TY  - JOUR
T1  - Efficacy of Autologous Platelet-Rich Plasma Use for Orthopaedic Indications: A Meta-Analysis
AU  - Sheth, Ujash
AU  - Simunovic, Nicole
AU  - Klein, Guy
AU  - Fu, Freddie
AU  - Einhorn, Thomas A.
AU  - Schemitsch, Emil
AU  - Ayeni, Olufemi R.
AU  - Bhandari, Mohit
Y1  - 2012/02/15
N1  - 10.2106/JBJS.K.00154
JO  - The Journal of Bone & Joint Surgery
SP  - 298
EP  - 307
VL  - 94
IS  - 4
N2  - Background: 
  The recent emergence of autologous blood concentrates, such as platelet-rich plasma, as a treatment option for patients with orthopaedic injuries has led to an extensive debate about their clinical benefit. We conducted a systematic review and meta-analysis to determine the efficacy of autologous blood concentrates in decreasing pain and improving healing and function in patients with orthopaedic bone and soft-tissue injuries.Methods: 
  We searched MEDLINE and Embase for randomized controlled trials or prospective cohort studies that compared autologous blood concentrates with a control therapy in patients with an orthopaedic injury. We identified additional studies by searching through the bibliographies of eligible studies as well as the archives of orthopaedic conferences and meetings.Results: 
  Twenty-three randomized trials and ten prospective cohort studies were identified. There was a lack of consistency in outcome measures across all studies. In six randomized controlled trials (n = 358) and three prospective cohort studies (n = 88), the authors reported visual analog scale (VAS) scores when comparing platelet-rich plasma with a control therapy across injuries to the acromion, rotator cuff, lateral humeral epicondyle, anterior cruciate ligament, patella, tibia, and spine. The use of platelet-rich plasma provided no significant benefit up to (and including) twenty-four months across the randomized trials (standardized mean difference, −0.34; 95% confidence interval [CI], −0.75 to 0.06) or the prospective cohort studies (standardized mean difference, −0.20; 95% CI, −0.64 to 0.23). Both point estimates suggested a small trend favoring platelet-rich plasma, but the associated wide confidence intervals were consistent with nonsignificant effects.Conclusions: 
  The current literature is complicated by a lack of standardization of study protocols, platelet-separation techniques, and outcome measures. As a result, there is uncertainty about the evidence to support the increasing clinical use of platelet-rich plasma and autologous blood concentrates as a treatment modality for orthopaedic bone and soft-tissue injuries.Level of Evidence: 
  Therapeutic Level II. Please see Instructions for Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.K.00154
UR  - http://dx.doi.org/10.2106/JBJS.K.00154
ER  -