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PRP Outcomes

PRP involves the extraction and concentration of platelets from the patient’s blood, creating a potent elixir rich in growth factors and biologically active proteins integral to reducing inflammation and promoting tissue repair and regeneration.

Knee OA is a formidable challenge. The insidious nature of knee OA is characterized by degeneration of the articular cartilage, subchondral bone changes, inflammation and burdens to quality of life. Knee OA significantly impacts an individual’s daily activities, leads to pain and stiffness and reduced mobility. Platelet – Rich Plasma treatment has been show to improve symptoms and increase function. Studies report that injections of Platelet – rich Plasma into the knee for arthritis can provide up to 12 months of pain relief and is superior to cortisone and hyaluronic acid. 5

PRP applied during arthroscopy for rotator cuff repair can reduce the rate of retearing and repair failure, improves outcomes and reduces recurrence rates. 6

Meniscal tears represent the most commonly encountered pathology within the knee, leading to altered knee biomechanics, pain, and disability. About 25% of meniscus repairs fail. Studies report that Platelet-rich Plasma is safe and useful in improving the survival rate of meniscus repair reducing failure rate to 9.9%. 7 Platelet – rich plasma is a potent adjunct to optimize healing after meniscus repair.

Degenerative meniscus lesions are common and can lead to knee arthritis. PRP injections are a reliable management modality for middle-aged patients with symptomatic degenerative meniscus lesions, providing a significant improvement of clinical symptoms for up to 12 months.8

Muscle lesions account for one-third of sport-related injuries, thus representing a substantial problem for both players and their teams.  Platelet -rich plasma for acute muscle strains may result in earlier return to sports, without significantly increasing the risk of reinjury at six months follow up. Platelet -rich plasma is currently being investigates for its effectiveness in accelerating healing of hamstring muscle injuries.9

Tendinopathy is a medical condition that includes a spectrum of inflammatory and degenerative tendon changes caused by traumatic or overuse injuries. Recent research reports that Platelet-rich plasma is effective in the treatment of chronic tendon injuries such as tennis elbow.  PRP can treat chronic tendon injuries including tennis elbow. 9 Therapy helps reduce pain and swelling to provide a good environment for tissue healing. The volume, concentration, intensity, and number of injections of Platelet – rich Plasma varied across the different studies.

Generally PRP injections do not lead to tissue regeneration.  Through an anti-inflammatory and paracrine mechanism, these injections can alleviate pain and swelling in arthritic joints.  In certain conditions like muscle tears and for the augmentation of cartilage and meniscus repair, there may be an observed regenerative/healing effect.  Ultimately, whether or not PRP can be used an a tool to improve your disease-specific outcomes should be discussed with the team at Hyper Regen Sports Medicine.  We will work with you to create a personalized treatment plan and help you get back to sport and life.

References

  1. Singh H, Knapik DM, Polce EM, Eikani CK, Bjornstad AH, Gursoy S, Perry AK, Westrick JC, Yanke AB, Verma NN, Cole BJ, Chahla JA. Relative Efficacy of Intra-articular Injections in the Treatment of Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Am J Sports Med. 2022 Sep;50(11):3140-3148. doi: 10.1177/03635465211029659. Epub 2021 Aug 17. PMID: 34403285.
  2. Jawanda H, Khan ZA, Warrier AA, Acuña AJ, Allahabadi S, Kaplan DJ, Ritz E, Jackson GR, Mameri ES, Batra A, Dornan G, Westrick J, Verma NN, Chahla J. Platelet-Rich Plasma, Bone Marrow Aspirate Concentrate, and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Arthroscopy. 2024 May;40(5):1623-1636.e1. doi: 10.1016/j.arthro.2024.01.037. Epub 2024 Feb 7. PMID: 38331363.
  3. Belk JW, Lim JJ, Keeter C, McCulloch PC, Houck DA, McCarty EC, Frank RM, Kraeutler MJ. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis. Arthroscopy. 2023 Jul;39(7):1714-1734. doi: 10.1016/j.arthro.2023.03.001. Epub 2023 Mar 11. PMID: 36913992.
  4. Balusani P Jr, Shrivastava S, Pundkar A, Kale P. Navigating the Therapeutic Landscape: A Comprehensive Review of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate in Knee Osteoarthritis. Cureus. 2024 Feb 23;16(2):e54747. doi: 10.7759/cureus.54747. PMID: 38524005; PMCID: PMC10960965.
  5. Dwyer T, Chahal J. Editorial Commentary: Injections for Knee Osteoarthritis: Doc, You Gotta Help Me! Arthroscopy. 2021 Apr;37(4):1288-1289. doi: 10.1016/j.arthro.2020.12.228. PMID: 33812528.
  6. Shen Z, Ye X, He Y, Shen G, Xu K, Zhang B, Wu L. Arthroscopic rotator cuff repair combined with platelet-rich plasma products can reduce the rate of retearing and improve clinical outcomes: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2024 May 3;103(18):e38069. doi: 10.1097/MD.0000000000038069. PMID: 38701265; PMCID: PMC11062711.
  7. Zaffagnini S, Poggi A, Reale D, Andriolo L, Flanigan DC, Filardo G. Biologic Augmentation Reduces the Failure Rate of Meniscal Repair: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2021 Feb 24;9(2):2325967120981627. doi: 10.1177/2325967120981627. PMID: 33709004; PMCID: PMC7907660
  8. Alessio-Mazzola M, Felli L, Trentini R, Formica M, Capello AG, Lovisolo S, Maffulli N. Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study. Sports Health. 2022 Mar-Apr;14(2):227-236. doi: 10.1177/19417381211011074. Epub 2021 Apr 24. PMID: 33896253; PMCID: PMC8883415.
  9. https://orthoinfo.aaos.org/en/treatment/platelet-rich-plasma-prp/
  10. Zhu T, Zhou J, Hwang J, Xu X. Effects of Platelet-Rich Plasma on Clinical Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2022 Jan 31;10(1):23259671211061535. doi: 10.1177/23259671211061535. PMID: 35127959; PMCID: PMC8811441.
At a Glance

Dr. Jas Chahal

  • Head of Orthopaedic Surgery, Women’s College Hospital
  • Team Physician Toronto FC and University of Toronto Varsity Blues
  • Associate Professor, University of Toronto Orthopaedic Sports Medicine Program
  • Has more than 100 peer-reviewed publications
  • Learn more

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