Abstract
In recent years, the interest in biological treatment of knee lesions has increased, especially the application of platelet-rich plasma is of particular note. The number of articles evaluating platelet-rich plasma (PRP) efficacy in the recovery of knee disorders and during knee surgery has exponentially increased over the last decade. A systematic review with meta-analyses was performed by assessing selected studies of local PRP injections to the knee joint. The study was completed in accordance with 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A multistep search of PubMed, Embase, Cochrane Database of Systematic Reviews, and Clinicaltrials.gov was performed to identify studies on knee surgery and knee lesion treatment with PRP. Of the 4004 articles initially identified, 357 articles focusing on knee lesions were selected and, consequently, only 83 clinical trials were analyzed using the revised Cochrane risk-of-bias tool to evaluate risk. In total, seven areas of meta-analysis reported a positive effect of PRP. Among them, 10 sub-analyses demonstrated significant differences in favor of PRP when compared to the control groups (p < 0.05). This study showed the positive effects of PRP, both on the recovery of knee disorders and during knee surgery; however further prospective and randomized studies with a higher number of subjects and with lower biases are needed.
Highlights
Knee disorders are among the most frequent disorders treated by orthopedic surgeons
Our study confirms significant benefits in the use of platelet-rich plasma (PRP) in osteoarthritis compared with various control groups
PRP is safe for patients when compared to control groups; there is an insignificant difference in adverse events in favor of control groups
Summary
Knee disorders are among the most frequent disorders treated by orthopedic surgeons. Traumatic knee injuries, as well as knee degeneration, require special attention and appropriate treatment.The first line of treatment is usually conservative and includes physical therapy, rehabilitation, braces or non-steroid inflammatory drugs. Knee disorders are among the most frequent disorders treated by orthopedic surgeons. Orthobiologics—naturally occurring substances in the body—were introduced to clinics [1,2]. One type of orthobiologic substance, platelet-rich plasma (PRP) shows promising results for minimally invasive treatment of knee lesions through enhanced healing potential of damaged cartilage, tendons, and ligaments [1]. PRP, known as platelet-rich fibrin (PRF), platelet concentrate or platelet-rich growth factors (PRGFs) is a concentration of platelets derived from the patient’s whole blood, which has to be centrifuged to obtain a ready-to-use product [2,3]. The mechanism of action relies on releasing cytokines and growth factors from alpha granules such as interleukin 1β, interleukin 8, tumor necrosis factor (TNF-α), platelet derived growth
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