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Daungsupawong H, Wiwanitkit V. Comment on ChatGPT and psoriasis patient concerns. Skin Res Technol 2024; 30:e13729. [PMID: 38716743 PMCID: PMC11077567 DOI: 10.1111/srt.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024]
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Pharmaceutical SciencesUniversity Centre for Research & Development, Chandigarh UniversityMohaliPunjabIndia
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2
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Razi S, Truong TM, Chandy RJ, Rao B. Evaluating the effect of social media on the popularity of vampire facial using google trends. Skin Res Technol 2024; 30:e13688. [PMID: 38558451 PMCID: PMC10982668 DOI: 10.1111/srt.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Shazli Razi
- Department of Internal MedicineJersey Shore University Medical CenterNeptuneNew JerseyUSA
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
| | - Thu M. Truong
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Department of MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Rithi J. Chandy
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Center for DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
| | - Babar Rao
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Center for DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
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Baird HBG, Ashy CC, Kodali P, Myer GD, Murray IR, Pullen WM, Slone HS. Most Publications Regarding Platelet-Rich Plasma Use in the Knee Are From Asia, Investigate Injection for Osteoarthritis, and Show Outcome Improvement: A Scoping Review. Arthroscopy 2024:S0749-8063(24)00252-4. [PMID: 38537725 DOI: 10.1016/j.arthro.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To evaluate and synthesize the available literature related to platelet-rich plasma (PRP) treatment of knee pathologies and to provide recommendations to inform future research in the field. METHODS PubMed, CINAHL, and Scopus databases were queried on October 6, 2023. All identified citations were collated and uploaded into Covidence for screening and data extraction. Studies were included if they were human studies published in English with adult cohorts that received PRP as a procedural injection or surgical augmentation for knee pathologies with patient-reported outcome measures (PROMs) and level of evidence Levels I-IV. RESULTS Our search yielded 2,615 studies, of which 155 studies from 2006 to 2023 met the inclusion criteria. Median follow-up was 9 months (±11.2 months). Most studies (75.5%) characterized the leukocyte content of PRP, although most studies (86%) did not use a comprehensive classification scheme. In addition, most studies were from Asia (50%) and Europe (32%) and were from a single center (96%). In terms of treatment, 74% of studies examined PRP as a procedural injection, whereas 26% examined PRP as an augmentation. Most studies (68%) examined treatment of knee osteoarthritis. Many studies (83%) documented significant improvements in PROMs, including 93% of Level III/IV evidence studies and 72% of Level I/II evidence studies, although most studies (70%) failed to include minimal clinically important difference values. The visual analog scale was the most-used PROM (58% of studies), whereas the Short Form Health Survey 36-item was the least-used PROM (5% of studies). CONCLUSIONS Most published investigations of knee PRP are performed in Asia, investigate procedural injection for osteoarthritis, and show significant outcome improvements. In addition, this review highlights the need for better classification of PRP formulations. LEVEL OF EVIDENCE Level IV, scoping Review of level I-IV studies.
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Affiliation(s)
- Henry B G Baird
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A..
| | - Cody C Ashy
- Department of Orthopedic Surgery and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Prudhvi Kodali
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Gregory D Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, U.S.A.; Emory Sports Medicine Center, Atlanta, Georgia, U.S.A.; Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, U.S.A.; The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, U.S.A.; Youth Physical Development Centre, Cardiff Metropolitan University, Wales, United Kingdom
| | - Iain R Murray
- The University of Edinburgh, Edinburgh, United Kingdom
| | - W Michael Pullen
- Department of Orthopedic Surgery and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Harris S Slone
- Department of Orthopedic Surgery and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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4
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Walker SL, Viaña JN. Mindful mindfulness reporting: Media portrayals of scientific evidence for meditation mobile apps. Public Underst Sci 2023:9636625221147794. [PMID: 36734473 DOI: 10.1177/09636625221147794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Promoting mental health is a major global challenge. As mindfulness meditation apps can help maintain and restore good mental health, it is important to understand how their efficacy and safety are portrayed in the media. This study systematically evaluates whether evidence from academic research is used to communicate the health effects of two popular mindfulness apps, Calm and Smiling Mind. A scoping review mapped research findings from 16 relevant articles, and a media analysis examined the types of evidence used in news reporting. Analysing 105 news articles revealed that 98% did not use evidence from academic research on app-based meditation to support health claims. Only 28.5% of articles included advice from a health expert, and 9.5% mentioned potential risks and alternative treatments. Stronger evidence-based reporting on the health effects of mindfulness apps is needed to enable people to make more informed decisions for their health and wellbeing.
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Affiliation(s)
| | - John Noel Viaña
- Australian National University, Australia; Commonwealth Scientific and Industrial Research Organisation, Australia
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Chou K, Gazendam A, Vemulakonda J, Bhandari M. Failure to disclose industry funding impacts outcomes in randomized controlled trials of platelet-rich plasma. Knee Surg Sports Traumatol Arthrosc 2023; 31:626-631. [PMID: 35986761 DOI: 10.1007/s00167-022-07118-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/05/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Platelet-rich plasma (PRP) represents a highly profitable biological therapy. Platelet-rich plasma is widely used to treat musculoskeletal disorders despite mixed evidence of its efficacy. As evidenced by literature from other domains, industry funding may influence the results of clinical trials. The objective of the current study was to determine the association between industry funding and positive results for randomized controlled trials (RCTs) assessing the efficacy of PRP in musculoskeletal disorders. METHODS A search of four databases was conducted. Included studies were RCTs comparing PRP to any non-PRP comparator in adults (18 years old or over) with musculoskeletal disorders and had full text available in English. Studies were excluded if they were published before 2016 or were non-human trials. A multivariate binomial logistic regression model was created to explore predictors of statistically significant findings. Covariates included the presence of industry funding, sample size, and length of study follow-up. 1440 records were screened with 87 trials included in the final analysis. RESULTS Of the 87 studies, 61 (70%) reported a statistically significant primary outcome. The presence of industry funding was not predictive of a statistically significant primary outcome [OR = 0.36, 95% CI 0.096-1.36, (n.s.)]. Studies that did not state whether industry funding was present had a higher chance of reporting a statistically significant primary outcome (OR = 3.61, 95% CI 1.1-11.9, p = 0.035). Sample size and length of follow-up were not predictive of a statistically significant primary outcome. CONCLUSION The results of the current study conclude that industry funding had no impact on the reporting of positive results for RCTs investigating PRP in musculoskeletal disorders. However, not disclosing sources of funding was associated with a higher likelihood of reporting positive results. The results of trials that fail to disclose funding sources should be interpreted with caution in the PRP literature. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Kaitlyn Chou
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Aaron Gazendam
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, St. Joseph's Hospital, Room G522, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
| | | | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, St. Joseph's Hospital, Room G522, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
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Arthur Vithran DT, He M, Xie W, Essien AE, Opoku M, Li Y. Advances in the Clinical Application of Platelet-Rich Plasma in the Foot and Ankle: A Review. J Clin Med 2023; 12. [PMID: 36769649 DOI: 10.3390/jcm12031002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
Autologous and recombinant biologic substances have been generated as a result of the research into the cellular features of the healing process. Orthobiologics are increasingly being used in sports medicine and musculoskeletal surgery. Nevertheless, clinical data are limited; consequently, further studies are required, particularly in foot and ankle pathologies. This review aims to provide evidence of the most recent literature results and ignite the interest of orthopedic specialists eager for an update about the most current discussion on platelet-rich plasma (PRP) clinical applications in the foot and ankle fields. Previous studies have shown that platelet-rich plasma can be beneficial in treating various conditions, such as chronic foot ulcers, osteoarthritis, Achilles tendinopathy, etc. Despite the positive effects of PRP on various musculoskeletal conditions, more prospective studies are needed to confirm its effectiveness at treating ankle and foot pathologies. In addition to clinical trials, other factors, such as the quality of the research and the procedures involved, must be considered before they can be used in patients. More long-term evaluations are needed to support or oppose its application in treating foot and ankle disorders. We present the most extensive review of PRP's clinical applications in the foot and ankle field.
