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Regenerative Research Roundup - December 2022

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.

It was a very dry month for new research, as the end of the year approaches and authors are looking to start of 2023 with fresh publications.

That being said, we still have some papers covering PRP + HA; Intra-osseous PRP; and moderate dose-PRP for hemophilic knee OA

Let's dive in!


Efficacy and safety of platelet-rich plasma combined with hyaluronic acid versus platelet-rich plasma alone for knee osteoarthritis: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research // LOI: lV

The combination of PRP with HA has been researched now for some time, with mixed results. Broadly speaking, some literature suggests an improvement over either intervention alone. However, considering the significant price increase to patients receiving both patients, we should demand an equal improvement in outcomes.

This review paper evaluates the efficacy and safety of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA), comparing with platelet-rich plasma alone. Thirteen articles (9 RCTs, 4 cohort studies), including 1118 patients, were covered.

The results of this paper indicated that PRP + HA therapy was not found to be superior to PRP-alone therapy in pain relief and function improvement for patients with KOA. They did note that the combination therapy did see a reduction in adverse events, however, I expect this is simply a data artifact.


Efficacy of Intra-articular, intra-osseous Injections of Platelet-Rich Plasma in Osteoarthritis Knee: A Randomized Clinical Trial

Archives of Physical Medicine and Rehabilitation // LOE: ll

This is a research summary only, however, covers a topic that has growing interest. Namely, whether intra-osseous application of PRP into the femoral-condyle can improve symptoms of OA vs. intra-articular injections of PRP.

In this prospective, randomized study, a total of 64 persons with OA knee with a Kellgren-Lawrence score of 3 were randomized into two groups. Persons in Group-I received 8ml of single intra-articular PRP injection, and persons in Group II received 18 ml of PRP (two-intra-osseous injections (5ml each in femoral-condyle and tibia plateau) and one intra-articular injection (8ml) of PRP (total 18 ml of PRP, for single joint)) the in the target knee joint under fluoroscopic guidance. All persons (n=64) were followed up at 3 and 6 months.

Though both groups showed significant improvement following PRP injections, additional injections of PRP in the subchondral region did not provide additional benefits (pain-relief and KOOS scores) than intra-articular-PRP injections at 6 months.


No Benefit to Platelet-rich Plasma Over Placebo Injections in Terms of Pain or Function in Patients with Hemophilic Knee Arthritis: A Randomized Trial

Clinical Orthopaedics & Related Research // LOE: l

Can moderate dosages of PRP still benefit patients suffering from hemophilic knee OA? The short answer, is not according to this study.

This was a prospective, parallel-group, double-blinded, single-center, placebo-controlled randomized clinical trial. Physicians delivered three sessions (one per week) of a standard intraarticular injection of PRP (n = 95) or placebo (n = 95). The PRP delivered was 4cc's at 3.4x baseline, which is below the 4-5x threshold that is generally regarded as the optimal concentration for PRP.

Over 24 months, authors concluded that PRP injections did not offer significant improvements over placebo. Add this to the evidence that low-to-moderate dose PRP may not provide any benefit to patients and care should be taken to ensure the platelet product is of sufficient quality to deliver expected results.

Physicians delivered three sessions (one per week) of a standard intra-articular injection of PRP (n = 95) or placebo (n = 95).


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




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.


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