroid US-guided injection with double blind randomized. The visual analogue scale (VAS) at baseline evaluated the pain level, three and twelve weeks after injection.
The improving symptoms in the corticosteroid group at the beginning were better and then decreased after 12 weeks; still the differences were significant, while in the PRP group symptoms progressively improved. The study results revealed that PRP is more powerful and strong than cortisone injection for the treatment of chronic plantar fasciitis, with less side effects and precautions.
ACCESS HERE: https://doi.org/10.32098/mltj.01.2023.14
If you have any questions or comments regarding the above research, or are wondering how you can apply it to your regenerative practice, please leave a comment below or shoot me an email at firstname.lastname@example.org
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