Updated: May 3, 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.
This month, we're reviewing the impact of common medications on PRP efficacy; PRP for knee OA; and PRP for Lateral Epicondylitis.
A Systematic Review on the Effect of Common Medications on Platelet Count and Function
Orthopaedic Journal of Sports Medicine // Level of Evidence: IV
It's well understood that certain medications are contra-indicated for the production and use of PRP. In this systematic review, authors looked at how certain medications impact platelet count and platelet function - both key areas that can implicate the efficacy of PRP treatment.
Medication inclusion criteria were: aspirin, acetaminophen, a nonsteroidal anti-inflammatory drug (NSAID), a statin, or gabapentin. In total, 20 studies were included in the analysis.
None of the medications led to a decrease in platelet count. Patients treated with aspirin (268 patients) or acetaminophen (13 patients) showed a significant decrease in platelet aggregation. Statin therapy (73 patients) did not result in a significant decrease in platelet aggregation. Patients who took NSAIDs (172 patients) demonstrated significantly decreased platelet aggregation only when treated with nonselective formulations. Those treated with cyclooxygenase (COX)-2–selective NSAIDs showed no significant difference in platelet aggregation.
Authors concluded that aspirin, acetaminophen, and nonselective NSAIDs should be considered for suspension before a PRP injection because of their potential to diminish the effects of the injection. COX-2–selective NSAIDs and statins do not need to be withheld before a PRP injection.
ACCESS HERE: https://doi.org/10.1177/23259671221088820
A prospective study to analyze functional outcome of intraarticular autologous platelet rich plasma (PRP) in management of osteoarthritis of knee joint
International Journal of Orthopaedic Sciences // Level of Evidence: ll
Most studies investigating the use of PRP for Knee OA have focused on a 2 or 3 injection protocol. However, there is often significant benefit achieved with only a single injection as demonstrated by this study.
This prospective study aimed to assess the functional outcome of 40 patients with OA when treated with a single autologous intraarticular PRP for a follow-up period of up to 15 months. Follow-up of patients was conducted at 1, 3, 6, 12, and 15 months after injection and mean platelet concentration was 5x above baseline.
Authors observed an excellent response as determined by VAS pain scores at 1 month and response was maintained all the way through 15 months.
ACCESS HERE: https://doi.org/10.22271/ortho.2022.v8.i1k.3105
Effectiveness of Platelet-Rich Plasma for Lateral Epicondylitis: A Systematic Review and Meta-analysis Based on Achievement of Minimal Clinically Important Difference
Orthopaedic Journal of Sports Medicine // Level of Evidence: lV
This is a systematic review of using PRP in the treatment of Lateral Epicondylitis. At a glance, it is not a newsworthy piece of evidence, however, authors of this review evaluated outcomes in the context of Minimal Clinically Important Difference (MCID) values. This was further correlated to the presence (or absence) of leukocytes in the PRP preparation.
A total of 26 studies were included in the analysis. Based on comparisons with the MCID values of commonly used outcome scores, PRP seems to be an effective form of treatment for lateral epicondylitis. Both the LR- PRP and the LP- PRP systems were effective in the context of meeting the MCID, however, LR-PRP appeared to improve outcome scores in earlier timepoints.
ACCESS HERE: https://doi.org/10.1177%2F23259671221086920
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 email@example.com
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