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 exploring the use of BMA for glenohumeral OA, more PRP for knee OA, and PRP + Microneedling for melasma. Let's dive in!
Injection of Bone Marrow Aspirate for Glenohumeral Joint Osteoarthritis: A Pilot Randomized Control Trial
Arthroscopy, Sports Medicine, and Rehabilitation // Level of Evidence: 2
This is new study compares the efﬁcacy of a single, intra-articular, nonconcentrated bone marrow aspirate (BMA) against Cortisone injections for the treatment of glenohumeral OA. The unique Marrow Cellutions fenestrated trocar was used to aspirate bone marrow that has much more CFU's than a traditional jamshidi aspiration.
The result? A signiﬁcant difference in changes in scores was seen in the QuickDASH (P = 0.006) and the EQ-5D-5L pain scores (P = 0.003) and the EQ-5D-5L health scores (P = 0.032) in favour of Marrow Cellution Injection.
Role of Triple Injection Platelet-Rich Plasma for Osteoarthritis Knees: A 2 Years Follow-Up Study
Indian Journal of Orthopaedics // Level of Evidence: 2
It's easy to pass on new literature supporting PRP injections for knee osteoarthritis, because it seems as if a new paper validates this treatment each month. However, each paper is an important reminder that if you are treating patients suffering from this condition, you need to have PRP in your toolbox.
This was a 2-year follow up of a prospective interventional study involving 68 cases (105 knees) with Kellgren-Lawrence (KL) grades I, II and III knee OA. Patients received 3 intra-articular injections of PRP 1 month apart.
While WOMAC and VAS scores for each patient group improved significantly, it's worth noting that improvements continued up until the end of the two-year observational period.
Estimated Time to Maximum Medical Improvement of Intra-articular Injections in the Treatment of Knee Osteoarthritis – A Systematic Review
Arthroscopy: The Journal of Arthroscopic & Related Surgery // Level of Evidence: 2
As a general rule, take any meta-analysis or review paper covering PRP with a grain of salt due to the heterogeneity of PRP preparations that makes it very difficult to compare one another.
With that being said, I'm including this review as it included 79 papers (LOE: 1) for the purposes of evaluating maximum medical improvement and minimal clinically important difference (MCID) of different injectables in the treatment of symptomatic knee osteoarthritis.
When compared to corticosteroid and hyaluronic acid injections, LP-PRP demonstrated the most prolonged pain relief, with the lowest VAS score of all groups measured at final follow-up. LP-PRP showed the lowest WOMAC scores at final follow-up, one year post-injection.
Therapeutic Effect of Microneedling with Platelet-rich Plasma Versus Microneedling with Tranexamic Acid for Melasma
Journal of Clinical and Aesthetic Dermatology // Level of Evidence: 3
Melasma is a chronic acquired focal pigment disorder showing symmetrical hyperpigmentation or hypermelanosis of photoexposed areas on the face. Tranexamic acid (TXA) is a treatment for melasma.
Authors of this paper investigated the effect of microneedling followed by PRP versus microneedling followed by tranexamic acid. Among 2 arms of 13 patients each, they found that microneedling with PRP offers better results than microneedling with TXA. Pain, erythema and post-inflammatory hyperpigmentation were the same among the two treatments.
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 firstname.lastname@example.org
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