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Platelet-Rich Plasma Injections for Wound Healing and Tissue Rejuvenation: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Published on: June 13, 2017
Project Number: RC0885-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of platelet-rich plasma (PRP) injections for wound healing or tissue rejuvenation in orthopedic and trauma patients?
  2. What is the cost-effectiveness of PRP injections for wound healing or tissue rejuvenation in orthopedic and trauma patients?
  3. What are the evidence-based guidelines regarding the use of PRP injections for wound healing or tissue rejuvenation in orthopedic and trauma patients?

Key Message

While there were some reports indicating modest improvements in some outcomes for PRP injections relative to comparators such as placebo, hyaluronic acid, or no PRP treatment, it is not possible to make definitive conclusions regarding the effectiveness of PRP in any of the clinical indications reviewed. The heterogeneity of clinical context, PRP intervention, and comparator agents, reduces certainty in the results. The interpretation of study investigators is also a source of heterogeneity, and in some cases, systematic review authors arrived at divergent conclusions in spite of the fact that they included similar studies in the systematic reviews. Assessing generalizability of the study results to the Canadian context is also difficult given the wide variety of PRP preparation methods used, the type of activator used, and variability in PRP treatment regimens.While there have been no consistent signals of increased risk of harm for PRP relative to control groups in the data reviewed, none of the studies reviewed appears to have been rigorously designed to evaluate harms.There was no relevant evidence identified to inform the cost-effectiveness of PRP injections for any indication.Two good quality guidelines from the UK suggest that there are no significant risks of harm associated with PRP use, but the evidence on efficacy was inadequate to support the use of PRP for osteoarthritis of the knee or tendinopathy.

Tags

orthopedic procedures, orthopedics, platelet-rich plasma, regeneration, skin ulcer, wound healing, musculoskeletal, granulation, Trauma, rejuvenation, wound therapy, discectomy, Arthroplasty