Search
Close this search box.

How Does PRP Compare to a DMOAD Drug Candidate? – Regenexx

Disease-modifying osteoarthritis drugs (DMOADs) are one of the holy grails of medicine. The idea is that you can inject something in a knee that will reduce the progression of osteoarthritis and that will, therefore, reduce the need for a knee replacement. I have previously blogged about a company called Biosplice that was testing a DMOAD drug. Today, we’ll dive deeper into the early results of one of their phase III trials and compare that to what we know about PRP.

Biosplice and a Financially Conflicted Academic

What is Biosplice? This is a company developing a drug to treat knee arthritis. Their main drug is lorecivivint, which is based on small-molecule inhibition of CLK/DYRK kinases. The concept is that patients will receive several injections, which will delay the progression of their knee OA. If that concept sounds familiar, it should because that’s how PRP is often used in the knee.

Why would I care about Biospice? I normally wouldn’t, as the more options I have to treat knee OA, the better. However, one of the company’s scientists made a public statement in the medical journal JAMA about a PRP knee OA study trial failure (1). The physician obviously knew very little about PRP, as he never noticed that the Australian trial he was holding up as the gold standard never actually used PRP, despite claiming to use that substance (2). What they injected was barely more concentrated in platelets than whole blood.

Who was that academic? A rheumatologist by the name of Jeff Katz. When I looked him up to find out why he never mentioned dozens of successful PRP knee OA PRPs in his JAMA editorial, it wasn’t hard to find that, IMHO Dr. Katz had a serious conflict of interest (10-58). This is from his required conflict of interest disclosure for this editorial:

“Dr Katz reported receiving support from Biosplice as principal investigator of an observational study of osteoarthritis outcomes.”

So, the guy who wrote this editorial about a bad knee OA PRP study is a university scientist taking grant money from a company developing a drug to treat knee arthritis that will have to compete with PRP. As I always say, you can’t make this stuff up. This editorial is a direct example of the drug development stakeholder problem PRP now faces.

Learn More About Regenexx® Procedures

Request a digital booklet and more information to learn about alternatives to orthopedic surgery and the Regenexx patient experience.

We do not sell, or share your information to third party vendors. By submitting the form you agree that you’ve read and consent to our Privacy Policy.

Biospice’s Knee OA Data

So, let’s review the data Biosplice has released and compare it to what’s in the PRP literature. First, the company failed its first phase III trial with its OA-10/11 drug candidates (higher dose lorecivivint). They blamed the pandemic and too many patients with severe OA in that first study. That failure is already instructive, as if this is a drug to treat mild to moderate OA, it’s moved squarely in the sweet spot as a PRP competitor.

The company reduced the dose, reduced the OA severity of the trial participants, and tried again. They issued a press release in 2023 about early phase 3 data presented at the ACR annual meeting. This was 138 mild to moderate knee OA patients in the placebo group compared to 138 who received the drug. This is what the company reported about the results:

“Patients who received three annual injections of lorecivivint and completed the study showed an absolute decline in mJSW of 0.06 mm versus baseline over 36 months. Patients receiving placebo injections after two years saw a decline of 0.21 mm, which is similar to average annual mJSW declines of 0.1-0.2 mm seen in population-wide studies of OA (Dupuis DE et al., Osteoarthritis and Cartilage, 2003). Comparing lorecivivint patients at 36 months to the last observation of placebo patients, a significant difference of 0.15 mm is seen (P=0.045). Assuming continued placebo progression from the last measurement point prior to crossover, consistent with longitudinal cohort studies of OA, the absolute difference between the active cohort and the placebo cohort is 0.26 mm, again a clinically and statistically significant result (P=0.001).

The structural benefits of lorecivivint were even more pronounced in patients with less severe disease (KL2 population), with an absolute increase in mJSW versus baseline of 0.17 mm following 36 months of treatment and statistically significant increase versus the last measurement point of placebo subjects prior to cross-over.”

The bolding above is mine.

Basically, the drug seemed to reduce the progression of the loss of joint space width, with the best results showing a very tiny separation from placebo of 0.15mm. Any reasonable person should ask the obvious next question: What’s the accuracy of a joint space width measurement?

Joint Space Width

Joint Space Width or JSW means that the investigators took X-rays and measured the width of the joint. This surprised me as, for the last decade-plus, the gold standard in OA studies looking at cartilage preservation is MRI, not x-ray measurement of JSW (4). Why? Sophisticated MRI shows the health of the cartilage in different regions of the knee, whereas X-rays cannot show that data. Why wasn’t the better technology used?

