original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: There has been a surge in high-level studies investigating platelet-rich plasma (PRP) for tendon and ligament injuries. A number of meta-analyses have been published, but few studies have focused exclusively on tendon and ligament injuries.
PURPOSE: To perform a meta-analysis assessing the ability of PRP to reduce pain in patients with tendon and ligament injuries.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of the literature was carried out in April 2017 using electronic databases PubMed, MEDLINE, and the Cochrane Library. Only level 1 studies were included. Platelet and leukocyte count, injection volume, kit used, participant age/sex, comparator, and activating agent used were recorded. The short-term and long-term efficacy of PRP was assessed using the visual analog scale (VAS) to measure pain intensity. Injury subgroups (rotator cuff, tendinopathy, anterior cruciate ligament, and lateral epicondylitis) were evaluated. Funnel plots and the Egger test were used to screen for publication bias, and sensitivity analysis was performed to evaluate the effect of potential outliers by removing studies one at a time.
RESULTS: Thirty-seven articles were included in this review, 21 (1031 participants) of which could be included in the quantitative analysis. The majority of studies published investigated rotator cuff injuries (38.1%) or lateral epicondylitis (38.1%). Seventeen studies (844 participants) reported short-term VAS data, and 14 studies (771 participants) reported long-term VAS data. Overall, long-term follow-up results showed significantly less pain in the PRP group compared with the control group (weighted mean difference [WMD], -0.84; 95% CI, -1.23 to -0.44; P < .01). Patients treated with PRP for rotator cuff injuries (WMD, -0.53; 95% CI, -0.98 to -0.09; P = .02) and lateral epicondylitis (WMD, -1.39; 95% CI, -2.49 to -0.29; P = .01) reported significantly less pain in the long term. Substantial heterogeneity was reported at baseline ( I2 = 72.0%; P < .01), short-term follow-up ( I2 = 72.5%; P < .01), long-term follow-up ( I2 = 76.1%; P < .01), and overall ( I2 = 75.8%; P < .01). The funnel plot appeared to be asymmetric, with some missingness at the lower right portion of the plot suggesting possible publication bias.
CONCLUSION: This review shows that PRP may reduce pain associated with lateral epicondylitis and rotator cuff injuries.
- “Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review,” Robert-Jan de Vos, Johann Windt, and Adam Weir, British Journal of Sports Medicine, 2014.
- “Impact of autologous blood injections in treatment of mid-portion Achilles tendinopathy: double blind randomised controlled trial,” Kevin J Bell, Mark L Fulcher, David S Rowlands, and Ngaire Kerse, British Medical Journal, 2013.
- “Platelet-rich therapies for musculoskeletal soft tissue injuries,” Vinícius Y Moraes, Mário Lenza, Marcel Jun Tamaoki, Flávio Faloppa, and João Carlos Belloti, Cochrane Database of Systematic Reviews, 2014.
- “Autologous growth factor injections in chronic tendinopathy,” Michelle A Sandrey, Journal of Athletic Training, 2014.
- “Popular Blood Therapy May Not Work,” Gina Kolata, New York Times.
- “Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis,” Yanhong Han, Hetao Huang, Jianke Pan, Jiongtong Lin, Lingfeng Zeng, Guihong Liang, Weiyi Yang, and Jun Liu, Pain Med, 2019.
- “The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment,” Xiao Chen, Ian A Jones, Caron Park, and Jr Vangsness, American Journal of Sports Medicine, 2018.
One article on PainScience.com cites Chen 2018 as a source:
- Does Platelet-Rich Plasma Injection Work? — An interesting treatment idea for arthritis, tendinopathy, muscle strain and more
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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