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Cohen SA, Brophy RH, Chen AF, Roberts KC, Quinn RH, Shea KG. Public Interest in Hyaluronic Acid Injections for Knee Osteoarthritis in the United States and Europe: An International Google Trends Analysis. Arthroplast Today 2022; 18:157-162. [PMID: 36353188 PMCID: PMC9638715 DOI: 10.1016/j.artd.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hyaluronic acid injections remain a common nonsurgical alternative for the treatment of knee osteoarthritis despite limited clinical evidence and varying global recommendations regarding its use. We used the Google Trends tool to provide a quantitative analysis of public interest in hyaluronic acid injections for knee osteoarthritis in the United States and Europe. Methods We customized Google Trends parameters to obtain search data from January 2009 to December 2019 in both the United States and Europe. Combinations of "arthritis", "osteoarthritis", "hyaluronic acid", "knee arthritis", "knee osteoarthritis", and "knee injection" were entered into the Google Trends tool, and trend analyses were performed. Results The models generated to describe public interest in hyaluronic acid for knee injections in both the United States and Europe showed increased Google queries as time progressed (P < .001). The United States growth model displayed linear growth (r2 = 0.90) while the European growth model displayed exponential growth (r2 = 0.90). Conclusions Our results indicate a significant increase in Google queries related to hyaluronic acid injections for knee osteoarthritis since 2009 in both the United States and Europe. Our models suggest that despite mixed evidence supporting its use, orthopedic surgeons should expect continued public interest in hyaluronic acid for knee osteoarthritis. The results of our study may help to prepare surgeons for patient inquiries, inform the creation of evidence-based shared decision-making tools, and direct future research.
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Coulange Zavarro A, De Girolamo L, Laver L, Sánchez M, Tischer T, Filardo G, Sabatier F, Magalon J. The Top 100 Most Cited Articles on Platelet-Rich Plasma Use in Regenerative Medicine-A Bibliometric Analysis-From the ESSKA Orthobiologic Initiative. Bioengineering (Basel) 2022; 9:580. [PMID: 36290547 PMCID: PMC9598782 DOI: 10.3390/bioengineering9100580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 08/12/2023] Open
Abstract
Over the past few decades, more and more articles about platelet-rich plasma (PRP) use in regenerative medicine have been published. The aim of this study was to determine which articles have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. Articles on the use of PRP in regenerative medicine were identified via the Thomson ISI Web of Science database. A majority of the articles originated from the USA (36%). The top journal in terms of number of articles was American Journal of Sports Medicine (12%). Musculoskeletal system and orthopedics (54%) were the most popular fields of applications. Preclinical studies were the most represented study type, from which only 8 from 46 (17.4%) provided a complete numerical description of the injected product. Analysis showed a time-dependent trend of increasing quality of the clinical studies (p = 0.004), although none of them provided a complete biological characterization of the injected PRP. This study demonstrated that the use of PRP in regenerative medicine is a growing and popular area of research, mainly focused on orthopedic applications. Studies on PRP-derived exosomes, biological characterization, and correlation with clinical results might be areas of future trends.
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Affiliation(s)
- Anouck Coulange Zavarro
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
| | - Laura De Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Lior Laver
- Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), Hadera 38100, Israel
- Arthrosport Clinic, Tel-Aviv, Israel
- Rappaport Faculty of Medicine, Technion University Hospital, Israel Institute of Technology, Haifa 32000, Israel
| | - Mikel Sánchez
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain
| | - Thomas Tischer
- Department of Orthopaedic Surgery, University of Rostock, 18051 Rostock, Germany
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Florence Sabatier
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005 Marseille, France
- SAS Remedex, 13008 Marseille, France
| | - Jérémy Magalon
- Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005 Marseille, France
- INSERM, INRA, C2VN, Aix Marseille Univ, 13005 Marseille, France
- SAS Remedex, 13008 Marseille, France
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Bugarin A, Schroeder G, Shi BY, Jones KJ, Kremen TJ. Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine. Orthop J Sports Med 2022; 10:23259671221093074. [PMID: 35656192 PMCID: PMC9152206 DOI: 10.1177/23259671221093074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/21/2022] [Indexed: 12/18/2022] Open
Abstract
Background: The wide range of clinical applications and controversial scientific evidence associated with platelet-rich plasma (PRP) therapy in musculoskeletal medicine requires an examination of the most commonly cited studies within this field. Purpose: To identify the 50 most cited articles on PRP, assess their study design, and determine any correlations between the number of citations and level of evidence (LoE) or methodological quality. Study Design: Cross-sectional study. Methods: The Web of Science database was queried to identify the top 50 most cited articles on PRP in orthopaedic surgery. Bibliometric characteristics, number of citations, and LoE were recorded. Methodological quality was evaluated using the Modified Coleman Methodology Score (MCMS), Methodological Index for Non-randomized Studies (MINORS), and Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO). The Pearson correlation coefficient and Spearman correlation coefficient (rS) were used to determine the degree of correlation between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. Student t tests were performed for 2-group comparisons. Results: The top 50 articles were published between 2005 and 2016 in 21 journals. The mean number of citations and citation density were 241 ± 94 (range, 151-625) and 23 ± 8, respectively, and the mean LoE was 2.44 ± 1.67, with 15 studies classified as LoE 1. The mean MCMS, MINORS score, and MIBO score were 66.9 ± 12.6, 16 ± 4.7, and 12.4 ± 3.7, respectively. No correlation was observed between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. A significant difference (P = .02) was noted in LoE in articles from the United States (3.56 ± 1.7) versus outside the United States (2 ± 1.5). Seven of the 8 in vivo studies were published between 2005 and 2010, whereas 19 of the 25 clinical outcome investigations were published between 2011 and 2016. Studies that were published more recently were found to significantly correlate with number of citations (rS = –0.38; P = .01), citation density (rS = 0.36; P = .01), and higher LoE (rS = 0.47; P = .01). Conclusion: The top 50 most cited articles on PRP consisted of high LoE and fair methodological quality. There was a temporal shift in research from in vivo animal studies toward investigations focused on clinical outcomes.