So, what’s the accuracy of JSW measurement? Meaning if two people measure the same x-ray and each measures the JSW, how off will they be? According to one study, 0.08-0.11 mm (3). However, the same study stated that you needed a change greater than 0.13 mm to ensure that you measured an actual and not random difference. At three years of treatment with lorecivivint, the cartilage preservation measured with this antiquated technology was at 0.15 mm, barely above this random measurement mark. For my US readers, that’s 0.006 inches, a very, very small difference. Another study states that the accuracy of JSW is much less at just above 1 mm, and this is because cartilage loss is greater in certain parts of the knee (5).

PRP DMOAD Studies

I reviewed the PRP literature in August 2023 and found four studies that used real PRP and examined OA disease progression, showing that PRP was also a DMOAD (6-9). The two studies that used fake PRP did not show these changes. What results were found in these studies, and how do they compare to the Biosplice drug candidate?

  • Bansal used a better technology for this purpose, which was MRI. They found that at 12 months, 83% of the PRP group didn’t lose cartilage compared to 62% of control patients. This is hard to compare to Biosplice as we don’t know the responder rates, and Biosplice used less sophisticated X-ray technology. Bansal also measured cytokines in the knees, a more sophisticated study than that performed by Biosplice.
  • Calis used ultrasound measurements in a small group of patients with more severe OA patients than in the Biosplice study. They demonstrated improvements in cartilage thickness at six months of 2mm (+/-0.2 mm). Because ultrasound can provide a cross-section of different parts of the cartilage, this is more sophisticated than JSW measured by X-rays.
  • Chu used more sophisticated MRI technology and MRI cartilage volume (different from cartilage thickness and, again, a better measure). They showed losses of 2.6% over five years in the saline group versus 1.4% in the PRP group. Again, a direct comparison to Biosplice is not possible. However, since these are 5-year volume measurements, this is better data than Biosplice produced. Chu also measured changes in inflammatory cytokines in PRP versus saline-treated knees, something I don’t see in the Biospice phase III data.
  • Baki used two PRP injections and ultrasound cartilage thickness measurements. They showed that cartilage thickness in one part of the knee was better in the PRP group by 0.1mm at six months, far earlier than the Biosplice study. However, other knee areas showed no changes in cartilage thickness over that period. This difference may be close to the accuracy of this measurement.

From the data we have, PRP has more sophisticated evidence it is a DMOAD than the Biosplice drug. While more research is always needed, Biosplice has used less sophisticated methods to track cartilage loss. In addition, based on the data we have, the PRP DMOAD effect seems to be seen far earlier in PRP patients with more severe disease.

Functional Scores

The WOMAC functional scores for lorecivivint are above. They aren’t great. There was only separation from the placebo at 6 and 12 months, with no differences at 18 and 24 months. That’s worse than most knee PRP studies. In addition, the company hasn’t published the absolute WOMAC changes, as these are only changes from the second injection. That begs the question, why? What does the separation from placebo look like in a recent 2-year PRP study:

The blue line is the Chu study. As you can see, at 24 months, real PRP is going strong compared to placebo. The poor results for the red line are from the Benell et al. study, which Dr. Katz hailed as the best study since sliced bread, despite that study never actually using PRP.

Cost?

How will this Biosplice drug be priced? With an estimated 200 million USD investment for the average FDA drug approval, even with 20,000 injections over the first few years, the cost must be approximately $10,000 a dose to break even. That means the cost for this stuff will be tens of thousands billed to insurance. Compare this to PRP, which seems to show its DMOAD effects earlier. Even if you reimbursed two PRP injections at $5,000, you could still beat the Biosplice drug on cost. If PRP gets commoditized with injections going for under $1,000 all in, there is no way the Biosplice drug could compete. This begs the question, is this what Dr. Katz was concerned about?

The upshot? As you can see, PRP compares very favorably to this drug approach to knee OA. This begs the question, is this why academic scientists taking money from pharma companies to develop new OA drugs are worried about PRP?

__________________________________________________________

References:

(1) Katz JN. Platelet-Rich Plasma for Osteoarthritis and Achilles Tendinitis. JAMA. 2021 Nov 23;326(20):2012-2014. doi: 10.1001/jama.2021.19540. PMID: 34812886.

(2) Bennell KL, Paterson KL, Metcalf BR, et al. Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA. 2021;326(20):2021–2030. doi:10.1001/jama.2021.19415

(3) Dupuis DE, Beynnon BD, Richard MJ, Novotny JE, Skelly JM, Cooper SM. Precision and accuracy of joint space width measurements of the medial compartment of the knee using standardized MTP semi-flexed radiographs. Osteoarthritis Cartilage. 2003 Oct;11(10):716-24. doi: 10.1016/s1063-4584(03)00158-4. PMID: 13129690.

