Clinician calls for further study on platelet-rich plasma formulations and impact

Orthopedics Today—September 11, 2012

MONTREAL — While there is evidence of successful treatment using platelet-rich plasma for various pathologies, the lack of unfailing positive clinical outcomes points to variability among patients and materials, according to a lecturer at the International Cartilage Repair Society World Congress 2012.

In his lecture, Scott A. Rodeo, MD, described his and others’ clinical experiences with platelet-rich plasma (PRP). His message — more research is needed about these materials and understanding the variability inherent in PRP formulations, patients and their pathologies is key.

“One of the fundamental issues, as a clinician if you are thinking of using PRP, is the tremendous variability,” Rodeo, of Hospital for Special Surgery in New York, said. “All PRPs are not the same. There is variability between the various commercial systems that are available. There is also variability, of course, within the individual patient and the underlying biology.”

He noted that cytokines influence several biological aspects of connective tissue.

Variability

A reason for this, Rodeo suggested, could be that PRP formulations differ among manufacturers and patients. Even within each individual, formulations can vary throughout the day.

Arthritis treatment

Although a number of studies have demonstrated a clinical improvement in symptoms after PRP injections for the treatment of arthritis, Rodeo noted that most of the data available refer only to the knee.

“There is little data for other joints,” he said. “Most studies do report better results in younger patients with lesser degrees of degeneration.

Rodeo noted that more research is needed about PRP.

“We certainly need more information,” he said. “Keep in mind, arthritis is a heterogeneous condition. The effect of a specific PRP formulation may differ significantly based on the underlying biologic or inflammatory milieu.”

He added, “Clinical results, clearly, are mixed. PRP seems to have the potential to be symptom-modifying, but clearly [it] does not appear to be structure-modifying.”

Reference:
Rodeo SA. Clinical experience with platelet-rich plasma. Paper 15.1.3. Presented at the International Cartilage Repair Society World Congress 2012. May 12-15. Montreal.

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