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Affiliation(s)
- Amador Bugarin
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Grant Schroeder
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Brendan Y. Shi
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Kristofer J. Jones
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Thomas J. Kremen
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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10
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Paget SP, Campbell L, Blaxland A, Lewis J, Morrow AM, Wimalasundera N. 'Life-changing surgery': English-language news media representation of selective dorsal rhizotomy. Child Care Health Dev 2021; 47:844-850. [PMID: 34251700 DOI: 10.1111/cch.12894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 01/26/2021] [Accepted: 07/02/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Selective dorsal rhizotomy (SDR) is a neurosurgical intervention to reduce spasticity in children with cerebral palsy. Parents researching SDR for their child may be influenced by framing of SDR in news media articles they read. This study examined framing of SDR in English-language news media. METHODS Content analysis of English-language news media articles including the search term 'rhizotomy' in the Factiva database published July 2015 to July 2018 in online or print form in Canada, New Zealand, Australia, United States of America and the United Kingdom. RESULTS One hundred and eighty-six articles were identified describing 91 different children (45 male), almost all with cerebral palsy, median age 4 years old. One hundred and twenty-six articles were written prior to surgery; in many articles, SDR surgery involved travel overseas and/or fundraising. SDR was described universally in positive terms with little discussion of risks. Content of articles variably included the specialized nature of SDR, parental frustration with their local health system and their hope for positive outcomes. There was geographical variation in both numbers of articles and content. CONCLUSIONS SDR is a common focus in cerebral palsy news media articles in some countries. Framing in these articles supports SDR as a beneficial and specialized procedure and may lead families to believe they need to work outside their local health systems. As news media are likely an important influence on families' attitudes to SDR, clinicians should be aware of this influence.
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Affiliation(s)
- Simon Paul Paget
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lani Campbell
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anneliese Blaxland
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Jennifer Lewis
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Angela Mary Morrow
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Cohen SA, Zhuang T, Xiao M, Michaud J, Amanatullah DF, Kamal RN. Google Trends Analysis Shows Increasing Public Interest in Platelet-Rich Plasma Injections for Hip and Knee Osteoarthritis. J Arthroplasty 2021; 36:3616-3622. [PMID: 34172346 PMCID: PMC8478783 DOI: 10.1016/j.arth.2021.05.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/15/2021] [Accepted: 05/29/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Osteoarthritis is a chronic musculoskeletal condition that frequently affects the hip and knee joints. Given the burden associated with surgical intervention for hip and knee osteoarthritis, patients continue to search for potential nonoperative treatments. One biologic therapy with mixed clinical and basic science evidence for treating osteoarthritis is platelet-rich plasma injections into the affected joint. We used the Google Trends tool to provide a quantitative analysis of national interest in platelet-rich plasma injections for hip and knee osteoarthritis. METHODS Google Trends parameters were selected to obtain search data from January 2009 to December 2019. Various combinations of "arthritis," "osteoarthritis," "PRP," "platelet-rich plasma," "knee," and "hip" were entered into the Google Trends tool and trend analyses were performed. RESULTS Three linear models were generated to display search volume trends in the United States for platelet-rich plasma and osteoarthritis, hip osteoarthritis, and knee osteoarthritis, respectively. All models showed increased Google queries as time progressed (P < .001), with R2 ranging from 0.837 to 0.940. Seasonal, income-related, and geographic variations in public interest in platelet-rich plasma for osteoarthritis were noted. CONCLUSION Our results demonstrate a significant rise in Google queries related to platelet-rich plasma injections for osteoarthritis of the hip and knee since 2009. Surgeons treating hip and knee osteoarthritis patients can expect continued interest in platelet-rich plasma, despite inconclusive clinical and basic science data. Trends in public interest may inform patient counseling, shared decision-making, and directions for future clinical research.
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Affiliation(s)
- Samuel A. Cohen
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
| | - Thompson Zhuang
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
| | - Michelle Xiao
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
| | - John Michaud
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
| | - Derek F. Amanatullah
- Stanford University, VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
| | - Robin N. Kamal
- VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway, Redwood City, CA, 94063
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Abstract
Tendon is a fibro-elastic structure that links muscle and bone. Tendon injury can be divided into two types, chronic and acute. Each type of injury or degeneration can cause substantial pain and the loss of tendon function. The natural healing process of tendon injury is complex. According to the anatomical position of tendon tissue, the clinical results are different. The wound healing process includes three overlapping stages: wound healing, proliferation and tissue remodeling. Besides, the healing tendon also faces a high re-tear rate. Faced with the above difficulties, management of tendon injuries remains a clinical problem and needs to be solved urgently. In recent years, there are many new directions and advances in tendon healing. This review introduces tendon injury and sums up the development of tendon healing in recent years, including gene therapy, stem cell therapy, Platelet-rich plasma (PRP) therapy, growth factor and drug therapy and tissue engineering. Although most of these therapies have not yet developed to mature clinical application stage, with the repeated verification by researchers and continuous optimization of curative effect, that day will not be too far away.
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Affiliation(s)
- Zhi Jie Li
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
| | - Qian Qian Yang
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
| | - You Lang Zhou
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
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13
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Mościcka P, Przylipiak A. History of autologous platelet-rich plasma: A short review. J Cosmet Dermatol 2021; 20:2712-2714. [PMID: 34214233 PMCID: PMC9291029 DOI: 10.1111/jocd.14326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 12/27/2022]
Abstract
Background Platelet‐rich plasma (PRP) is a medical material with numerous applications. It produces particularly spectacular effects when applied in cosmetic dermatology. Aim To illustrate the origin of the treatment. Conclusion The therapy originates from transfusiology, where it is applied as a concentrate of platelets to treat trombocytopenia. PRP treatment is 70 years old and has an increasing number of applications. PRP holds particular promise for cosmetic dermatology.
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Affiliation(s)
- Patrycja Mościcka
- Department of Esthetic Medicine, Faculty of Pharmacy, Medical University of Białystok, Bialystok, Poland
| | - Andrzej Przylipiak
- Department of Esthetic Medicine, Faculty of Pharmacy, Medical University of Białystok, Bialystok, Poland
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14
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Vozel D, Božič D, Jeran M, Jan Z, Pajnič M, Pađen L, Steiner N, Kralj-Iglič V, Battelino S. Autologous Platelet- and Extracellular Vesicle-Rich Plasma Is an Effective Treatment Modality for Chronic Postoperative Temporal Bone Cavity Inflammation: Randomized Controlled Clinical Trial. Front Bioeng Biotechnol 2021; 9:677541. [PMID: 34307321 PMCID: PMC8294456 DOI: 10.3389/fbioe.2021.677541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/10/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose To determine the efficacy of autologous platelet- and extracellular vesicle-rich plasma (PVRP) to treat chronic postoperative temporal bone cavity inflammation (CPTBCI) after exhausting surgical and standard conservative therapies. Materials and Methods Patients were randomly allocated to treatment with PVRP (PVRP group) or standard conservative methods (control group) in a setting of four once-monthly checkups and subsequent follow-up. The treatment outcome was measured with the Chronic Otitis Media Questionnaire-12 (COMQ-12), CPTBCI focus surface area, and CPTBCI symptom-free time after the fourth checkup. Results Eleven patients from each group completed the trial; 95% of patients suffered from chronically discharging mastoid cavity (the type of CPTBCI). Within four checkups, the COMQ-12 score decreased statistically significantly in the PVRP group (p < 0.001) but not in the control group (p = 0.339). The CPTBCI foci surface area decreased statistically significantly between the first and second checkups (p < 0.0005) but not between other checkups (p > 0.05) in the PVRP group. No statistically significant differences in CPTBCI foci surface area were detected between checkups in the control group (p = 0.152). Nine patients from the PVRP group and three patients from the control group were CPTBCI symptom-free at the fourth checkup. The median symptom-free time was 9.2 months (95% CI [7.4, 11.9]) in the PVRP group. Cumulatively, 49% of patients in the PVRP group remained CPTBCI symptom-free for 12.7 months after the fourth checkup. Conclusion Autologous PVRP represents a novel additional and successful treatment modality for a chronically discharging radical mastoid cavity when the surgical and standard conservative treatment methods have been exhausted. Trial Number https://clinicaltrials.gov (NCT04281901).
