Written by Dr. Matias Fernandez Vina.
CEO Stem Cell Therapy Argentina.
Diploma and Expert in Regenerative Medicine and Advanced Therapies from the Universidad Abierta Interamericana de Rosario, Argentina.
I am part of a virtual social group of Regenerative Medicine and Advanced Therapies, where we discuss cases of Regenerative Medicine… and by chance, I receive a “Screenshot”, where a colleague, calls “CHANTAS” to those who use PRP as a non-surgical treatment of osteoarthritis for patients not prepared for major knee surgery.
This arises from a scientific study published in Bone Joint on“PRP” compared to placebo group for early degenerative knee osteoarthritis. Lewis E, Merghani K, Robertson I, Mulford J, Prentice B, Mathew R, Van Winden P, Ogden K. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J. 2022 Jun;104-B(6):663-671. doi: 10.1302/0301-620X.104B6.BJJ-2021-1109.R2. PMID: 35638203.
This study of “False PRP” refers to the injection of platelets and saline solution in a knee as being the same….
The study is from Australia. As you will see as we analyze this research, something is definitely going on… some doctor, a specialist in traumatology in Argentina, defends that PRP should still NOT be used, and that even those who apply it, are “CHANTAS”, and obviously not for free…(as if these doctors have always operated/worked for free..)
Let’s review this scientific study that they seek to have as an excuse to defend a totally decadent and obsolete position, (although they may think they have a back, but they really need a good chair of regenerative medicine at the University and know better what we are talking about…).
This new research studied 102 patients with knee arthritis and was published in The Journal of Bone and Joint Surgery, a journal with a scientific impact of 5.
They randomized patients with mild to moderate knee arthritis into three groups: saline alone, PRP alone and then PRP for the first injection, and saline for two more injections. This is the first place where the study gets a little strange…. Given that three weekly PRP injections are the least common type of treatment for this type of knee arthritis, this design makes little common sense…. For example, if you wanted to compare a single PRP injection to a placebo, it would be a comparison to a single saline injection. If you wanted to compare three PRP injections to a placebo, you would obviously compare it to three saline injections. However, it is a mystery why PRP and saline would ever be combined in the same treatment group….. we already got off to a bad start with the research design.
In the end, the authors found no difference between the groups…. This contradicts nearly two dozen randomized, randomized studies with positive published on the use of REAL PRP (x7 times baseline) to treat osteoarthritis of the knee…. However, since this study used the Arthrex ACP device characterized by Magalon et al, which produces a pitiful X1.3 platelet concentration relative to basal in patient blood, if not even twice the basal value…, this study never used a“REAL PLASMA PLATELET RICH…. PRP”. Rather it is a“PLATELET POOR PLASMA“.
Therefore, the original title of this article was:
- The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial….
But it should have been:
- The effectiveness of leucocyte-poor platelet-POOR plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial….
The fact that leukocyte-poor and PLATELET-poor plasma works no better than saline injections for knee arthritis is NOT SURPRISING. We already know this, those who encourage in favor of surgery, discrediting colleagues in the field of regenerative medicine who also believe in surgical and non-surgical therapies (we are not against surgery), need to know that WE ALREADY KNOW that low dose PRP DOES NOT WORK in patients over 35 years of age.
I describe this as an example of a situation of having a major headache, and being medicated with a 50mg/day ibuprofen, when the correctdose should be 600mg/day for this problem. Medicine does not work this way…
The vast majority of physicians who read these studies only read the abstract. Which means they will assume that both studies used legitimate PRP rather than just plasma. That has the potential to set the field back.
Simply put, if you are in the field of Regenerative Medicine, spread the word that these are NOT“REAL PRP” studies. They are studies of FAKE PRP, disguised as PRP. They have platelet concentrations up to X2 times the basal value, and to be a REAL PRP, they must have X5.5 to X10, X15 or X20 inclusive.
Finally, talk to your academic colleagues and inform them regarding the CORRECT PRP studies , such as those published in Nature [BANSAL] or AJSM [PATEL] and the ones that are INCORRECT, such as this one or like the RESTORE TRIAL, IN JAMAThese doctors deserve to be singled out because they misinform patients and the population about a health problem that is controllable for many patients .
The result? Bogus “PRP” studies continue to be produced. These are expensive and resource-intensive studies conducted by academics who don’t know what the endgame is. We should all denounce that.
As a summary of this blog, we invite Physicians who want to be properly trained in Regenerative Medicine in Regenerative Medicineto take a short training [even free and introductory], or medium or long term, to get well informed before publishing comments or statements in their social networks that are FALSE, and DISLOYAL TO COLLEAGUES AND PATIENTS, mainly because the scientific evidence of PRP, is quite significant and above all, that is scientifically supported, not only by prestigious national societies, but by international consensus, mainly by groups such as the ESSKA, from Europe, through the ORBIT consensus.
In these cases, a phrase that I can define to close this blog is:“make sure that your words are soft and sweet, in case you have to swallow them one day... you have to be careful with science, which often turns around, in an instant and suddenly…
