PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies.
OBJECTIVE
To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects.


METHODS
Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis."


RESULTS
The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies.


CONCLUSIONS
Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.
1 Department of Orthopaedics and Sports Medicine Service, "Meir" Medical Center and Tel-Aviv University Hospital, Kfar-Saba, Israel.
Lior
L
Laver
1 Department of Orthopaedics and Sports Medicine Service, "Meir" Medical Center and Tel-Aviv University Hospital, Kfar-Saba, Israel.
Niv
N
Marom
2 O.A.S.I. Bioresearch Foundation Gobbi NPO, Milan, Italy.
Lad
L
Dnyanesh
3 Sports Medicine and Hip Preservation Service, Department of Orthopedics, University of Colorado, Aurora, CO, USA.
Omer
O
Mei-Dan
4 Orthopaedics Department of Minho University, Minho, Portugal.|5 Clínica do Dragão-Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal.|6 Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.|7 ICVS/3B's PT Government Associate Laboratory, Braga, Guimarães, Portugal.
João
J
Espregueira-Mendes
2 O.A.S.I. Bioresearch Foundation Gobbi NPO, Milan, Italy.
Alberto
A
Gobbi
PRP; cartilage; hyaluronic acid; injections; osteoarthritis; platelet-rich plasma