Regenerative Research Roundup - November 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 more failed PRP trials; Intradiscal PRP; and PRP best practices for acne scarring!

Let's dive in!

 

Double-Blind Randomized Controlled Trial Comparing Platelet-Rich Plasma With Intra-Articular Corticosteroid Injections in Patients With Bilateral Knee Osteoarthritis

Cureus // LOI: l

Despite the sound of a broken record playing in the distance, we receive monthly reminders that dose matters in PRP. This recent RCT comparing intra-articular PRP to steroid injections is just that.

In a double-blinded RCT, 29 patients (58 knees) with radiologically confirmed mild-to-moderate bilateral knee osteoarthritis received an intra-articular PRP injection into one knee and a methylprednisolone injection with a local anesthetic into the contralateral knee.

The PRP used was Arthrex ACP, which although not characterized in this study, will at most deliver a product that is ~2x above baseline. This is far below the therapeutic threshold for PRP efficacy in knee OA that has been established in the literature.


Difference in WOMAC pain change from baseline

Unsurprisingly, authors found no statistically significant difference between treatment groups at 6 weeks, three, or six months. This is a notable divergent from best-in-class research comparing PRP to steroid injections for joint pathologies. Remember - dose matters!

ACCESS HERE: https://doi.org/10.7759/cureus.29744

 

Intradiscal Leukocyte Rich Platelet Rich Plasma for Degenerative Disc Disease

Physical Medicine and Rehabilitation Clinics of North America // LOE: ll

Intra-discal PRP for the treatment of discogenic LBP has been a "hit or miss" research area. There is promising research, however, the jury is still out on optimal preparation methods and dose. Fortunately for us, Dr. Greg Lutz has been advancing research in this field for over a decade and his new research summary adds an important puzzle piece.

Based on this new paper, the leukocyte-rich fraction of PRP is critical to outcomes in DDD. This is in addition to the high-platelet dose revealed in his work published in March 2022.

ACCESS HERE: https://doi.org/10.1016/j.pmr.2022.08.009


 

Intradiscal Autologous Platelet-Rich Plasma Injection for Discogenic Low Back Pain: A Clinical Trial

BioMed Research International // LOE: ll

It's a 2-for-1 month for intradiscal PRP, which another research paper highlighting the promise of this intervention for discogenic low-back pain.

In this study, 39 participants received a single injection of PRP and were assessed at various timepoints out to 48 weeks. The PRP used was ~4.7x above baseline and leukocyte-rich, which are both in-line with emerging intradiscal best practices.


Change in pain scores over time. # indicates statistical significance.

Compared to pre-injection values, pain and lumbar function were significantly improved. 71% of patients were classified as a success after the intradiscal injection, which was defined as meeting the MCID for both pain and function without the need for surgery.

ACCESS HERE: https://doi.org/10.1155/2022/9563693

 

Which is more effective in atrophic acne scars treatment microneedling alone or platelet rich plasma alone or combined both therapeutic modalities?

Dermatologic Therapy // LOE: lll

Acne scarring is a common cosmetic pathologies that is often treated with multiple modalities, however, limited evidence exists on which is better - microneedling or intradermal PRP?

In this study, 30 patients with facial post-acne scars were randomly recruited and divided into two groups. Each group received microneedling + PRP on half of their faces, with the other half receiving either microneedling alone or intra-dermal PRP. The PRP used was not characterized, although it followed a dual-spin approaching moving from 15ml WB to 1ml PRP, suggesting an adequate concentration. Treatments were performed every 3 weeks for a maximum of 4 sessions.



Authors concluded that the combination of microneedling + PRP produced the best outcomes in patients.


ACCESS HERE: https://doi.org/10.1111/dth.15925

 

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.