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Affiliation(s)
- Domen Vozel
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Darja Božič
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia.,Laboratory of Physics, Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Marko Jeran
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia.,Laboratory of Physics, Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Zala Jan
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Manca Pajnič
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Ljubiša Pađen
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Nejc Steiner
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Veronika Kralj-Iglič
- Laboratory of Clinical Biophysics, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia.,Extracellular Vesicles and Mass Spectrometry Laboratory, Institute of Biosciences and BioResources, National Research Council of Italy, Naples, Italy
| | - Saba Battelino
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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15
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Bec C, Rousset A, Brandin T, François P, Rabarimeriarijaona S, Dumoulin C, Heleu G, Grimaud F, Veran J, Magalon G, Dignat-George F, Sabatier F, Louis ML, Magalon J. A Retrospective Analysis of Characteristic Features of Responders and Impaired Patients to a Single Injection of Pure Platelet-Rich Plasma in Knee Osteoarthritis. J Clin Med 2021; 10:jcm10081748. [PMID: 33920633 PMCID: PMC8073986 DOI: 10.3390/jcm10081748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/13/2022] Open
Abstract
(1) Background: The emergence of injectable “biologic” medication creates a new approach to treat osteoarthritis (OA). Among them, the use of intra-articular injection of PRP became widespread despite the absence of consensus regarding its optimal composition. The aim of this study was to retrospectively correlate an extensive biological characterization of injected PRP to the clinical responses of patients presenting knee OA. (2) Methods: This retrospective study included 75 patients with knee OA. Cartilage lesions were assessed using magnetic resonance imaging and the International Cartilage Regeneration Society (ICRS) classification. PRP extensive biological characterization was performed and patients’ subjective symptoms were recorded before injection and 3 and 6 months after injection using the Knee injury and Osteoarthritis Outcome Score (KOOS). Responders were defined by an improvement of 10 points on KOOS. (3) Results: At 6 months, 63.0% of the patients were responders. Impairment was characterized by a significantly higher proportion of patients with three compartments altered at baseline MRI and receiving a significantly higher dose of platelets compared to responders. (4) Conclusions: Single injection of pure PRP resulted in significant clinical improvement in the management of knee OA. Both baseline MRI and PRP biological features may be predictive factors of the clinical response, highlighting that a better understanding of action mechanism of PRP is still required.
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Affiliation(s)
- Cécilia Bec
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Axelle Rousset
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Thibault Brandin
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Pauline François
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
| | - Sitraka Rabarimeriarijaona
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Chloé Dumoulin
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Gaëlle Heleu
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Fanny Grimaud
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | - Julie Veran
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
| | | | - Françoise Dignat-George
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - Florence Sabatier
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Remedex SAS, 13008 Marseille, France;
| | - Marie-Laure Louis
- Orthopedic Department, Hopital Nord, AP-HM, 13015 Marseille, France;
- ICOS, Sport and Orthopedics Surgery Institute, 13008 Marseille, France
- Orthopedic Department, Clinique Juge, Almaviva, 13008 Marseille, France
| | - Jérémy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, 13005 Marseille, France; (C.B.); (A.R.); (T.B.); (P.F.); (S.R.); (C.D.); (G.H.); (F.G.); (J.V.); (F.S.)
- Aix Marseille Univ, INSERM, INRA, C2VN, 13005 Marseille, France;
- Remedex SAS, 13008 Marseille, France;
- Correspondence:
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16
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Abstract
CONTEXT Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. EVIDENCE ACQUISITION An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. CONCLUSIONS Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.
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Affiliation(s)
- Jonathan K Ochoa
- Department of Orthopaedic Surgery, University of California-Irvine, Orange, California
| | - Christopher E Gross
- Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina
| | - Robert B Anderson
- Bellin Health Titletown Sports Medicine and Orthopedics, Green Bay, Wisconsin
| | - Andrew R Hsu
- Department of Orthopaedic Surgery, University of California-Irvine, Orange, California
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17
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Harrison P, Alsousou J. The state of the art and future of PRP therapy. Platelets 2021; 32:150-151. [PMID: 33463374 DOI: 10.1080/09537104.2020.1869718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Joseph Alsousou
- Kadoorie Centre for Critical Care Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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18
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Wang P, Li K, Jiang Z, Qiu B, Nie C, Luo H, Li Z. Impact of the numbers of injections of platelet rich plasma on the clinical outcomes in patients with knee osteoarthritis: A protocol for an updated network meta-analysis. Medicine (Baltimore) 2021; 100:e24250. [PMID: 33429829 PMCID: PMC7793368 DOI: 10.1097/md.0000000000024250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/17/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Two published meta-analyses have investigated the effects of the number of injections of platelet rich plasma (PRP) on clinical outcomes in knee osteoarthritis patients, however conflicting findings were generated. METHODS We will systematically search PubMed, Embase, and China National Knowledgement Infrastructure (CNKI) to capture additional eligible studies. After screening citations, extracting essential data, assessing the risk of bias, we will use RevMan software and Open BUGS to perform head-to-head and network meta-analysis of pain alleviation and improvement of joint functionality, respectively. DISCUSSION Knee joint osteoarthritis (KOA) is the main cause of joint degeneration in elderly, which seriously reduces patients quality of life. Although intra-articular PRP has been extensively prescribed to treat KOA, a definitive conclusion about the appropriate number of injections has not yet been generated in published meta-analyses. The present updated network meta-analysis will comprehensively answer this question. ETHICS AND DISSEMINATION We will communicate our findings through participating in academic conferences or submiting it to be considered for publication in peer reviewed scholar journal. INPLASY REGISTRATION NUMBER We registered this protocol in International Plateform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) platform and obtained an identifier of INPLASY2020110043 (https://inplasy.com/inplasy-2020-11-0043/).
