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Regenerative Research Roundup - January to April 2025


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 explore:

  • Optimal PRP frequency for KOA

  • PRP Concentration for Lateral Epicondylitis

  • PRP vs. HA for KOA

  • PRP & Adipose Tissue for Regenerative Treatments


Let's dive in!



Optimal frequency of platelet-rich plasma injections for managing osteoarthritis: A longitudinal study


Regenerative Therapy // LOE: II (Prospective clinical trial)


This longitudinal clinical trial followed 167 patients with knee osteoarthritis to evaluate outcomes following variable numbers of intra-articular PRP injections. Patients were stratified by KL grade and followed for 24 months.

Key findings:

  • KL 1–2 patients experienced maximal symptom relief with 4 injections; KL 3–4 required ≥5 injections.

  • Each injection delivered ~2.5 billion platelets via 2.4 mL of 5x leukocyte-rich PRP.

  • 73% of patients were OMERACT-OARSI responders at final follow-up.

  • Structural improvements observed via MRI (e.g., reduced bone marrow lesions).

Clinical Perspective: While the platelet dose per injection was modest, the study underscores that KL grade drives the number of PRP injections required. This has implications for treatment planning—especially for advanced OA where a single injection is unlikely to suffice. More robust dosing strategies, especially for KL 3–4, may further enhance outcomes.


Platelet Concentration Explains Variability in Outcomes of Platelet-Rich Plasma for Lateral Epicondylitis: A High Dose Is Critical for a Positive Response

American Journal of Sports Medicine // LOE: I (Meta-regression)


This meta-regression analyzed 13 randomized controlled trials (n=791) to investigate the relationship between platelet concentration in PRP and clinical outcomes in lateral epicondylitis.

Key findings:

  • High-dose PRP (≥3x baseline concentration) yielded significant pain relief over placebo or low-dose PRP.

  • Low-dose PRP showed no clinically meaningful benefit.

  • Platelet concentration explained 58.5% of between-study outcome variability.

Clinical Perspective: This study reinforces the critical role of platelet dose in achieving therapeutic efficacy. For tendinopathies like lateral epicondylitis, using under-concentrated PRP likely results in underwhelming outcomes. Clinicians should confirm platelet yield and concentration when selecting systems and protocols.




Intraarticular leukocyte-poor platelet-rich plasma injection is more effective than intraarticular hyaluronic acid injection in the treatment of knee osteoarthritis: a systematic review and meta-analysis of 12 randomized controlled trials


Knee Surgery & Related Research // LOE: I (Meta-analysis)


This meta-analysis compared leukocyte-poor PRP to HA injections across 12 RCTs for treating KOA.


Key findings:

  • LP-PRP showed superior pain relief and functional improvements at 6 and 12 months compared to HA.

  • WOMAC, IKDC, and VAS scores all favored PRP over HA.

  • No significant difference in adverse events between groups.

Clinical Perspective: For patients who have failed viscosupplementation, this study justifies the use of LP-PRP as a next-line, evidence-supported treatment. Even without leukocytes, PRP provides longer-lasting and more comprehensive benefits than HA alone.



A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis


Journal of Orthopaedic Surgery and Research // LOE: I (Meta-analysis)


This meta-analysis of 11 RCTs (n=1023) evaluated outcomes in KOA patients treated with either PRP + HA or PRP alone.

Key findings:

  • PRP + HA significantly outperformed PRP alone on WOMAC, VAS, Lequesne Index, and IKDC scores.

  • 59% reduction in adverse event risk observed in the combination group.

  • Results were consistent across studies with minimal heterogeneity.

Clinical Perspective:


Adding HA to PRP appears to offer synergistic benefits in KOA patients, particularly for pain and function. This strategy may appeal to clinicians accustomed to HA use who want to transition toward biologics without abandoning familiar modalities.



The Regenerative Marriage Between High-Density Platelet-Rich Plasma and Adipose Tissue


Preprints.org // LOE: V (Narrative review)


This review explores the biological rationale and clinical applications for combining HD-PRP with stromal vascular fraction (t-SVF) derived from adipose tissue.

Key findings:

  • HD-PRP (>1 billion plt/mL) provides high levels of growth factors and immunomodulatory agents.

  • t-SVF contributes AD-MSCs, pericytes, fibroblasts, and scaffold-like matrix.

  • The combination enhances tissue repair, angiogenesis, and reduces inflammation in diverse applications.


Clinical Perspective:


While early-stage, this review synthesizes emerging strategies that combine cell and scaffold-based regenerative approaches. It’s particularly relevant for aesthetic and orthopedic applications where structural and biologic repair are both priorities. As biocellular therapies become more common, PRP-t-SVF blends may set the standard.


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.

 
 
 

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