Systematic Review and Meta-Analysis
Ke-Vin Chang, MD
Archives of Physical Medicine and Rehabilitation
Volume 95, Issue 3 , Pages 562-575, March 2014
Abstract
Objective
To explore the effectiveness of platelet-rich plasma (PRP) in treating cartilage degenerative pathology in knee joints.
Data Sources
Electronic databases, including PubMed and Scopus, were searched from the earliest record to September 2013.
Study Selection
We included single-arm prospective studies, quasi-experimental studies, and randomized controlled trials that used PRP to treat knee chondral degenerative lesions. Eight single-arm studies, 3 quasi-experimental studies, and 5 randomized controlled trials were identified, comprising 1543 participants.
Data Extraction
We determined effect sizes for the selected studies by extracting changes in functional scales after the interventions and compared the PRP group pooled values with the pretreatment baseline and the groups receiving placebo or hyaluronic acid (HA) injections.
Data Synthesis
PRP injections in patients with knee degenerative pathology showed continual efficacy for 12 months compared with their pretreatment condition. The effectiveness of PRP was likely better and more prolonged than that of HA. Injection doses ≤2, the use of a single-spinning approach, and lack of additional activators led to an uncertainty in the treatment effects. Patients with lower degrees of cartilage degeneration achieved superior outcomes as opposed to those affected by advanced osteoarthritis.
Conclusions
PRP application improves function from basal evaluations in patients with knee joint cartilage degenerative pathology and tends to be more effective than HA administration. Discrepancy in the degenerative severity modifies the treatment responses, leading to participants with lower degrees of degeneration benefiting more from PRP injections.