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Affiliation(s)
- Pan Wang
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Kai Li
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Zuxin Jiang
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Beiming Qiu
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Cheng Nie
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Hongsheng Luo
- Department of Orthopedics, the Second People's Hospital of Yibin, Yibin
| | - Zhengjiang Li
- Department of Orthopedics, Chengdu Fifth People's Hospital, Chengdu, China
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19
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Harrison P, Didembourg M, Wood A, Devi A, Dinsdale R, Hazeldine J, Alsousou J, Keene DJ, Hulley P, Wagland S, Parsons S, Thompson J, Byrne C, Schlüssel MM, O'Connor H, Dutton SJ, Lamb SE, Willett K. Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study. Platelets 2020; 32:273-279. [PMID: 33242293 DOI: 10.1080/09537104.2020.1849604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Platelet-rich plasma (PRP) is an autologous preparation that has been claimed to improve healing and mechanobiological properties of tendons both in vitro and in vivo. In this sub-study from the PATH-2 (PRP in Achilles Tendon Healing-2) trial, we report the cellular and growth factor content and quality of the Leukocyte-rich PRP (L-PRP) (N = 103) prepared using a standardized commercial preparation method across 19 different UK centers. Baseline whole blood cell counts (red cells, leukocyte and platelets) demonstrated that the two groups were well-matched. L-PRP analysis gave a mean platelet count of 852.6 x 109/L (SD 438.96), a mean leukocyte cell count of 15.13 x 109/L (SD 10.28) and a mean red blood cell count of 0.91 x 1012/L (SD 1.49). The activation status of the L-PRP gave either low or high expression levels of the degranulation marker CD62p before and after ex-vivo platelet activation respectively. TGF-β, VEGF, PDGF, IGF and FGFb mean concentrations were 131.92 ng/ml, 0.98 ng/ml, 55.34 ng/ml, 78.2 ng/ml and 111.0 pg/ml respectively with expected correlations with both platelet and leukocyte counts. While PATH-2 results demonstrated that there was no evidence L-PRP is effective for improving clinical outcomes at 24 weeks after Achilles tendon rupture, our findings support that the majority of L-PRP properties were within the method specification and performance.
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Affiliation(s)
- Paul Harrison
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Marie Didembourg
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Alexander Wood
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Amarpreet Devi
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Robert Dinsdale
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Jon Hazeldine
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Joseph Alsousou
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David J Keene
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Philippa Hulley
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan Wagland
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Scott Parsons
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jacqueline Thompson
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Christopher Byrne
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Heather O'Connor
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan J Dutton
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Keith Willett
- Kadoorie Centre for Critical Care Research, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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20
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Affiliation(s)
- Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Joseph Alsousou
- Kadoorie Centre for Critical Care Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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21
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Magalon J, Brandin T, Francois P, Degioanni C, De Maria L, Grimaud F, Veran J, Dignat-George F, Sabatier F. Technical and biological review of authorized medical devices for platelets-rich plasma preparation in the field of regenerative medicine. Platelets 2020; 32:200-208. [PMID: 33155867 DOI: 10.1080/09537104.2020.1832653] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Platelet-rich plasma (PRP) has seen increased interest and utilization over the past decade, particularly in the field of musculoskeletal disease. This growth has been accompanied by the development of medical devices to realize PRP preparation which includes blood collection, centrifugation, and PRP isolation. The final PRP composition is directly influenced by this preparation step and absence of biological quality control led to a lack of comparability between PRP products that could explain the large variability in the clinical benefit of PRP reported in literature. To circumvent this issue, the scientific community developed different PRP classifications but none of them have been adopted. The goal of this review is to furnish both technical and biological characteristics from PRP commercial systems. On review of 1379 studies, 105 studies were selected according to inclusion criteria for technical analysis and led to the identification of 50 commercial systems that have been classified in three technical categories based on the blood harvesting technique (tubes, syringes or bags). Twelve studies were selected and sufficiently describe biological characteristics from only 14 commercial systems from the 50 identified in the technical analysis. Inclusion of duplicates characterization from a same PRP system lead to the final analysis of 36 PRP preparations that met the inclusion criteria of the biological analysis. All these PRP preparations have been classified among the seven existing classifications. Comparison from all biological parameters and classifications revealed a large heterogeneity among the available current PRP commercial systems. Index of biological sensitivity of classifications to distinguish PRP preparations were also variable. Although these findings should help clinicians in selecting a system that meets their specific needs, this also raises the question to standardize the parameters to biologically define PRP preparation among users and to systematically performed PRP qualification when used.
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Affiliation(s)
- Jeremy Magalon
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France.,SAS Remedex, Marseille, France
| | - Thibault Brandin
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France
| | - Clara Degioanni
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Lucille De Maria
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | - Julie Veran
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France
| | | | - Florence Sabatier
- Cell Therapy Laboratory, Hôpital De La Conception, AP-HM, Marseille, France.,INSERM, INRA, C2VN, Aix Marseille Univ, Marseille, France.,SAS Remedex, Marseille, France
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Abstract
OBJECTIVE The spread of misinformation has accompanied the coronavirus pandemic, including topics such as immune boosting to prevent COVID-19. This study explores how immune boosting is portrayed on the internet during the COVID-19 pandemic. DESIGN Content analysis. METHODS We compiled a dataset of 227 webpages from Google searches in Canada and the USA using the phrase 'boost immunity' AND 'coronavirus' on 1 April 2020. We coded webpages for typology and portrayal of immune boosting and supplements. We recorded mentions of microbiome, whether the webpage was selling or advertising an immune boosting product or service, and suggested strategies for boosting immunity. RESULTS No significant differences were found between webpages that appeared in the searches in Canada and the USA. The most common types of webpages were from news (40.5%) and commercial (24.7%) websites. The concept of immune boosting was portrayed as beneficial for avoiding COVID-19 in 85.5% of webpages and supplements were portrayed as beneficial in 40% of the webpages, but commercial sites were more likely to have these portrayals. The top immune boosting strategies were vitamin C (34.8%), diet (34.4%), sleep (34.4%), exercise (30.8%) and zinc (26.9%). Less than 10% of the webpages provide any critique of the concept of immune boosting. CONCLUSIONS Pairing evidence-based advice for maintaining one's health (eg, healthy diet, exercise, sleep) with the phrase immune boosting and strategies lacking in evidence may inadvertently help to legitimise the concept, making it a powerful marketing tool. Results demonstrate how the spread of misinformation is complex and often more subtle than blatant fraudulent claims.
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Affiliation(s)
- Christen Rachul
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Benjamin Collins
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Anthropology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Timothy Caulfield
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
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23
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Magalon J, Brandin T, Grimaud F, Rabarimeriarijaona S, Veran J, Dignat George F, Sabatier F. Platelet-rich plasma preparations in sports rehabilitation: Where we started and where we should go. Ann Phys Rehabil Med 2020; 65:101414. [PMID: 32622011 DOI: 10.1016/j.rehab.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Jeremy Magalon
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France.
| | - Thibault Brandin
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | - Fanny Grimaud
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | | | - Julie Veran
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France
| | - Françoise Dignat George
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France
| | - Florence Sabatier
- Cell therapy laboratory, Inserm CIC BT 1409, hôpital de la Conception, AP-HM, Marseille, France; Inserm, Inra, C2VN, Aix Marseille université, Marseille, France
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24
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Marcon AR, Allan D, Barber M, Murdoch B, Caulfield T. Portrayal of umbilical cord blood research in the North American popular press: promise or hype? Regen Med 2020; 15:1228-1237. [PMID: 32101099 DOI: 10.2217/rme-2019-0149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: This study examined how umbilical cord blood (UCB) use was portrayed in the English language North American popular press. Methods: Directed content analysis was conducted on 400 articles from 2007 to 2017 containing 'cord blood,' published by the most read Canadian and American news sources. Results: A total of 86.3% of the articles detailed UCB treatments and therapies, the majority of which align with clinical evidence. Some articles portrayed speculative/experimental therapies as efficacious. Public and private banking initiatives received substantial attention, and were portrayed diversely. Promotional narrative messaging was evident around private banking. Conclusion: Findings demonstrate the need for continual monitoring of the media portrayals of UCB as stem cell and transplantation research develops and as clinics continue to operate.
