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're reviewing PRP vs. CS for rotator cuff; PRP for melasma; ADSCs + PRP for knee OA; and PRP for diabetic foot ulcers.
Let's explore!
Platelet-rich Plasma Injection Can Be a Viable Alternative to Corticosteroid Injection for Conservative Treatment of Rotator Cuff Disease: A Meta-analysis of Randomized Controlled Trials
Arthroscopy: The Journal of Athroscopic & Related Surgery // LOE: ll
The purpose of this study was to explore whether PRP injection can be a viable alternative to CS injection for conservative treatment of rotator cuff disease, evaluating only RCTs including patients treated after 1990.
As with all meta-analysis involving PRP, there is a level of skepticism necessary due to the heterogeneity of preparations and the fact that not all PRP is created equal. We already know that low-dose PRP (<4x baseline) can compromise patient outcomes.
With that said, authors of this review found that PRP injections may reduce rates of subsequent injection or surgery, and might provide better improvement in pain and function in the medium- to long-term, over CS injections. The noted that the negative effects of CS may have contributed to the better long-term outcomes associated with PRP injections.
ACCESS HERE: https://doi.org/10.1016/j.arthro.2022.06.022
Evaluation of platelet-rich plasma efficacy in melasma
Journal of Cosmetic and Laser Therapy // LOE: lll
Platelet-rich plasma (PRP), which is widely used in many dermatologic conditions, has also been used in the treatment of melasma in recent years. The objective of this study is to determine the efficacy of PRP in melasma when applied intradermally into 15 female patients.
Authors used a PRP preparation system called EasyPRP - a simple gel-tube system that would not have concentrated the product to >2x baseline. 2ml of product was applied intra-dermally every 3 weeks.
Authors found a significant improvement in melasma and skin rejuvenation at all time-points, with no significant side effects. They recommend applying PRP for more than three sessions and combining it with other depigmentation agents. Also, repeating PRP treatments two to three sessions per year will provide better results in melasma treatment.
It is worth mentioning that the authors may have experienced greater improvement in outcomes, in fewer treatments, by utilizing a PRP system that delivered a higher dose of platelets (<4x above baseline) in a single treatment.
ACCESS HERE: https://doi.org/10.1080/14764172.2022.2099898
The intra-articular injection of adipose-derived stem cells decreases pain and reduces inflammation in knee osteoarthritis, with or without the addition of platelet-rich plasma also improves functionality
Journal of Tissue Engineering and Regenerative Medicine // LOE: ll
The use of Adipose-Derived Stem Cells (ADSCs) and PRP in the treatment of osteoarthritis is growing in popularity - with the combination of regenerative growth factors in PRP working synergistically with the mesenchymal stem cell fraction in adipose tissue to combat the degenerative joint disease. In Canada, MDBiologix is actively involved in supporting clinical trials within this research area to determine safety and efficacy for patients.
In this study, authors analyzed four types of interventions: platelet-rich plasma (PRP), adipose-derived stem cells (ADSCs), ADSCs + PRP and the standard surgical video arthroscopy (All groups passed through standard arthroscopy before intervention).
It is important to note two important factors in the biological product used. 1) the ADSC product was digested with an enzyme called collagenase to isolate the stem-cell fraction and 2) the PRP product was a simple, home-spin system that authors were not able to confirm concentrated product to >2x above baseline.
All in, authors founds that therapies with ADSCs + PRP and only ADSCs are safe and effective over 6 months for the improvement of pain, functional capacity and joint inflammation in volunteers with OA. It is also considered that the use of ADSCs + PRP, particularly, is a promising alternative to help manage this disease, due to the better results presented among the four propose interventions.
ACCESS HERE: https://doi.org/10.1002/term.3337
Autologous Platelet-Rich Plasma in The Management of Diabetic Foot Ulcer: A Systematic Review of Randomized Controlled Trials
Journal of Skin and Stem Cell // LOE: ll
Diabetic foot ulcer (DFU) remains a devastating and prevalent complication of diabetes, which leads to significant morbidity, mortality, and economic implications. In this systematic review, authors evaluated only RCTs to determine efficacy of PRP in treating this pathology.
To repeat my earlier point regarding meta-analysis involving PRP, there is a level of skepticism necessary due to the heterogeneity of preparations and the fact that not all PRP is created equal.
Authors of this review found that PRP performed well with regards to healing DFU wounds with a high rate of healing, which leads to a shorter time to wound closure. However, only 6 reviews were included, so much more research is needed before we are able to draw firm conclusions. We covered some additional RCTs on this subject in our January 2022 and February 2022 research roundup.
ACCESS HERE: https://dx.doi.org/10.5812/jssc-126907
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 cdowns@mdbiologix.com
Cheers!
Connor
This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and any related subjects. The views and opinions expressed in this post are those of the author and may not reflect the views and opinions of MDBiologix. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if any treatment is right for you.