(4) Guermazi, A., Roemer, F.W., Burstein, D. et al. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis . Arthritis Res Ther 13, 247 (2011). https://doi.org/10.1186/ar3488

(5) Nishiyama Y, et al. Radiological evaluation of joint space width in medial knee osteoarthritis. Acta Med. Nagasaki 65: 123−129

(6) Çalış, Havva Talay et al. “Efficacy of Intra-Articular Autologous Platelet Rich Plasma Application in Knee Osteoarthritis.” Archives of Rheumatology 30 (2015): 198-205.

(7) Bansal, H., Leon, J., Pont, J.L. et al. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Sci Rep 11, 3971 (2021). https://doi.org/10.1038/s41598-021-83025-2

(8) Chu J, Duan W, Yu Z, Tao T, Xu J, Ma Q, Zhao L, Guo JJ. Intra-articular injections of platelet-rich plasma decrease pain and improve functional outcomes than sham saline in patients with knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2022 Dec;30(12):4063-4071. doi: 10.1007/s00167-022-06887-7. Epub 2022 Feb 6. PMID: 35124707.

(9) Baki M. Abdel Noha ,Nawito O. Zeinab ,Abdelsalam M. S. Nehal ,Sabry Dina , Elashmawy Hossam,Seleem A. Nagy ,Taha Ali Abdel-azeem Azza , El Ghobashy Mohamed, “Does Intra-Articular Injection of Platelet-Rich Plasma Have an Effect on Cartilage Thickness in Patients with Primary Knee Osteoarthritis?”, Current Rheumatology Reviews 2021; 17(3) . https://doi.org/10.2174/1573397117666210114151701

(10) Senna MK, Shaat RM, Ali AAA. Platelet-rich plasma in treatment of patients with idiopathic carpal tunnel syndrome. Clin Rheumatol. 2019 Dec;38(12):3643-3654. doi: 10.1007/s10067-019-04719-7. Epub 2019 Aug 16. PMID: 31420812.

(11) Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PMID: 23893418.

(12) Malahias MA, Nikolaou VS, Johnson EO, Kaseta MK, Kazas ST, Babis GC. Platelet-rich plasma ultrasound-guided injection in the treatment of carpal tunnel syndrome: A placebo-controlled clinical study. J Tissue Eng Regen Med. 2018 Mar;12(3):e1480-e1488. doi: 10.1002/term.2566. Epub 2017 Dec 17. PMID: 28873284.

(13) Malahias MA, Nikolaou VS, Johnson EO, Kaseta MK, Kazas ST, Babis GC. Platelet-rich plasma ultrasound-guided injection in the treatment of carpal tunnel syndrome: A placebo-controlled clinical study. J Tissue Eng Regen Med. 2018 Mar;12(3):e1480-e1488. doi: 10.1002/term.2566. Epub 2017 Dec 17. PMID: 28873284.

(14) Uslu Güvendi E, Aşkin A, Güvendi G, Koçyiğit H. Comparison of Efficiency Between Corticosteroid and Platelet Rich Plasma Injection Therapies in Patients With Knee Osteoarthritis. Arch Rheumatol. 2017;33(3):273–281. Published 2017 Nov 2. doi: 10.5606/ArchRheumatol.2018.6608

(15) Tavassoli M, Janmohammadi N, Hosseini A, Khafri S, Esmaeilnejad-Ganji SM. Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial. World J Orthop. 2019;10(9):310–326. Published 2019 Sep 18. doi: 10.5312/wjo.v10.i9.310

(16) Joshi Jubert N, Rodríguez L, Reverté-Vinaixa MM, Navarro A. Platelet-Rich Plasma Injections for Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-Blinded Clinical Trial. Orthop J Sports Med. 2017;5(2):2325967116689386. Published 2017 Feb 13. doi: 10.1177/2325967116689386

(17) Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:1–8. Published 2015 Jan 7. doi: 10.4137/CMAMD.S17894

(18) Montañez-Heredia E, Irízar S, Huertas PJ, et al. Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in the Treatment of Osteoarthritic Knee Pain: A Randomized Clinical Trial in the Context of the Spanish National Health Care System. Int J Mol Sci. 2016;17(7):1064. Published 2016 Jul 2. doi: 10.3390/ijms17071064

(19) Görmeli G, Görmeli CA, Ataoglu B, Çolak C, Aslantürk O, Ertem K. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2017 Mar;25(3):958-965. doi: 10.1007/s00167-015-3705-6.