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Affiliation(s)
- Alessandro R Marcon
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada, T6G 2H5
| | - David Allan
- Ottawa Hospital Research Institute, Canadian Blood Services, University of Ottawa, Ottawa ON, Canada, K1Y 4E9
| | - Morgan Barber
- University of Alberta, Faculty of Law, Edmonton, AB, Canada, T6G 2H5
| | - Blake Murdoch
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada, T6G 2H5
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada, T6G 2H5
- School of Public Health, University of Alberta, Edmonton, AB, Canada, T6G 1C9
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Vilchez-Cavazos F, Millán-Alanís JM, Blázquez-Saldaña J, Álvarez-Villalobos N, Peña-Martínez VM, Acosta-Olivo CA, Simental-Mendía M. Comparison of the Clinical Effectiveness of Single Versus Multiple Injections of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis. Orthop J Sports Med 2019; 7:2325967119887116. [PMID: 31897409 PMCID: PMC6918503 DOI: 10.1177/2325967119887116] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Reports have concluded that platelet-rich plasma (PRP) is an effective and safe biological approach in the treatment of knee osteoarthritis (OA). However, no consensus has been established regarding the number of injections required to observe a therapeutic effect. Purpose To compare the clinical effectiveness reported in randomized controlled trials (RCTs) of single versus multiple PRP injections in the treatment of knee OA. Study Design Systematic review; Level of evidence, 1. Methods A comprehensive search was conducted for RCTs published between 1970 and 2019 that compared the effect of single versus multiple PRP injections on pain and functionality in patients with knee OA. Searched databases included MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. A data extraction form was designed to obtain bibliographic information of the study as well as patient, intervention, comparison, and outcomes of interest data. A random-effects model was used to pool quantitative data from the primary outcomes. Results We included 5 clinical trials with a low-moderate risk of bias that reported data for 301 patients. Meta-analysis showed that, at 6 months after the intervention, single and multiple (double or triple) injections had similar pain improvement, with no significant differences (standardized mean difference [SMD], 0.61 [95% CI, -1.09 to 2.31]; I 2 = 97%; P = .48). A significant improvement in knee functionality was observed in favor of multiple injections (SMD, 2.29 [95% CI, 0.45-4.12]; I 2 = 97%; P = .01). Subanalysis showed that the significant improvement was only evident for the results of single versus triple injections (SMD, 3.12 [95% CI, 0.64-5.60]; I 2 = 97%; P = .01). Conclusion According to our results, a single injection was as effective as multiple PRP injections in pain improvement; however, multiple injections seemed more effective in joint functionality than a single injection at 6 months. We consider that the available evidence is still insufficient, and future research on this specific topic is needed to confirm our results.
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Affiliation(s)
- Félix Vilchez-Cavazos
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
| | - Juan Manuel Millán-Alanís
- Universidad Autónoma de Nuevo León, Plataforma Invest-KER Unit Mexico, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
| | - Jaime Blázquez-Saldaña
- Universidad Autónoma de Nuevo León, Plataforma Invest-KER Unit Mexico, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
| | - Neri Álvarez-Villalobos
- Universidad Autónoma de Nuevo León, Plataforma Invest-KER Unit Mexico, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México.,Universidad Autónoma de Nuevo León, Clinical Research Unit, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México.,Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Víctor Manuel Peña-Martínez
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
| | - Carlos Alberto Acosta-Olivo
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
| | - Mario Simental-Mendía
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario Dr José Eleuterio González, Monterrey, México
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Keene DJ, Alsousou J, Harrison P, Hulley P, Wagland S, Parsons SR, Thompson JY, O'Connor HM, Schlüssel MM, Dutton SJ, Lamb SE, Willett K. Platelet rich plasma injection for acute Achilles tendon rupture: PATH-2 randomised, placebo controlled, superiority trial. BMJ 2019; 367:l6132. [PMID: 31748208 PMCID: PMC6863552 DOI: 10.1136/bmj.l6132] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether an injection of platelet rich plasma improves outcomes after acute Achilles tendon rupture. DESIGN Randomised, placebo controlled, two arm, parallel group, participant and assessor masked, superiority trial. SETTING Secondary care trauma units across 19 hospitals in the United Kingdom's health service. PARTICIPANTS Recruitment commenced in July 2015 and follow-up was completed in March 2018. 230 adults aged 18 years and over were included, with acute Achilles tendon rupture presenting within 12 days of injury and managed with non-surgical treatment. Exclusions were injury at the insertion or musculotendinous junction, major leg injury or deformity, diabetes mellitus, platelet or haematological disorder, systemic corticosteroids, anticoagulation treatment, and other contraindicating conditions. INTERVENTIONS Participants were randomised 1:1 to platelet rich plasma (n=114) or placebo (dry needle; n=116) injection. All participants received standard rehabilitation care (ankle immobilisation followed by physiotherapy). MAIN OUTCOMES AND MEASURES Primary outcome was muscle tendon function at 24 weeks, measured objectively with the limb symmetry index (injured/uninjured×100) in maximal work done during the heel rise endurance test (an instrumented measure of repeated single leg heel rises until fatigue). Secondary outcomes included patient reported function (Achilles tendon rupture score), quality of life (short form 12 version 2®), pain (visual analogue scale), goal attainment (patient specific functional scale), and adverse events. A central laboratory analysed the quality and content of platelet rich plasma. Analyses were by modified intention to treat. RESULTS Participants were 46 years old on average, and 57 (25%) of 230 were female. At 24 weeks, 202 (88%) participants completed the heel rise endurance test and 216 (94%) the patient reported outcomes. The platelet rich plasma was of good quality, with expected growth factor content. No difference was detected in muscle tendon function between participants receiving platelet rich plasma injections and those receiving placebo injections (limb symmetry index, mean 34.7% (standard deviation 17.7%) v 38.5% (22.8%); adjusted mean difference -3.9% (95% confidence interval -10.5% to 2.7%)) or in any secondary outcomes or adverse event rates. Complier average causal effect analyses gave similar findings. CONCLUSIONS There is no evidence to indicate that injections of platelet rich plasma can improve objective muscle tendon function, patient reported function, or quality of life after acute Achilles tendon rupture compared with placebo, or that they offer any patient benefit. TRIAL REGISTRATION ISRCTN54992179.
