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 findings on platelet and leukocyte concentrations in PRP therapy, PRP's role in rotator cuff repair, and PRP's efficacy in post-meniscectomy recovery.
Let's dive in!
Influence of Platelet Concentration on the Clinical Outcome of Platelet-Rich Plasma Injections in Knee Osteoarthritis
The American Journal of Sports Medicine // LOE: III
This cohort study of 253 patients examined how platelet concentration affects outcomes in knee OA treated with PRP injections.
Key findings:
Higher platelet concentrations (>1,200,000 platelets/mL) showed superior outcomes
Failure rates were significantly lower in high-platelet groups (3.3% vs 15.0%)
Better KOOS Pain scores were seen at 2, 6, and 12 months with higher concentrations
Results suggest practitioners should aim for higher platelet concentrations
The authors conclude that platelet concentration is a crucial factor in treatment success and emphasize the importance of standardizing and maximizing platelet concentrations for optimal outcomes.
Clinical Perspective: While this study provides compelling evidence for the importance of platelet concentration, it would be valuable to see how a single injection of even higher-dose PRP (e.g., 10 billion platelets) would perform against these treatment groups. Recent evidence suggests that higher doses may be even more effective in knee OA treatment, and exploring this upper threshold could help establish optimal treatment protocols.
ACCESS HERE: https://doi.org/10.1177/03635465241283463
Leukocytes Do Not Influence the Safety and Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis
The American Journal of Sports Medicine // LOE: I
This double-blind RCT of 132 patients investigated the impact of leukocyte concentration on PRP outcomes in knee OA treatment.
Key findings:
No significant differences in clinical outcomes between LR-PRP and LP-PRP
Comparable improvements in pain and function between groups
Similar adverse event rates and treatment failures
Results challenge assumptions about negative effects of leukocytes
The study suggests that leukocyte concentration may be less important than other factors in PRP preparation for knee OA treatment.
Clinical Perspective: It's important to note that the leukocyte concentration difference between the two treatment groups in this study was relatively modest. Most commercial systems produce LR-PRP with approximately 4x baseline leukocyte concentration, which typically results in higher adverse event rates than those observed in this study. This distinction should be considered when interpreting these results in clinical practice.
ACCESS HERE: https://doi.org/10.1177/03635465241283500
Platelet-Rich Plasma Injections Do Not Improve the Recovery After Arthroscopic Partial Meniscectomy
The American Journal of Sports Medicine // LOE: I
This double-blind RCT evaluated PRP's effectiveness in improving recovery after arthroscopic partial meniscectomy in 90 patients.
Key findings:
No significant differences between PRP and control groups
Similar outcomes in pain relief and function
Comparable return-to-sport timelines
No advantage in objective parameters at 6 months
The authors conclude that routine use of PRP following arthroscopic partial meniscectomy may not be justified based on these results.
Clinical Perspective: It's noteworthy that this study utilized the Arthrex ACP system, which typically produces PRP with less than 2x baseline platelet concentration. Given the growing body of evidence supporting higher platelet doses for optimal clinical outcomes, the question remains whether PRP might show better results in this application with more concentrated preparations. Further research using higher-concentration PRP would be valuable to definitively determine its potential role in post-meniscectomy recovery.
ACCESS HERE: https://doi.org/10.1177/03635465241283052
Platelet-Rich Plasma for Arthroscopic Rotator Cuff Repair: A 3-Arm Randomized Controlled Trial
American Journal of Sports Medicine // LOE: I
This randomized controlled trial investigated whether leukocyte-rich PRP (LR-PRP) or leukocyte-poor PRP (LP-PRP) could improve outcomes after arthroscopic rotator cuff repair in 150 patients.
Key findings:
No significant differences in primary functional outcomes among the three groups at 12 months
LR-PRP group showed better ASES scores at 3 and 6 months compared to control
Overall retear rate was 8% with no differences between groups
Minimal complications (3% postoperative stiffness) across all groups
No difference in structural integrity between PRP and control groups
The authors conclude that neither LR-PRP nor LP-PRP demonstrated superior functional or structural outcomes at 12 months compared to control, though LR-PRP showed some early functional benefits.
Clinical Perspective: As with the meniscectomy study, this trial utilized PRP preparations that produce relatively low platelet concentrations. Recent evidence increasingly suggests that higher platelet concentrations may be necessary for optimal clinical outcomes. Future studies investigating more concentrated PRP preparations in rotator cuff repair could help determine whether higher doses might provide more substantial benefits in this application.
ACCESS HERE: https://doi.org/10.1177/03635465241283964
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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