Treatment Of Knee Osteoarthritic Pain with Platelet-Rich Plasma: A Systematic Review of Clinical Studies

Abstract

Introduction: Knee osteoarthritis is a degenerative joint disease that is secondary to degradation of articular cartilage, reformation of subchondral bone through degradation and proliferation as well as presence of synovitis. Materials & methods: This systematic review was conducted and reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Results: A total of 30 of the 48 comparators showed statistically significant superiority with platelet-rich plasma (PRP) compared with a control, while the other 16 comparators showed no significant difference between PRP and the comparator. Conclusion: We can only recommend PRP for patients with early-stage osteoarthritis (I or II) and who are aged below 65, based on our findings. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) recommendations, while studies reviewed were randomized controlled studies, and therefore, high grade, due to variance in imprecision, risk of bias and inconsistency among the 37 studies, it would be reasonable to rate this paper as subjectively moderate.

Keywords::

• analgesia
• chronic pain
• nociceptive pain
• osteoarthritis
• pain
• pain management

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/pmt-2020-0052

Acknowledgments

The authors thanked Henry Ford Health System librarians S Moore and C Streeter for performing the initial data collection from the literature databases utilized for this systematic review.

Financial & competing interests disclosure

CW Hunter is on the medical advisory boards for Abbot (IL, USA), Mainstay (Dublin, Ireland), Nalu (CA, USA), PainTEQ (FL, USA), Saluda (Artarmon, Australia), Spine BioPharma (NY, USA) and Vertiflex (CA, USA). He is a consultant for Flowonix Medical (NJ, USA) and a member of the speakers’ bureau for TerSera (IL, USA). He is involved in clinical research for Abbot (IL, USA), Avanos Medical (GA, USA), Biotronik (Berlin, Germany), Vertiflex (CA, USA), Saluda (Artarmon, Australia), Mesoblast Limited (Melbourne, Australia), VIVEX Biologics (GA, USA), DiscGenics (UT, USA), Semnur Pharmaceuticals Inc. (CA, USA) and Kolon TissueGene, Inc. (MD, USA), and holds ownership of Axonics Modulation Technologies, Inc. (CA, USA), Nalu (CA, USA), PainTEQ (FL, USA) and Spine BioPharma (NY, USA). A Gulati is a consultant for Medtronic, Flowonix, Spark biomedical SPR therapeutics and Nalu Medical. He is on the advisory board for AIS HealthCare. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.