(20) Lana JF, Weglein A, Sampson SE, et al. Randomized controlled trial comparing hyaluronic acid, platelet-rich plasma and the combination of both in the treatment of mild and moderate osteoarthritis of the knee. J Stem Cells Regen Med. 2016;12(2):69–78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227106/

(21) Tavassoli M, Janmohammadi N, Hosseini A, Khafri S, Esmaeilnejad-Ganji SM. Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial. World J Orthop. 2019;10(9):310–326. Published 2019 Sep 18. doi: 10.5312/wjo.v10.i9.310

(22) Lin KY, Yang CC, Hsu CJ, Yeh ML, Renn JH. Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial. Arthroscopy. 2019 Jan;35(1):106-117. doi: 10.1016/j.arthro.2018.06.035.

(23) Huang Y, Liu X, Xu X, Liu J. Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis : A prospective randomized controlled study. Orthopade. 2019 Mar;48(3):239-247. doi: 10.1007/s00132-018-03659-5.

(24) Di Martino A, Di Matteo B, Papio T, Tentoni F, Selleri F, Cenacchi A, Kon E, Filardo G. Platelet-Rich Plasma Versus Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis: Results at 5 Years of a Double-Blind, Randomized Controlled Trial. Am J Sports Med. 2019 Feb;47(2):347-354. doi: 10.1177/0363546518814532.

(25) Yu W, Xu P, Huang G, Liu L. Clinical therapy of hyaluronic acid combined with platelet-rich plasma for the treatment of knee osteoarthritis. Exp Ther Med. 2018;16(3):2119–2125. doi: 10.3892/etm.2018.6412

(26) Buendía-López D, Medina-Quirós M, Fernández-Villacañas Marín MÁ. Clinical and radiographic comparison of a single LP-PRP injection, a single hyaluronic acid injection and daily NSAID administration with a 52-week follow-up: a randomized controlled trial. J Orthop Traumatol. 2018;19(1):3. Published 2018 Aug 20. doi: 10.1186/s10195-018-0501-3

(27) Su K, Bai Y, Wang J, Zhang H, Liu H, Ma S. Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis. Clin Rheumatol. 2018 May;37(5):1341-1350. doi: 10.1007/s10067-018-3985-6.

(28) Louis ML, Magalon J, Jouve E, Bornet CE, Mattei JC, Chagnaud C, Rochwerger A, Veran J3, 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 May;34(5):1530-1540.e2. doi: 10.1016/j.arthro.2017.11.035.

(29) Lisi C, Perotti C, Scudeller L, Sammarchi L, Dametti F, Musella V, Di Natali G. Treatment of knee osteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial. Clin Rehabil. 2018 Mar;32(3):330-339. doi: 10.1177/0269215517724193

(25) Cole BJ, Karas V, Hussey K, Pilz K, Fortier LA. Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis. Am J Sports Med. 2017 Feb;45(2):339-346. doi: 10.1177/0363546516665809.

(30) Kaminski R, Maksymowicz-Wleklik M, Kulinski K, Kozar-Kaminska K, Dabrowska-Thing A, Pomianowski S. Short-Term Outcomes of Percutaneous Trephination with a Platelet Rich Plasma Intrameniscal Injection for the Repair of Degenerative Meniscal Lesions. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study. Int J Mol Sci. 2019 Feb 16;20(4):856. doi: 10.3390/ijms20040856. PMID: 30781461; PMCID: PMC6412887.

(31) Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial. Cartilage. 2021 Jan;12(1):51-61. doi: 10.1177/1947603518805230. Epub 2018 Oct 20. PMID: 30343590; PMCID: PMC7755966.

(32) Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. Am J Sports Med. 2016 Mar;44(3):664-71. doi: 10.1177/0363546515620383. Epub 2016 Jan 21. PMID: 26797697.

(33) Battaglia M, Guaraldi F, Vannini F, Rossi G, Timoncini A, Buda R, Giannini S. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics. 2013 Dec;36(12):e1501-8. doi: 10.3928/01477447-20131120-13. PMID: 24579221.

(34) Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome. Arch Rheumatol. 2019 Mar 28;34(3):308-316. doi: 10.5606/ArchRheumatol.2019.7225. PMID: 31598597; PMCID: PMC6768781.

(35) Shams A, El-Sayed M, Gamal O, Ewes W. Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears. Eur J Orthop Surg Traumatol. 2016 Dec;26(8):837-842. doi: 10.1007/s00590-016-1826-3. Epub 2016 Aug 20. PMID: 27544678.

(36) Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PMID: 23893418.

