Originally Posted by inuic
BTW that article about PRP is a number of years old the evidence since then proves it out even more.
The most recent articles that I found about PRP therapy (those who say anything meaningfull, at least), are these two:
"Clin J Sport Med. 2011 Jan;21(1):37-45.
Platelet-rich plasma treatment for ligament and tendon injuries.
Paoloni J, De Vos RJ, Hamilton B, Murrell GA, Orchard J.
Source
Sports Medicine Department, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar. justin.paoloni@aspetar.com
Abstract
Platelet-rich plasma (PRP) is derived from centrifuging whole blood, has a platelet concentration higher than that of the whole blood, is the cellular component of plasma that settles after centrifugation, and contains numerous growth factors.
There is increasing interest in the sports medicine and athletic community about providing endogenous growth factors directly to the injury site, using autologous blood products such as PRP, to potentially facilitate healing and earlier return to sport after musculoskeletal injury.
Despite this interest, and apparent widespread use, there is a lack of high-level evidence regarding randomized clinical trials assessing the efficacy of PRP in treating ligament and tendon injuries. Basic science and animal studies and small case series reports on PRP injections for ligament or tendon injuries, but few randomized controlled clinical trials have assessed the efficacy of PRP injections and none have demonstrated scientific evidence of efficacy. Scientific studies should be performed to assess clinical indications, efficacy, and safety of PRP, and this will require appropriately powered randomized controlled trials with adequate and validated clinical and functional outcome measures and sound statistical analysis. Other aspects of PRP use that need to be determined are (1) volume of injection/application, (2) most effective preparation, (3) buffering/activation, (4) injection technique (1 depot vs multiple depots), (5) timing of injection to injury, (6) single application versus series of injections, and (7) the most effective rehabilitation protocol to use after PRP injection. With all proposed treatments, the doctor and the patient should weigh up potential benefits of treatment, potential risks, and costs.
Based on the limited publications to date and theoretical considerations, the potential risks involved with PRP are fortunately very low. However, benefits remain unproven to date, particularly when comparing PRP with other injections for ligament and tendon injuries.
Platelet-rich plasma treatment for ligament and tendon injuries
JAMA. 2010 Jan 13;303(2):144-9.
Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial.
de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL.
Abstract
CONTEXT:
Tendon disorders comprise 30% to 50% of all activity-related injuries; chronic degenerative tendon disorders (tendinopathy) occur frequently and are difficult to treat. Tendon regeneration might be improved by injecting platelet-rich plasma (PRP), an increasingly used treatment for releasing growth factors into the degenerative tendon.
OBJECTIVE:
To examine whether a PRP injection would improve outcome in chronic midportion Achilles tendinopathy.
DESIGN, SETTING, AND PATIENTS:
A stratified, block-randomized, double-blind, placebo-controlled trial at a single center (The Hague Medical Center, Leidschendam, The Netherlands) of 54 randomized patients aged 18 to 70 years with chronic tendinopathy 2 to 7 cm above the Achilles tendon insertion. The trial was conducted between August 28, 2008, and January 29, 2009, with follow-up until July 16, 2009.
INTERVENTION:
Eccentric exercises (usual care) with either a PRP injection (PRP group) or saline injection (placebo group). Randomization was stratified by activity level.
MAIN OUTCOME MEASURES:
The validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, which evaluated pain score and activity level, was completed at baseline and 6, 12, and 24 weeks. The VISA-A score ranged from 0 to 100, with higher scores corresponding with less pain and increased activity. Treatment group effects were evaluated using general linear models on the basis of intention-to-treat.
RESULTS:
After randomization into the PRP group (n = 27) or placebo group (n = 27), there was complete follow-up of all patients. The mean VISA-A score improved significantly after 24 weeks in the PRP group by 21.7 points (95% confidence interval [CI], 13.0-30.5) and in the placebo group by 20.5 points (95% CI, 11.6-29.4). The increase was not significantly different between both groups (adjusted between-group difference from baseline to 24 weeks, -0.9; 95% CI, -12.4 to 10.6). This CI did not include the predefined relevant difference of 12 points in favor of PRP treatment.
CONCLUSION:
Among patients with chronic Achilles tendinopathy who were treated with eccentric exercises, a PRP injection compared with a saline injection did not result in greater improvement in pain and activity.
Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial