Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis

Background: Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis. Purpose: To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks. Results: Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot &amp; Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P =.31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures. Conclusion: For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections. Registration: NTR7261 (Netherlands Trial Register).</p

Understanding the effects of Covid-19 through a life course lens

The Covid-19 pandemic is shaking fundamental assumptions about the human life course in societies around the world. In this essay, we draw on our collective expertise to illustrate how a life course perspective can make critical contributions to understanding the pandemic’s effects on individuals, families, and populations. We explore the pandemic’s implications for the organization and experience of life transitions and trajectories within and across central domains: health, personal control and planning, social relationships and family, education, work and careers, and migration and mobility. We consider both the life course implications of being infected by the Covid-19 virus or attached to someone who has; and being affected by the pandemic’s social, economic, cultural, and psychological consequences. It is our goal to offer some programmatic observations on which life course research and policies can build as the pandemic’s short- and long-term consequences unfold

Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients with Ankle Osteoarthritis: A Randomized Clinical Trial

Importance: Approximately 3.4% of adults have ankle (tibiotalar) osteoarthritis and, among younger patients, ankle osteoarthritis is more common than knee and hip osteoarthritis. Few effective nonsurgical interventions exist, but platelet-rich plasma (PRP) injections are widely used, with some evidence of efficacy in knee osteoarthritis. Objective: To determine the effect of PRP injections on symptoms and function in patients with ankle osteoarthritis. Design, Setting, and Participants: A multicenter, block-randomized, double-blinded, placebo-controlled clinical trial performed at 6 sites in the Netherlands that included 100 patients with pain greater than 40 on a visual analog scale (range, 0-100) and tibiotalar joint space narrowing. Enrollment began on August 24, 2018, and follow-up was completed on December 3, 2020. Interventions: Patients were randomly assigned (1:1) to receive 2 ultrasonography-guided intra-articular injections of either PRP (n = 48) or placebo (saline; n = 52). Main Outcomes and Measures: The primary outcome was the validated American Orthopaedic Foot and Ankle Society score (range, 0-100; higher scores indicate less pain and better function; minimal clinically important difference, 12 points) over 26 weeks. Results: Among 100 randomized patients (mean age, 56 years; 45 [45%] women), no patients were lost to follow-up for the primary outcome. Compared with baseline values, the mean American Orthopaedic Foot and Ankle Society score improved by 10 points in the PRP group (from 63 to 73 points [95% CI, 6-14]; P <.001) and 11 points in the placebo group (from 64 to 75 points [95% CI, 7-15]; P <.001). The adjusted between-group difference over 26 weeks was -1 ([95% CI, -6 to 3]; P =.56). One serious adverse event was reported in the placebo group, which was unrelated to the intervention; there were 13 other adverse events in the PRP group and 8 in the placebo group. Conclusions and Relevance: Among patients with ankle osteoarthritis, intra-articular PRP injections, compared with placebo injections, did not significantly improve ankle symptoms and function over 26 weeks. The results of this study do not support the use of PRP injections for ankle osteoarthritis. Trial Registration: Netherlands Trial Register: NTR7261

In-situ calibration and validation of CryoSat-2 observations over Arctic first year sea ice north of Svalbard

Large areas of the Arctic Ocean are covered with sea ice, the extent, thickness, concentration and properties of which change seasonally, interannually and on longer time scales. The Arctic Ocean is often difficult to access, making satellite remote sensing the only means to obtain information about the sea ice on a pan-Arctic scale. In order to improve the processing and interpretation of satellite data and imagery, in-situ calibration and validation are necessary. In spring 2011, measurements on first year sea ice north of Svalbard were performed during two scientific cruises with the ships KV “Svalbard” and RV “Lance” as a part of the CryoVEx 2011 project. During these cruises, detailed measurements of snow and ice thickness, freeboard, and snow density were performed on ice stations and from a helicopter. The data collected contributes to the calibration and validation of the SIRAL sensor data from the CryoSat-2 radar altimeter satellite, which measures the freeboard of sea ice for estimating its thickness. In snow pits, the stratigraphy of the snow pack was recorded. The collected data are currently being integrated with satellite data, airborne observations from helicopter that measured ice thickness using an electromagnetic induction sounder (EM-bird) and conducted aerial photography, and a Twin-Otter aircraft carrying the ESA Airborne Synthetic Aperture and Interferometric Radar Altimeter System (ASIRAS) system, the airborne radar altimeter designed to simulate the SIRAL radar on board the satellite, as well as a laser scanner. The first analysis of airborne and in- situ data indicates that the ASIRAS radar altimeter used in this experiment did not fully penetrate the snow layer on top of the sea ice. The regional sea ice characteristics for the research area are described using SAR products, obtained from the Envisat and Radarsat-2 satellites, in order to improve the interpretation and conclusions of the CryoSat-2 calibration and validation

Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis

Background:Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis.Purpose:To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks.Results:Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot &amp; Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P = .31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures.Conclusion:For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections.Registration:NTR7261 (Netherlands Trial Register)