What did the study look at?
Platelet-rich plasma (PRP) is a product prepared from a person's own blood and injected into the joint in knee osteoarthritis. The authors note that earlier work has shown variability in how PRP is prepared, but that it is unclear whether study design and outcome measures in trials of this treatment have been standardised.
The aim was to determine the variability in study design and outcome reporting across randomised controlled trials of intra-articular PRP injection for knee osteoarthritis. In other words, this review does not measure how well PRP works; it examines how the research was carried out.
How was it done?
This is a systematic review: no new patients were treated; published studies were searched. The Cochrane Database, PubMed, EMBASE and MEDLINE were searched. Level I and II randomised controlled trials of intra-articular PRP injection for knee osteoarthritis were included. Methodological quality was assessed with the Jadad score.
What did it find?
- Twenty-seven studies were included.
- Only 5 studies repeated imaging after treatment.
- The most commonly used patient-reported outcome measures were the Visual Analogue Scale for pain (63%) and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index, 59.3%), followed by KOOS (29.6%).
- Twelve trials (44%) reported three or more patient-reported outcome measures.
- Most trials (70.4%) did not report objective outcome measures.
The authors' conclusion
The authors conclude that randomised controlled trials of outcomes after intra-articular PRP injection for knee osteoarthritis show substantial variability. They suggest that standardising the population most likely to benefit, in terms of arthritis grade, may help limit heterogeneity so that future studies can be compared and pooled. They also recommend that patient-reported outcomes be reported by domain, allowing pain, function and health-related quality of life to be assessed.
Limitations
The authors state that the findings were largely descriptive, with limited use of statistical evaluation. The review was also not registered with PROSPERO, the international register for systematic reviews. The authors report the level of evidence as "level II; systematic review of level I-II randomised controlled trials". This summary is based on the published abstract, as the full text could not be accessed.
Reference
Beletsky A, Vadhera AS, Strauss EJ, Sachadev R, Singh H, Gürsoy S, Dasari SP, Hevesi M, Cole BJ, Verma NN, Chahla J. (2022). A systematic review on the high variability in study design and outcome reporting in randomized controlled trials examining intra-articular platelet-rich plasma injection for knee osteoarthritis. Journal of Cartilage & Joint Preservation, 2(1), 100041. Licence: CC BY-NC-ND 4.0.
DOI: 10.1016/j.jcjp.2022.100041
Free full text: cartilagejournal.org (PDF)
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