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Affiliation(s)
- David J Keene
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Joseph Alsousou
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Paul Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Philippa Hulley
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan Wagland
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Scott R Parsons
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jacqueline Y Thompson
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Heather M O'Connor
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Michael Maia Schlüssel
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Susan J Dutton
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Keith Willett
- Kadoorie Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Alsousou J, Harrison P. Therapeutic Platelet-Rich Plasma in Wound Healing. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Graiet H, Lokchine A, Francois P, Velier M, Grimaud F, Loyens M, Berda-Haddad Y, Veran J, Dignat-George F, Sabatier F, Magalon J. Use of platelet-rich plasma in regenerative medicine: technical tools for correct quality control. BMJ Open Sport Exerc Med 2018; 4:e000442. [PMID: 30498575 PMCID: PMC6241975 DOI: 10.1136/bmjsem-2018-000442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 01/01/2023] Open
Abstract
Background/aims Platelet-rich plasma (PRP) injections are used in sports medicine and have been the subject of increased clinical interest. However, there have been very few reports of the composition of initial whole blood and the final PRP product. The objective of this study was to provide technical tools to perform a correct characterisation of platelets, leucocytes and red blood cells (RBCs) from whole blood and PRP. Methods Blood and PRP were obtained from 26 healthy volunteers and prepared according to the varying parameters encountered within PRP process preparation and quantification (harvesting method, anticoagulant used, sampling method, counting method). Concentrations were measured at t=0, t=1, t=6 and t=24 hours. Results Sampling of blood in Eppendorf tubes significantly decreased platelet concentration over time, whereas sampling in Microvette EDTA-coated tube kept platelet concentration stable until 24 hours. A non-significant difference was observed in platelet counts in PRP with impedance (median (IQR): 521.8 G/L (505.3–524.7)) and fluorescence (591.5 G/L (581.5–595.8)) methods. Other studied parameters did not influence platelet concentrations in blood or PRP samples. Leucocytes and RBC counts were similar whatever the anticoagulant, sampling, harvesting and counting methods used for both blood and PRP samples. Conclusions Systematic sampling of blood and PRP in EDTA-coated tubes for quality control is recommended. The use of a validated counter for PRP sample should also be taken into account.
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Affiliation(s)
- Hajer Graiet
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Anna Lokchine
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pauline Francois
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
| | - Melanie Velier
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Maxime Loyens
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Yael Berda-Haddad
- Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | - Julie Veran
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Francoise Dignat-George
- INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France.,Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France
| | | | - Jeremy Magalon
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INSERM, INRA, C2VN, Aix-Marseille University, Marseille, France
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Andia I, Maffulli N. A contemporary view of platelet-rich plasma therapies: moving toward refined clinical protocols and precise indications. Regen Med 2018; 13:717-728. [PMID: 30246605 DOI: 10.2217/rme-2018-0042] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The positive extensive clinical experience with platelet-rich plasma (PRP) in different medical areas has prompted researchers to explore clinical opportunities for optimized PRP therapies. PRP is safe but we have to make it more effective. The growing diversity of formulations and presentations enrich the field of PRP research and offer hope to refine clinical indications. Moving toward targeting the right disease phenotypes with the right PRP formulation or combination product (PRP + cell products) can offer opportunities to change treatment options in osteoarthritis and nonhealing wounds. Both are active areas of research that could offer opportunities, although cost efficacy is still an open question. Our position is to believe that these serious disease areas are likely to benefit from PRP therapies.
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Affiliation(s)
- Isabel Andia
- Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, 48903 Barakaldo, Spain
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine & Dentristry, Salerno, Italy.,Queen Mary University of London, Barts & the London School of Medicine & Dentistry, London, UK
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Harrison P. The use of platelets in regenerative medicine and proposal for a new classification system: guidance from the SSC of the ISTH. J Thromb Haemost 2018; 16:1895-1900. [PMID: 30099839 DOI: 10.1111/jth.14223] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Indexed: 11/26/2022]
Abstract
Autologous and single-donor allogenic platelet preparations are increasingly being used in many areas of regenerative medicine. However, there are few properly controlled randomized clinical trials, and the preparation, content and characteristics of platelet preparations are generally poorly defined and controlled. The Platelet Physiology Subcommittee of the Scientific and Standardization Committee (SSC) of the ISTH formed a working party of experts with the aim of producing consensus recommendations for guidance on the use of platelets in regenerative medicine. Owing to a lack of investigations that provide definitive evidence for the efficacy, definition and use of different platelet preparations in regenerative medicine, there were insufficient data to develop evidence-based guidelines. Therefore, the RAND method was used, which obtains a formal consensus among experts particularly when scientific evidence is absent, scarce and/or heterogeneous. Using this approach, each expert scored as 'appropriate', 'uncertain' or 'inappropriate' a series of 45 statements about the practice of regenerative medicine with platelets, which included different sections on general aspects, platelet preparations, clinical trial design, and potential utility in different clinical scenarios. After presentation and public discussion at SSC meetings, the assessments were further refined to produce final consensus recommendations, which constitute the subject of the present report.
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Affiliation(s)
- P Harrison
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Abstract
INTRODUCTION Regular engagement in sports produces many health benefits, but also exposes to increased injury risk. The quality of medical care available is crucial not only for sports trauma but also to avoid overuse syndromes and post-traumatic degenerative conditions. AREAS COVERED We provide background information on some clinical needs in sport injuries and describe the main families of biological products used in clinical practice. We also discuss limitations of the current clinical experience. EXPERT OPINION Sport and exercise impairment affects different segments of the population with different needs. The exceptional demands of elite athletes and subsequent media coverage have created hype around regenerative therapies. Statistical evidence, whether weak (cell products) or moderate (PRPs), is not enough to drive medical decisions because of the heterogeneity of the biological products available and their application procedures. Moreover, the specific needs of the different segments of the population along with the available clinical evidence for each musculoskeletal condition should be considered in the decision-making process. There is urgent need to develop regenerative protocols combined with post-intervention rehabilitation, and gather meaningful clinical data on the safety and efficacy of these interventions in the different populations segments.
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Affiliation(s)
- Isabel Andia
- a Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital , Barakaldo , Spain
| | - Nicola Maffulli
- b Department of Musculoskeletal Disorders , University of Salerno School of Medicine and Dentristry , Salerno , Italy.,c Centre for Sport and Exercise Medicine , Queen Mary University of London, Barts and the London School of Medicine and Dentistry , London , England
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Piuzzi NS, Oñativia JI, Vietto V, Franco JVA, Griffin XL. Autologous bone marrow-derived and blood-derived biological therapies (including cellular therapies and platelet-rich plasma) for bone healing in adults. Hippokratia 2018. [DOI: 10.1002/14651858.cd013050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Nicolas S Piuzzi
- Instituto Universitario Hospital Italiano; Argentine Cochrane Centre; Potosi 4234 Buenos Aires Buenos Aires Argentina C1199ACL
- Cleveland Clinic; Department of Orthopaedic Surgery; 9500 Euclid Avenue Cleveland Ohio USA 44195
| | - Jose I Oñativia
- Instituto Universitario del Hospital Italiano; Department of Orthopaedic Surgery; Potosi 4234 Buenos Aires Argentina C1199ACL
| | - Valeria Vietto
- Hospital Italiano de Buenos Aires; Family and Community Medicine Service; Buenos Aires Argentina
| | - Juan VA Franco
- Instituto Universitario Hospital Italiano; Argentine Cochrane Centre; Potosi 4234 Buenos Aires Buenos Aires Argentina C1199ACL
| | - Xavier L Griffin
- University of Oxford, John Radcliffe Hospital; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS); Kadoorie Centre Headley Way Oxford UK OX3 9DU
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Abstract
Aim: To better understand how prospective customers interpret claims of businesses marketing unproven stem cell products that they are engaging in research activities. Materials & methods: The authors examined 408 crowdfunding campaigns for unproven stem cell interventions for references to research activities. Results: The authors identified three overarching themes: research as a signifier of scientific credibility; the experimental nature of stem cells as a rationale for noncoverage by insurers; and contributing to the advancement of science by engaging in research. Conclusion: The NIH, US FDA and others should be concerned about being co-opted to misrepresent the nature of these businesses’ activities. Efforts are also needed to better inform those considering purchasing unproven stem cell interventions about their relationship to legitimate research.
