Tanguilig Grace, Dhillon Jaydeep, Kraeutler Matthew J
Tulane University School of Medicine, New Orleans, LA, 70112, USA.
Samaritan Health Services, Department of Orthopedics, Corvallis, OR, 97330, USA.
Curr Rev Musculoskelet Med. 2024 Oct;17(10):415-421. doi: 10.1007/s12178-024-09916-9. Epub 2024 Jul 13.
Platelet-rich plasma (PRP) is an emerging biological intervention for osteoarthritis (OA), yet the outcomes remain uncertain. The purpose of this study was to review current literature regarding the use of PRP for knee and hip OA.
Recent systematic reviews have found significant clinical improvements in outcomes after the administration of PRP compared to hyaluronic acid (HA) in patients with knee OA. One of these reviews included bone marrow aspirate concentrate (BMAC) as a comparison group and found no significant differences in outcomes between PRP and BMAC. Currently, the literature is lacking on whether leukocyte-rich or leukocyte-poor PRP is superior in patients with knee OA. The literature on PRP for hip OA has not provided consistent results as it has for the knee. Two recent systematic reviews evaluated RCTs for patients undergoing treatment with either PRP or HA for hip OA and found no significant differences in clinical outcomes between groups at final follow-up. Current literature regarding the association between OA grade and PRP efficacy has found varying results. The use of PRP injections in the treatment of knee OA appears to be favorable, resulting in clinically comparable or superior outcomes compared to other injection treatments. However, the clinical efficacy of PRP injections in hip OA is far less consistent. Evidence is lacking to suggest that the presence of leukocytes significantly influences clinical outcomes. Further randomized controlled trials on larger cohorts, with longer follow-up, and with comparable formulations are required before recommendations can be made regarding use of PRP for hip OA, the effect of leukocyte concentration, and clinical efficacy based on OA grade.
富血小板血浆(PRP)是一种新兴的骨关节炎(OA)生物干预方法,但其疗效仍不明确。本研究旨在综述目前关于PRP用于膝和髋骨关节炎的文献。
近期的系统评价发现,与透明质酸(HA)相比,膝骨关节炎患者使用PRP后临床结局有显著改善。其中一项综述将骨髓抽吸浓缩物(BMAC)作为对照组,发现PRP与BMAC在结局上无显著差异。目前,关于富含白细胞或缺乏白细胞的PRP在膝骨关节炎患者中哪种更优的文献较少。关于PRP用于髋骨关节炎的文献结果并不一致,不像膝骨关节炎那样。最近两项系统评价评估了接受PRP或HA治疗的髋骨关节炎患者的随机对照试验,发现最终随访时两组临床结局无显著差异。目前关于骨关节炎分级与PRP疗效之间关联的文献结果各异。PRP注射用于治疗膝骨关节炎似乎是有益的,与其他注射治疗相比,能产生临床相当或更好的结局。然而,PRP注射用于髋骨关节炎的临床疗效远没有那么一致。缺乏证据表明白细胞的存在会显著影响临床结局。在就PRP用于髋骨关节炎、白细胞浓度的影响以及基于骨关节炎分级的临床疗效提出建议之前,需要进一步开展更大样本量、更长随访时间且配方可比的随机对照试验。