My sense is that the popularity of platelet-rich plasma (PRP) is increasing independent of research in this field. BJSM has covered this with front cover attention:
- Platelet-rich plasma: Debate. Jul 2010, (44)9
- IOC consensus paper on the use of platelet-rich plasma in sports medicine. Dec 2010, (44)15
Of most interest to blog readers will be the Podcast on PRP with Robert Jan de Vos and Adam Weir. These authors have arguably the highest quality study testing PRP to date. We congratulate the Dutch researchers on their quality study design and comprehensive investigations.
Conclusions?
– No clinical benefit in 6 months:
- de Vos, R, Weir, A et al. 2010. Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy. JAMA, 303(2)
– No ultrasound evidence of benefit:
- de Vos, R, Weir, A et al. 2010. No effects of PRP on ultrasonographic tendon structure and neovascularisation in chronic midportion Achilles tendinopathy. BJSM, Online first November, 2010
– and now no benefit at 12 months:
- de Jonge, S, de Vos, R., Weir, A et al. 2011. One-Year Follow-up of Platelet-Rich Plasma Treatment in Chronic Achilles Tendinopathy: A Double-Blind Randomized Placebo-Controlled Trial. AJSM. August 39.
No benefit at 12 months is not a surprise given previous findings. The proposed mechanism for PRP therapy is accelerated early healing. Nevertheless, these data are important as some evangelical PRP providers may be tempted to discount the 6-month results and argue for a ‘delayed benefit’. This is not the last word on PRP and BJSM Associate Editor Kim Harmon (see: Musculoskeletal ultrasound: taking sports medicine to the next level) has pointed out reasons for this series of Dutch studies having ‘no effect’. BJSM is one of the leading venues for rational debate on PRP and we look forward to adding to your knowledge about the clinical utility of this ‘hot’ therapy that is gaining clinical popularity. Time for a quality randomized trial of PRP versus the Alfredson program for Achilles tendinopathy?