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Affiliation(s)
- Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Leigh Turner
- Center for Bioethics, University of Minnesota, N-302 Boyn HS, 410 Church Street SE, Minneapolis, MN 55455, USA
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Kramer ME, Keaney TC. Systematic review of platelet-rich plasma (PRP) preparation and composition for the treatment of androgenetic alopecia. J Cosmet Dermatol 2018; 17:666-671. [DOI: 10.1111/jocd.12679] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 12/18/2022]
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Louis ML, Magalon J, Jouve E, Bornet CE, Mattei JC, Chagnaud C, Rochwerger A, Veran J, Sabatier F. Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in Knee Osteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation. Arthroscopy 2018; 34:1530-1540.e2. [PMID: 29366744 DOI: 10.1016/j.arthro.2017.11.035] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in knee osteoarthritis, and identify biological characteristics of PRP that may affect their efficacy. METHODS Fifty-four patients with symptomatic knee osteoarthritis received a single injection of either PRP (26 patients) or HA (28 patients). They were assessed at baseline and at 1, 3, and 6 months. The primary endpoint was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at 3 months, and secondary endpoints were responders' rate (improvement of at least 5 points or 40% of WOMAC total score at 3 months) of pain evaluation and patient's subjective satisfaction. Cell counts and the contents of vascular endothelial growth factor (VEGF), platelet-derived growth factor-AB (PDGF-AB), transforming growth factor beta 1 (TGF-β1) content of injected PRP were assessed to analyze their relationship with clinical outcome. RESULTS Both treatments proved their improvement in knee functional status and symptom relief, with a significant decrease observed at 1 month on all scores except for pain VAS in PRP group and WOMAC function score in the HA group. No difference between groups regarding WOMAC and VAS scores was observed. A higher percentage of responders was observed in the PRP group (72.7%) than in the HA group (45.8%) without significance (P = .064). The quantity of injected PDGF-AB and TGF-β1 correlated with the change in WOMAC scores at 3 months and was lower in responders than in nonresponders (P = .009 and P = .003, respectively). CONCLUSIONS Current results indicated that a single injection of very pure PRP offers a significant clinical improvement in the management of knee osteoarthritis, equivalent to a single HA injection in this patient population. Moreover, a significant correlation between the doses of TGF-β1 and PDGF-AB and the worsening of WOMAC score 3 months after the procedure was found. LEVEL OF EVIDENCE Level II, randomized double blind controlled trial.
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Affiliation(s)
- Marie Laure Louis
- Orthopedic Department, Hôpital Nord, AP-HM, Marseille, France; ICOS, Sport and Orthopedics Surgery Institute, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France; Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, INSERM UMR 1076, Marseille, France.
| | - Elizabeth Jouve
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France
| | | | | | | | | | - Julie Veran
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France
| | - Florence Sabatier
- Unité de Pharmacométrie CIC-CPCET, Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, AP-HM, Marseille, France; Hematology and Vascular Biology Department, Hôpital de la Conception, AP-HM, Marseille, France; Vascular Research Center of Marseille, Aix-Marseille University, INSERM UMR 1076, Marseille, France
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Abstract
Background: The indications for the use of platelet-rich plasma (PRP) are vaguely defined despite the frequency of its use as a treatment for athletes. While select studies have advocated for its efficacy, the majority of orthopaedic research conducted on the topic has been equivocal. Purpose: To define the use of PRP in elite athletes by team physicians from professional sports leagues. Study Design: Cross-sectional study. Methods: A survey assessing treatment timing, usage patterns, indications, and complications was generated by fellowship-trained sports medicine orthopaedic surgeons. The survey was distributed to team physicians from the National Football League, National Basketball Association, Major League Baseball, National Hockey League, Major League Soccer, and the “Power 5” Division I conferences of the National Collegiate Athletic Association. From a compilation of publicly available email addresses and those available from professional team physician associations, 149 team physicians were sent this PRP assessment tool. Results: Of the 149 professional and collegiate team physicians contacted, 59 started the survey and 46 completed it, resulting in a 39.6% participation rate and a 30.9% completion rate. Approximately 93% of physicians stated that they use PRP in their practices, and 72% use ultrasonography for injection guidance. On average, collegiate team physicians and National Football League physicians treated the most players per season with PRP (69.4 and 60.4 players, respectively), while National Hockey League physicians treated the fewest (18.0 players). The majority of respondents reported no complications from PRP injections (70%), with pain being the most common complication reported (26%). There was no consensus on the most important aspect of PRP formulation, with the top 2 responses being platelet concentration (48%) and white blood cell concentration (39%). When grading the importance of indications to use PRP, physicians found athlete desire on average (7.5 ± 2.2 [SD]; out of 10) to be more important than reimbursement (2.2 ± 2.2) (P < .001). Importantly, physicians stated that they moderately (5.4 ± 2.3) believed in the evidence behind PRP. Physicians listed hamstring injuries as the most common injury treated with PRP. Hamstring injuries were treated with a mean 3.14 PRP injections, as opposed to 2.19 injections for nonhamstring injuries. Conclusion: Professional and collegiate team physicians frequently use PRP despite a lack of consensus regarding the importance of the formulation of the product, the timing of treatment, and the conditions that would most benefit from PRP treatment.
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Affiliation(s)
- David E Kantrowitz
- Department of Orthopedic Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA
| | - Ajay S Padaki
- Department of Orthopedic Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA
| | - Christopher S Ahmad
- Department of Orthopedic Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA
| | - T Sean Lynch
- Department of Orthopedic Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA
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Affiliation(s)
- Isabel Andia
- Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Jose Ignacio Martin
- Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
- Interventional Imaging. Department of Radiology, Cruces University Hospital, Barakaldo, Spain
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentristry, Salerno, Italy
- Barts and the London School of Medicine and Dentistry Centre for Sports and Exercise Medicine, Queen Mary University of London, London, England
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Marcon AR, Bieber M, Caulfield T. Representing a "revolution": how the popular press has portrayed personalized medicine. Genet Med 2018; 20:950-956. [PMID: 29300377 DOI: 10.1038/gim.2017.217] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/26/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study investigated the portrayal of "personalized" and "precision" medicine (PM) in North American news over the past decade. Content analysis of print and online news was conducted to determine how PM has been defined and to identify the frames used to discuss PM, including associated topics, benefits, and concerns. METHODS A data set was built using the FACTIVA database, searching for popular North American publications with the terms "personalized (personalised) medicine" and/or "precision medicine" from 1 January 2005 to 15 March 2016. The final set of publications totaled 774. RESULTS PM is almost exclusively defined as related to genetics and is often part of a story related to cancer. The PM story is overwhelmingly one of highlighting (potential) benefits and optimism, especially in shorter publications, and ones where PM is not the main focus. This promotional PM discourse has remained fairly consistent over the past decade. CONCLUSION The numerous concerns associated with PM have received little attention over the past decade, especially in articles more likely to be encountered by a more general audience. This promotion of PM serves as an example of the science hyping that takes place in science reportage and may have implications for consumers, public expectations, and related health policy.
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Affiliation(s)
- Alessandro R Marcon
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Bieber
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada. .,Faculty of Law and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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