Which works better for osteoarthritis of the knee? Find out next…
Efficacy Of Platelet-Rich Plasma In The Treatment Of Knee Osteoarthritis: A Meta-Analysis Of Randomized Controlled Trials.
Dr. Jack Cush writing in Rheumnow reported on a large study evaluating the use of platelet rich plasma (PRP) vs other therapies. The analysis showed that at 6 months postinjection, PRP and hyaluronic acid (HA) had similar effects with respect to pain relief. At 12 months postinjection, however, PRP was associated with significantly better pain relief than HA. The researchers also noted that PRP did not increase the risk of adverse events compared with HA and saline.
Current evidence indicates that, compared with HA, intra-articular PRP injection may have more benefit in pain relief and functional improvement in patients with symptomatic knee OA at 1 year postinjection.
Comment: PRP is definitely an effective treatment modality for OIA of the knee. It must be administered via US though for best results.
Platelet-Rich Plasma Injections May Not Help Hamstring Muscles Heal Faster
Gene Emery writing for Reuters reported that according to a report published in the New England Journal of Medicine, platelet-rich plasma injections into hamstring muscles that are acutely injured do not help the muscles heal any faster than placebo injections. The study involved 80 athletes. “For our clinic, in our practice, we don’t use this treatment for muscle injuries anymore because the evidence shows there’s no benefit,” chief author Dr. Gustaaf Reurink of the Erasmus Medical Center in Rotterdam, the Netherlands, told Reuters Health. But the study results, reported in a letter in the New England Journal of Medicine, may not be widely embraced.
“I’d hate for people to throw the baby out with the bathwater here,” said Dr. Michael Terry, an orthopedic surgeon at Northwestern University Feinberg School of Medicine in Chicago. He asserted that the technique “works for recurrent or chronic muscle injuries. I think it’s one of the areas where it can be very useful. There are other data that suggest it’s helpful.”
Comment: Our experience is that it does work. However, I agree that large double blind studies are needed.
The shoulder is a complex joint consisting of three bones (the scapula, the humerus, and the clavicle) and held together by an arrangement of ligaments, tendons, muscles, and bursae. Shoulder pain is a common complaint. It’s important to separate shoulder pain from referred pain coming from the neck. Most primary shoulder pain is due to degeneration occurring in the rotator cuff or biceps tendons. The term tendonitis is incorrect since there is very little inflammation. The problem is tendon degeneration. Accurate diagnosis is important. Examination with history, physical, and imaging procedures can establish the correct diagnosis. Treatment involves the use of rest, ice, physical therapy, stretching and strengthening exercises. More aggressive measures include steroid injection, needle tenotomy with platelet rich plasma, and Tenex.
Nick Tate writing in Newsmax Health reported on a study by researchers from the Hospital for Special Surgery in New York City, which showed that PRP greatly improves pain and function in patients with knee osteoarthritis. It also found that the treatment appeared to delay the progression of the disease in up to 73 percent of patients.
“This is a very positive study,” said Brian Halpern, M.D., chief of the Primary Care Sports Medicine Service at the hospital, who led the study, published in the Clinical Journal of Sports Medicine. For the new study, researchers enrolled 15 patients with early osteoarthritis, gave each an injection of PRP, and then monitored them for one year, evaluating overall knee pain, stiffness, function, and the ability to perform various activities of daily living. Physicians also evaluated the knee cartilage with magnetic resonance imaging (MRI). The results showed PRP helped ease the patients’ knee pain and stiffness, while improving function. Using a standardized pain measurement scale, researchers found patients’ pain levels were reduced by more than 56 percent at six months and nearly 59 percent at one year. They also showed improvements in knee function and, for a large majority of patients, there was no additional cartilage loss after PRP treatmentComment: PRP and stem cells will revolutionize the way we treat osteoarthritis.
PRP Injections Help Young Athletes With UCL Tears.
John Gever writing in MedPage Today reports, “Young athletes with torn elbow ligaments, where rest and physical therapy were ineffective, quickly returned to play after receiving platelet-rich plasma (PRP) injections, a researcher said” during “the American Orthopaedic Society for Sports Medicine’s Specialty Day, part of the American Academy of Orthopaedic Surgeons’ annual meeting.” Researcher Scott Crow, MD found that “16 of 17 teenage and young adult patients with partial ulnar collateral ligament (UCL) tears were able to return to regular play within 15 weeks of receiving PRP injection.”