Is platelet rich plasma (PRP) injection an effective therapy in improving patient functional outcomes and decreasing pain postoperatively in adults with meniscal repairs?

Abstract

Objective: The objective of this selective EBM review is to determine: “Is platelet rich plasma (PRP) injection an effective therapy in improving patient functional outcomes and decreasing pain postoperatively in adults with meniscal repairs.” Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2018 and 2019. Data Sources: All three RCTs were discovered using PubMed, AMED, CINAHL Plus, and Rehabilitation & Sports Medicine Source. The articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question. Outcome Measured: Patients’ pain was assessed using the Visual Analog Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to measure patient quality of life. Outcomes were assessed pre- and post-intervention, the mean change from baseline was calculated once intervention was received. Results: In the RCT by Kaminski et al. (2018), meniscal repair with PRP injection administered at repair site provided significant improvement in quality of life postoperatively compared with the control group with P \u3c 0.01, but patient pain measured by the VAS assessment was found to be non-significant between in the groups. In the RCT by Kaminski et al. (2019), there was no difference in patient quality of life outcomes between trephination repair alone and trephination with PRP, p-value was all non-significant, but the p-value was \u3c0.05 and statistically significant for pain between groups on the VAS score. Lastly, Elnemr et al. demonstrated improvement in patient pain and quality of life with PRP injections administer at the meniscal repair site post-operatively compared to the control group with statistical significance of P \u3c 0.05 for both measures. Conclusion: Two studies in this review demonstrated that PRP injection used in meniscal repairs significantly improves patient pain and quality of life, and one study found that PRP injections had no significant impact on these measures. Based on this review, the evidence for the effectiveness of PRP injections in meniscal repairs is promising, but ultimately inconclusive and further studies to explore this therapy are warranted