Cervical facet joint platelet-rich plasma in people with chronic whiplash-associated disorders: A prospective case series of longer term 6- and 12- month outcomes

Abstract

ObjectiveTo explore the 6- and 12-month effectiveness of a single autologous injection of platelet-rich plasma (PRP) in cervical facet joints of people with chronic WAD and facet-mediated pain. DesignA prospective case series of people with chronic whiplash-associated disorders and cervical facet joint mediated pain in a community setting. InterventionsWe investigated 44 consecutive people who underwent cervical facet joint PRP ( ​± ​adjunct physiotherapy) between 2019 and 2021, selected for PRP based on 80% relief following single diagnostic medial branch blocks or 50% relief and a significant improvement in performing a previously limited activity of daily living. MeasuresMeasures of pain (numerical pain rating scale - NPRS) and disability (Neck Disability Index - NDI) were collected prior to and 3-, 6- and 12- months following cervical facet joint PRP in an electronic registry database. Success was defined as those exceeding the minimal clinically important difference (MCID) for pain (>15%) and disability (>10%). We also calculated the proportion of people with greater than 50% relief of pain. People not reached for follow-up were considered failures for worst-case analysis. ResultsForty-four people (82% female, mean age ​= ​45.2 (range: 25–71) years) underwent cervical facet joint PRP. Nine people received repeat PRP interventions. Thirty-five people provided 12-month data. There was a significant improvement in pain and disability following PRP (and possibly adjunct physiotherapy) received during this time period. At 12-months, 53% of people exceeded MCID for pain, reporting a mean improvement of 66% (95%CI: 55–77%) on the NPRS. For NDI scores, 69% of people exceeded MCID, reporting a mean improvement of 48% (95%CI: 38–58%). Thirty-seven percent of people reported greater than 50% relief of pain 12-months post-cervical facet joint PRP. ConclusionIn people with chronic WAD and facet-mediated pain, our long-term data suggests that PRP (and possibly adjunct physiotherapy) is effective. A controlled study is warranted to evaluate the efficacy of PRP.