Tuesday, January 19, 2010

Recent JAMA Platelet Rich Plasma article

A new PRP study from researchers in the Netherlands declared platelet-rich plasma is ineffective in healing moderate Achilles tendinopathy. Researchers had 54 patients gauge pain levels at 6, 12 and 24 weeks following treatment. One patient group was given a PRP injection and the other, a saline injection (placebo). The study published in JAMA (Journal of the American Medical Association) by de Vos et al, concluded PRP was no more effective than the saline injection when both groups added therapeutic exercises into their recovery routines.

The study has received extensive media coverage and has been quick to cite PRP as ineffective. It is important to view the controls of the study before conclusions are made however.

This study's data does support PRP's ineffectiveness after a 6 month period in only moderate Achilles tendinopathy. It does not include either minor or severe cases. This study was published at its midpoint. Researchers will follow up on patients' recovery in 12 months and it is possible PRP patients will continue to improve and the placebo group will not.

Importantly, no data is available on platelet concentrations given to the PRP group. As this study is one of many to come determining the proper use of PRP, platelet concentration levels in PRP groups will be crucial to disclose. If patients received too low a platelet concentration in their injection, results would likely vary in higher doses. This will be a vital component of determining the optimal formula of PRP.

Patients receiving PRP to treat plantar fasciitis and Achilles tendinopathy have been benefited by the use of a boot following therapy. This allows the injury time to heal without chronic tension and permits the growth factors to work without continued trauma. There is no data in this study on whether boots were used.

Legitimate studies are very important to further the understanding of PRP's effectiveness and uses and this study should be recognized as such. The study is however, incomplete. This must be taken into account before significant conclusions are drawn about PRP's effectiveness.

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