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 found new research on PRP for ankle arthritis, Plasma gel, PRP concentrations in hair restoration, and BMAC for acetabular labral repair. Let's explore!
Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis: A Randomized Clinical Trial
The Journal of the American Medical Association // Level of Evidence: l
We're starting off with a paper that exploded on social media, as the authors findings did not support the use of PRP injections for patients with ankle osteoarthritis - which is contrary to the bulk of high-quality evidence to-date.
After reviewing the study in detail, it appears that the lackluster results can be attributed to the authors use of 2cc's of Arthrex ACP as the PRP injectate. This product routinely concentrates PRP around ~2x above baseline, which we already know is a common reason for poor patient outcomes. The vast majority of evidence supports a minimum of >4x above baseline to achieve clinically significant results, and in some cases even higher.
Study of Platelet Rich Plasma Injection versus Plasma Gel in Periorbital Rejuvenation
QJM: An International Journal of Medicine // Level of Evidence: lll
Plasma gel is a great way to develop a 3D fibrin matrix for your PRP that can overcome the problem of product diffusion into surrounding tissue.
This comparative split face study included 40 females with periorbital wrinkles. Using both Plasma gel and PRP, authors concluded via 3D imaging and subjective patient evaluation that Plasma Gel resulted in better patient outcomes.
It's worth noting that the method of PRP preparation used would likely yield only 2x above baseline, while the Plasma gel was prepared from PPP. A better preparation protocol would have been to use a PRP product with >5x concentration (like Harvest PRP) and mix that with the plasma gel in a 1:5 ratio. This would create a product that has strong physical characteristics while retaining a high-concentration of platelets for tissue regeneration.
A Split Scalp Study of Single versus Double Spin Platelet-rich plasma Injections in Treatment of Female Pattern Hair Loss: Clinical Effect and Relation to Vascular Endothelial Growth Factor in PRP
QJM: An International Journal of Medicine // Level of Evidence: lll
Another study demonstrating why double-spin systems (like Harvest) that produce high concentrations of platelets will outperform single-spin systems (i.e. Gel Tubes).
This split scalp study involved 15 patients that received PRP produced from either a single-spin, or double-spin method. 3 treatments were performed approximately 3 weeks apart, which is the standard for hair restoration procedures. Treatment response was done through comparing patients' global photographs, assessment of patients' satisfaction and folliscopic assessment before and after treatment. Authors concluded that the area of the scalp that received the double-spin PRP had greater hair-density per follicle, than the area of the scalp that received the single-spin PRP.
Functional Outcomes of Arthroscopic Acetabular Labral Repair with and without Bone Marrow Aspirate Concentrate
The Journal of Bone and Joint Surgery // Level of Evidence: lll
BMAC has demonstrated success in stacking the deck in your favour during orthopedic procedures.
The current study examined the clinical efficacy of BMAC application in patients undergoing arthroscopic acetabular labral repair by comparing patient-reported outcome measures (PROMs) between groups with and without BMAC application. A total of 62 patients were included in each treatment group.
Authors concluded that patients with moderate cartilage injury undergoing arthroscopic acetabular labral repair with BMAC application reported significantly greater functional improvements when compared with similar patients without BMAC application.
ACCESS HERE: https://journals.lww.com/jbjsjournal/Fulltext/9900/Functional_Outcomes_of_Arthroscopic_Acetabular.368.aspx
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.