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Regenerative Research Roundup - November 2023





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 PRP + HA vs. PRP alone; PRP vs. PPP for plantar fasciitis; and PRP for jumper's knee.


Let's dive in!


 

Efficacy and Safety of Hyaluronic Acid and Platelet-Rich Plasma Combination Therapy Versus Platelet-Rich Plasma Alone in Treating Knee Osteoarthritis: A Systematic Review

Cureus // LOE: IV


Combination therapy with HA + PRP is becoming increasingly popular in the clinical space. The basic science rationale of combining PRP + HA is promising. These two solutions have unique and complementary effects on the OA environment and combination therapy aims to titrate these unique effects and maximize the therapeutic potential.

Authors of this paper conducted a systematic review to examine the effectiveness and safety of combining HA and PRP therapy versus using PRP therapy alone in KOA patients. They made efforts to characterize the PRP and HA products used in each study, however, this will continue to be a notable limitation of systematic review.

From a safety perspective, the combo did not lead to any higher rate of incidence compared with the PRP alone or control groups.

For outcomes ,the combo produced outcomes similar to PRP therapy alone in the short term, up to 12 months. when considering longer-term results, particularly in the 24-month follow-up, dual therapy holds the potential to produce superior outcomes compared to PRP alone therapy.


 

A randomized study comparing the effect of platelet-rich plasma and platelet poor plasma for the treatment of plantar fasciitis

Research, Society and Development // LOE: l


In this study, authors sought to determine whether it was the presence of platelets or potentially other therapeutic components of blood plasma that have an impact on PRP therapy for plantar fasciitis. It is worth noting that while evidence continues to emerge, PRP for PF is generally regarded as a promising option for patients.

In jumping to the conclusion, authors stated the following - PPP or PRP were able to reduce the VAS, but the presence of platelets did not have a role in the pain relief. Other factors in the plasma may play a role in reducing the pain caused by plantar fasciitis for a period of up to 180 days.

However, upon a review of the methods it was clear that the authors achieved a final PRP concentration of only ~2.5x despite using a double-spin technique. While a trivial platelet count to begin with, they further diluted the product AFTER sampling by adding calcium chloride in a 2:1 manner - suggesting the final concentration of the product to likely be closer to baseline.





Therefore, it's unsurprising that they found no significant difference between the two treatment arms - they were basically injecting the same thing!

 


Platelet-rich plasma for jumper's knee: a comprehensive review of efficacy, protocols, and future directions


Euro J. Ortho Surg & Trau. // LOE: lV


This comprehensive review evaluates the current state of platelet-rich plasma (PRP) treatment for jumper's knee, also known as patellar tendinopathy. The aim is to assess the efficacy of PRP as a therapeutic option compared to other available procedures, investigate the benefits and potential drawbacks of PRP infiltration, and provide insights into the optimal protocols for PRP preparation and administration.

In conclusion, authors found that PRP has demonstrated promising results in promoting cellular remodeling and accelerating the healing process in the jumper's knee. It shows potential benefits in pain reduction, improved function, and accelerated recovery. However, they note that there is a lack of standardization in the literature and thus the field is held back.



Based on clinicians achieving the best results with treating this modality, a platelet preparation (~5x baseline) that is leukocyte-rich tends to yield the best results although may induce a higher change of post-injection pain due to the inflammatory nature of the LR- preparation.

 

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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