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Discouraging data from the first rigorous study of platelet-rich plasma therapy

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The results of the first randomized controlled trial looking at the effectiveness of platelet-rich plasma (PRP) are out, and they fail to support the therapy sought by many amateur and professional athletes alike, including Tiger Woods. An injection of PRP was no better than a saline injection in alleviating pain and aiding recovery among a group of Achilles tendonitis sufferers, according to the study published January 13 in the JAMA The Journal of the American Medical Association.

The field of PRP therapy has been in need of this type of rigorous trial in which the therapy was compared to a placebo treatment, Dennis Cardone, a doctor of osteopathic medicine at the New York University Hospital for Joint Diseases, told on December 17. Without these trials, doctors cannot know about the potential effectiveness of PRP, or whether just sticking a needle in an injured site could spur some recovery. Still, Cardone offers platelet injections to patients with diverse injuries who have failed conventional therapies because he says that, in some cases, it does seem to help.

In the current study, researchers treated 54 patients who had suffered from Achilles pain for at least two months. Subjects received an injection of either PRP or saline solution (a placebo). At six, 12 and 24 weeks after the injections, patients in both groups experienced some recovery. The group that received PRP did not, however, report significantly improved pain and activity levels compared with the placebo group.

Johannes Tol, an orthopedic researcher at the Hague Medical Center in the Netherlands and lead author of the study, says that this negative result does not write off platelet injections altogether because the therapy could have different effects on different injuries, The New York Times reported.

Indeed, studies are currently under way to assess the effectiveness of PRP for treating knee and rotator cuff tendon injuries and plantar fasciitis (inflammation of tissue at the bottom of the foots), according to the newspaper.

The results of clinical trials coming out this year could make or break PRP therapy, says Cardone, who is part of a group studying PRP for rotator cuff damage. For certain types of injuries, these studies could inform doctors how to get the best results from PRP.

Image courtesy of iStockphoto/LionHector

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  1. 1. wpattersonpolo 11:04 am 01/16/2010

    Possibly the chronic nature of the achilles tendonitis is not an appropriate treatment objective for PRP. As an equine veterinarian, I have incorporated PRP therapy in tendon and ligament injuries for the last 5 years. Case selection and timing are in my opinion very crucial to favorable outcome. For example an acute tendon injury with core fiber tearing needs to be treated at an adventitious period 10 to 30 days post injury depending on when acute inflammation subsides to more subacute signs.

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  2. 2. wpattersonpolo 11:10 am 01/16/2010

    Possibly the poor result of this PRP trial relate to the treatment object. As an equine veterinarian, I have incorporated PRP in the treatment of tendon and ligament injuries for the last 5 years. It has been my experience that case selection and tioming are crucial. I select cases for treatment from core injuries generally in the 10 to 30 day range from injury: generally in the transition from acute to subacute inflammation. In my experience, chronic injuries do not perform well.

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  3. 3. 17Wrangler 4:13 pm 10/17/2010

    I am a patient at the Cleveland clinic and have suffered many side effects from several PRP treatments. It has helped in the healing of the initial injury for a while but 13 moths later I find the temporary relief is not worth the side effects. If you are considering this form of treatment feel free to contact me and I will share my story!

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  4. 4. ctot93 3:02 pm 11/12/2010

    The symptoms I am experiencing after my 1 time injection are pain after standing for more than 1 hour, a feeling of tendon "dryness", and if standing or walking to much I will have pain throughout night. I was just wondering what problems your were having. The MD said I would start having less and less pain and in 6 months would see full results. Its now 8 months and I have more pain now then before procedure. I should have known I was in trouble when he didn’t schedule a followup appointment.

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