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 hair loss following COVID-19; IO+IA PRP for Knee OA; LR-PRP for Severe Knee OA; and using PRP for the treatment of non-healing diabetic ulcers.
Platelet-Rich Plasma Treatment for Accelerated Androgenetic Alopecia Pattern Hair Loss After COVID-19 Infection: A Case Series
Journal of Cosmetic Dermatology // Level of Evidence: IV
Hair-related manifestations such as alopecia areata or telogen effluvium have been reported during COVID-19 disease. Given PRP's recent success in treating these conditions, authors of this case series treated 9 patients with complaints of hair loss after an average of 220 ± 24.2 (min: 182 max: 264) day after recovery of COVID-19. Each patient received 4 injections of PRP.
Hair Pull Test (HPT) score decreased to 6.0 ± 1.6 after the first PRP application (p = 0.007, CI 95%:2.7–5.2) and decreased to 1.2 ± 0.8 after the last PRP session (p = 0.008, CI 95%: 6.4–11.1). Five (55.5%) of the patients described the treatment as “very effective” after treatment with HGQ.
Single intra-articular injection with or without intra-osseous injections of platelet-rich plasma in the treatment of osteoarthritis knee: A single-blind, randomized clinical trial
International Journal of the Care of the Injured // Level of Evidence: l
While joint injections with PRP have emerged as the gold standard in Knee OA treatment, Intra-osseous PRP is becoming a subject of research. IA BMAC has been applied since the late 1990's, however, can PRP offer the same regenerative punch?
This was a single-blind, parallel-group, randomized clinical trial. Fifty patients, with OA knee (K&L grade III), with ages between 50 and 65 years, were randomly allocated into ‘intra-osseous, intra-articular PRP’ (‘IO+IA-PRP’) (n = 25) or ‘intra-articular PRP’ group (‘IA-PRP’) (n = 25). Patients in the ‘IO+IA-PRP’ group received 18 ml PRP injection, and the ‘IA-PRP’ group received 8 ml PRP injection. Intra-osseous injections were given at the tibial plateau (5 ml) and femoral condyle (5 ml), along with intra-articular knee injection (8 ml), under fluoroscopic guidance.
Both groups showed significant improvement following the intervention. However, intra-osseous PRP injections did not provide any additional benefit over intra-articular PRP injection until six months regarding pain relief and functional improvement.
Consecutive injections of leukocyte-rich platelet-rich plasma are effective in not only mild but also severe knee degeneration
Journal of Orthopaedics // Level of Evidence: III
This was a prospective cohort study involving a very large sample size (n=260) of patients that received LR-PRP injections between June 2016 and May 2021. Patients of all K-L grades (I-IV) were included and each received treatment every 4 weeks for over four times (mean 5.8 times).
The clinical evaluation used the Knee Injury and Osteoarthritis Outcome Score, visual analogue scale, and magnetic resonance imaging osteoarthritis knee score-body mass lesions to determine the therapeutic effect using the Outcome Measures in Rheumatology-Osteoarthritis Research Society International responder criteria for osteoarthritis.
Among those administered with LR-PRP, the responder rate was 72.0%, 78.1%, 78.1%, and 77.1% at 3, 6, 12, and 24 months, respectively. Although not statistically significant, patients with K-L grade IV tended to achieve peak values at 1 year after treatment, and these values then tended to taper compared with those of patients with K-L grade I, suggesting that more severe degeneration requires longer-term treatment and additional doses.
Authors acknowledged that LP-PRP is the gold standard for knee OA treatment, so it's worth considering how these results may have been improved with the use of that PRP preparation.
A comparative study on effect of platelet rich plasma Vs conventional dressing in healing rate of chronic diabetic ulcers
Biomedicine // Level of Evidence: ll
We’ve been seeing a growing volume of evidence supporting the application of autologous biologics in wound healing. Specifically, the treatment of non-healing, chronic, diabetic ulcers.
This was a non-randomized comparative study undertaken to evaluate efficacy of platelet rich plasma (PRP) dressing with conventional dressing in 120 patients (60 per group).
Authors found that the average rate of healing per week was found to be significantly better among the PRP group than normal dressing group. The ulcer showed significant reduction in size among the PRP group in comparison to the normal dressing group with a significant P value (0.001).
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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