What is the evidence for the use of Platelet-Rich Plasma (PRP) injection in knee meniscal repair?
AMSTAR Rating
Summary
Patient Population:
1164 patients with confirmed meniscal injury undergoing surgical repair (Male = 730, Female = 434)
9 studies including ONLY 2 RCTs
Intervention:
PRP augmentation at time of surgical repair (n = 519)
PRP preparation and delivery heterogeneous amongst studies (ie. Leukocyte Rich and Poor)
Comparison:
No-PRP (Standard surgical intervention) (n = 645)
Outcome:
- The failure rate in the PRP group was significantly lower than that in the non-PRP group [odds ratio: 0.64, 95% confidence interval (CI) (0.42, 0.96), P = 0.03].
- The PRP group was associated with a statistically significant improvement in the visual analog scale for pain [Mean difference (MD): − 0.76, 95% CI (− 1.32, − 0.21), P = 0.007]
- The PRP group was associated with statistically significant improvement in Knee injury and Osteoarthritis Outcome Score-symptom [MD: 8.02, 95% CI (2.99, 13.05), P = 0.002] compared with the non-PRP group.
- However, neither the IKDC score nor the Lysholm knee scale showed any differences between the two groups.
Guideline Recommendations
| Source | Recommendation |
|---|---|
| AAOS | Can be considered (Moderate but Limited evidence) |
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Outcomes (PRP intraoperative v. No PRP)
Failure Rate
VAS (pain)
Other measures of pain and disability
Relevant Clinical Info
**Meta-Analysis Results interpreted with caution due to use of NON-RCTs**
Largest RCT was Kaminski, et al. (2019) which included 72 participants, treated with or without pre-cutaneous intra-mensical PRP in conjunction with surgical repair. The failure rate was significantly higher in the control group than in the PRP augmented group (70% vs. 48%, P = 0.04). Kaplan-Meyer analysis for arthroscopy-free survival showed significant reduction in the number of performed arthroscopies in the PRP augmented group. A notably higher percentage of patients treated with PRP achieved minimal clinically significant difference in visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) symptom scores.
Int J Mol Sci. 2019 Feb 16;20(4):856. doi: 10.3390/ijms20040856. PMID: 30781461; PMCID: PMC6412887.
Participant Information
of participants
were Male
the sample size was 1164
their were 9 studies used.
