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 studies on LR-PRP vs. LP-PRP for KOA; PRP vs. HA for KOA; Cryopreservation of PRP; and PRP for lumbar disc herniation.
Let's dive in!
Leukocyte-Rich Platelet-Rich Plasma Is Predominantly Anti-inflammatory Compared With Leukocyte-Poor Platelet-Rich Plasma in Patients With Mild-Moderate Knee Osteoarthritis: A Prospective, Descriptive Laboratory Study
American Journal of Sports Medicine // LOE: lV
Over the past several years, the optimal preparation of PRP for joint pathologies has been the subject of much debate - specifically whether leukocytes are beneficial or harmful. Clinically, there has been a preference towards LP-PRP due to an observed reduction in post-injection flare ups.
In this laboratory study, 24 unique samples of PRP were prepared in order to assess 48 samples of LR-PRP and LP-PRP taken from 12 patients (6 male and 6 female) with symptomatic knee OA of Kellgren-Lawrence grade 2 to 3. Patients underwent blood collection for LR-PRP and LP-PRP preparation through a double-spin protocol to obtain baseline whole blood, platelet concentration, and white blood cell subtypes.
LR-PRP expressed significantly more IL-1Ra, IL-4, and IL-8, suggesting that LR-PRP may be more anti-inflammatory than LP-PRP. MMP-9 was expressed in higher concentrations in LR-PRP, suggesting that LR-PRP may be more chondrotoxic than LP-PRP.
ACCESS HERE: https://doi.org/10.1177/03635465231170394
The effect of short-term cryopreservation on the properties and functionality of platelet-rich plasma
Platelets // LOE: l
Another laboratory study, but one that may advance the industries understanding about the implications of cryopreserving platelets for delayed PRP treatments. The idea that a patient could arrive for a blood draw, have multiple platelet preparations cryopreserved, and then receive PRP therapy over a series of weeks could help streamline clinical operations.
To assess the suitability of freezing, after collecting PRP and platelet lysates (activated PRP) from 6 patients, they were preserved for 1 or 3 months at temperatures of −20ºC and −80°C. Measurements were then made on platelet number and integrity, growth factor levels, biomechanical properties of the clot and its bioactivity on cultured cells.
The results showed that freezing affected platelet size, the levels of platelet-derived GFs and the biomechanical properties of the clot. However, plasmatic levels of growth factors or its capacity to boost cellular proliferation were not affected.
ACCESS HERE: https://doi.org/10.1080/09537104.2023.2210243
Single blind randomized study for comparison of efficacy of injection of platelet rich plasma versus high molecular weight viscous supplementation in osteoarthritis knee
Journal of Cardiovascular Disease Research // LOE: ll
This RCT investigated the effects of PRP vs. high-molecular weight HA in KOA. Thirty patients were chosen and randomly divided into two groups of 15 each. Patients with same K L grade in both knees were chosen for study. In group A, patients were given platelet rich plasma in right knee and high molecular weight viscous supplement in left knee. In group B, patients were given high molecular weight viscous supplement in right knee and platelet rich plasma in left knee.
As is characteristic of many of these studies, authors reported an initial reduction in VAS for the HA group in the first month, however, at 3 and 6 months the PRP group achieved a signification reduction in VAS over the HA group.
There may be benefit to combination therapy that can deliver the immediate pain relief via the HA, with PRP providing more long-term pain relief beyond 6 weeks.
“Platelet-Rich Plasma” epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial
BMC Musculoskeletal Disorders // LOE: l
This RCT evaluated the efficacy of PRP in treatment of single-level lumbar herniation in comparison to triamcinolone (epidural steroid injection).
Thirty patients were treated by transforaminal epidural injections. PRP was obtained from 24 ml venous blood through standardized double-spin protocol. The end product was characterized at 2.85x baseline and leukocyte-rich.
Patients treated by PRP injections showed statistically and clinically significant reduction in LegVAS at 6, 12, and 24 weeks, and in ODI at 24 weeks compared to the control group.
ACCESS HERE: https://doi.org/10.1111/os.13732
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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