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 new research on PRP for knee arthritis, single vs. multi-dose protocols, BMA from the novel Marrow Cellutions trocar, and PRP for Female hair loss. Let's explore!
Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial
The Journal of the American Medical Association (JAMA) // Level of Evidence: l
JAMA has now gone back-to-back with publishing poorly done research papers on PRP…
This paper, along with the one from last months Research Roundup, are representative of a pervasive weakness in PRP research. So much so that I decided to dedicate an entire article to debunking it here - a must read for anybody interested in regenerative medicine.
Multiple platelet-rich plasma injections are superior to single PRP injections or saline in osteoarthritis of the knee: the 2-year results of a randomized, double-blind, placebo-controlled clinical trial
Arthroscopy and Sports Medicine // Level of Evidence: l
For the past few years, clinicians have recognized that in some cases multiple injections of PRP spaced out over a month may create stronger patient outcomes. In this study, 237 patients diagnosed with OA were randomly separated into 4 groups, who were administered the following: single dose of PRP (n: 62), single dose of sodium saline (NS) (n: 59), three doses of PRP (n: 63), and three doses of NS (n: 53). Clinical evaluations were made pre-treatment and at 1, 3, 6, 12 and 24 months post-treatment.
Authors found that the 3-dose PRP protocol provided an extended benefit to treatment. However, despite their claims that the PRP used was >5x above baseline, I am highly suspicious of this given that the went from 32ml whole blood down to 8ml of PRP - a 4x volume reduction from a single spin. Preparation methods such as this typically yield around ~2x above baseline, which makes me curious as to whether or not a single injection of highly concentrated PRP, like from the Harvest PRP system, could produce the same extended benefits as their 3-dose protocol.
A single step, centrifuge-free method to harvest bone marrow highly concentrated in mesenchymal stem cells: results of a pilot trial
International Orthopaedics // Level of Evidence: lV
This small cohort study was undertaken to evaluate BMA harvested with the novel Marrow Cellutions fenestrated trocar and it's ability to drive positive clinical outcomes in Knee OA. In particular, the experiments performed demonstrated that the content of BMSCs was able to control inflammation and counteract the catabolic cascade triggered by an inflammatory stimulus.
The Marrow Cellutions trocar allows physicians to harvest high quality BMA from a single location without the need for further refinement via centrifugation or filtration. This dramatically reduces processing time and thus time to complete non-surgical interventions such as joint injections.
Systematic review: The Platelet-Rich Plasma use in Female Androgenetic Alopecia as effective autologous treatment of regenerative plastic surgery
Journal of Plastic, Reconstructive and Aesthetic Surgeons // Level of Evidence: ll
Evidence is growing for the us of PRP in treating male androgenic alopecia (MAA), but how does it perform in women with the same condition?
In this systematic review of level 1 evidence, 5 articles were found using PRP for treatment of specifically Female Androgenic Alopecia. 80% of the articles selected reported a positive effect without major side effects.
As with all systematic reviews, these findings should be interpreted with the knowledge that not all authors are using highly concentrated PRP!
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
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