Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/710
Title: The effectiveness of platelet-rich plasma in the treatment of tendinopathy: a meta-analysis of randomized controlled clinical trials.
Epworth Authors: Fitzpatrick, Jane
Other Authors: Bulsara, Max
Zheng, Ming
Keywords: Tendinopathy
Tendinitis
Injection Therapy
Platelet-Pich Plasma
PRP
Platelet-Poor Plasma
PPP
Autologous Blood
Treatment Outcomes
Clinical Effectiveness
Sports Medicine
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2016
Publisher: Sage Publications
Citation: Am J Sports Med. 2016 Jun 6.
Abstract: BACKGROUND: Tendinopathy is very common in the general population. There are increasing numbers of clinical studies referring to platelet-rich plasma (PRP) and platelet-poor plasma (PPP) as treatments for tendinopathy. PURPOSE: To perform a meta-analysis of the outcomes of the PRP groups by preparation method and injection technique in tendinopathy. To determine the clinical effectiveness of the preparations and to evaluate the effect of controls used in the studies reviewed. STUDY DESIGN: Systematic review and meta-analysis. METHODS: The PubMed, EMBASE, CINAHL, and Medline databases were searched in March 2012, April 2014, and August 2015, and randomized controlled trials using autologous blood, PRP, PPP, or autologous conditioned plasma in tendinopathy with outcome measures of pain and follow-up time of 3 months were included in this review. Trials including surgery, tendon tears, and muscle or ligament injuries were excluded. Study quality was assessed using the Cochrane Collaboration risk-of-bias tool by 2 reviewers. Data were pooled using random-effects meta-analysis. The primary outcome measure was a change in pain intensity. Where more than 1 pain scale was included, a functional score was selected ahead of a visual analog scale score. RESULTS: A total of 18 studies (1066 participants) were included. Eight studies were deemed to be at low risk of bias. The most significant outcomes in the PRP groups were seen in those treated with highly cellular leukocyte-rich PRP (LR-PRP) preparations: GPS kit (standardized mean difference [SMD], 35.75; 95% CI, 28.40-43.10), MyCells kit (SMD, 31.84; 95% CI, 17.56-46.13), Prosys kit (SMD, 42.99; 95% CI, 37.73-48.25), and unspecified LR-PRP (SMD, 34.62; 95% CI, 31.69-37.55). When the LR-PRP system types were grouped, there was a strongly positive effect (SMD, 36.38; 95% CI, 34.00-38.77) when compared with leukocyte-poor PRP (SMD, 26.77; 95% CI, 18.31-35.22). In assessing the control groups, there was no clear difference between different types of control injections: saline (SMD, 14.62; 95% CI, 10.74-18.50), local anesthetic (SMD, 15.00; 95% CI, 7.66-22.34), corticosteroid (SMD, 23.82; 95% CI, 10.74-18.50), or dry needling (SMD, 25.22; 95% CI, 21.27-29.16). CONCLUSION: There is good evidence to support the use of a single injection of LR-PRP under ultrasound guidance in tendinopathy. Both the preparation and intratendinous injection technique of PRP appear to be of great clinical significance.
URI: http://hdl.handle.net/11434/710
DOI: 10.1177/0363546516643716
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/27268111
ISSN: 0363-5465
1552-3365
Journal Title: The American Journal of Sports Medicine
Type: Journal Article
Affiliated Organisations: University of Western Australia, Perth, Australia
University of Notre Dame Australia, Freemantle, Australia.
Type of Clinical Study or Trial: Meta-Analysis
Appears in Collections:Musculoskeletal

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