(37) Cai YU, Sun Z, Liao B, Song Z, Xiao T, Zhu P. Sodium Hyaluronate and Platelet-Rich Plasma for Partial-Thickness Rotator Cuff Tears. Med Sci Sports Exerc. 2019;51(2):227-233. doi:10.1249/MSS.0000000000001781

(38) Lin J. Platelet-rich plasma injection in the treatment of frozen shoulder: A randomized controlled trial with 6-month follow-up
. Int J Clin Pharmacol Ther. 2018 Aug;56(8):366-371. doi: 10.5414/CP203262. PMID: 29932415.

(39) Nejati P, Ghahremaninia A, Naderi F, Gharibzadeh S, Mazaherinezhad A. Treatment of Subacromial Impingement Syndrome: Platelet-Rich Plasma or Exercise Therapy? A Randomized Controlled Trial. Orthop J Sports Med. 2017 May 19;5(5):2325967117702366. doi: 10.1177/2325967117702366. PMID: 28567426; PMCID: PMC5439655.

(40) Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome. Arch Rheumatol. 2019 Mar 28;34(3):308-316. doi: 10.5606/ArchRheumatol.2019.7225. PMID: 31598597; PMCID: PMC6768781.

(41) Rha DW, Park GY, Kim YK, Kim MT, Lee SC. Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial. Clin Rehabil. 2013 Feb;27(2):113-22. doi: 10.1177/0269215512448388. Epub 2012 Oct 3. PMID: 23035005.

(42) Senna MK, Shaat RM, Ali AAA. Platelet-rich plasma in treatment of patients with idiopathic carpal tunnel syndrome. Clin Rheumatol. 2019 Dec;38(12):3643-3654. doi: 10.1007/s10067-019-04719-7. Epub 2019 Aug 16. PMID: 31420812.

(43) Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome. Arch Rheumatol. 2019 Mar 28;34(3):308-316. doi: 10.5606/ArchRheumatol.2019.7225. PMID: 31598597; PMCID: PMC6768781.

(44) Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, Vermillion DA, Ramsey ML, Karli DC, Rettig AC. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med. 2014 Feb;42(2):463-71. doi: 10.1177/0363546513494359. Epub 2013 Jul 3. PMID: 23825183.

(45) Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome. Arch Rheumatol. 2019 Mar 28;34(3):308-316. doi: 10.5606/ArchRheumatol.2019.7225. PMID: 31598597; PMCID: PMC6768781.

(46) Martínez-Montiel O, Valencia-Martinez G, Blanco-Bucio P, Villalobos-Campuzano C. Tratamiento de epicondilitis de codo con plasma rico en plaquetas versus corticosteroide local [Treatment of elbow epicondylitis with platelet rich plasma versus local corticosteroids]. Acta Ortop Mex. 2015 May-Jun;29(3):155-8. Spanish. PMID: 26999966.

(47) Palacio EP, Schiavetti RR, Kanematsu M, Ikeda TM, Mizobuchi RR, Galbiatti JA. Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial. Rev Bras Ortop. 2016 Jan 13;51(1):90-5. doi: 10.1016/j.rboe.2015.03.014. PMID: 26962506; PMCID: PMC4767828.

(48) Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome. Arch Rheumatol. 2019 Mar 28;34(3):308-316. doi: 10.5606/ArchRheumatol.2019.7225. PMID: 31598597; PMCID: PMC6768781.

(49) Gautam VK, Verma S, Batra S, Bhatnagar N, Arora S. Platelet-rich plasma versus corticosteroid injection for recalcitrant lateral epicondylitis: clinical and ultrasonographic evaluation. J Orthop Surg (Hong Kong). 2015 Apr;23(1):1-5. doi: 10.1177/230949901502300101. PMID: 25920633.

(50) Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med. 2011 Jun;39(6):1200-8. doi: 10.1177/0363546510397173. Epub 2011 Mar 21. PMID: 21422467.

(51) Merolla G, Dellabiancia F, Ricci A, Mussoni MP, Nucci S, Zanoli G, Paladini P, Porcellini G. Arthroscopic Debridement Versus Platelet-Rich Plasma Injection: A Prospective, Randomized, Comparative Study of Chronic Lateral Epicondylitis With a Nearly 2-Year Follow-Up. Arthroscopy. 2017 Jul;33(7):1320-1329. doi: 10.1016/j.arthro.2017.02.009. Epub 2017 Apr 19. PMID: 28433443.

(52) Raeissadat SA, Rayegani SM, Hassanabadi H, Rahimi R, Sedighipour L, Rostami K. Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial. BMC Sports Sci Med Rehabil. 2014 Mar 18;6:12. doi: 10.1186/2052-1847-6-12. PMID: 24635909; PMCID: PMC4006635.

(53) Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med. 2011 Oct;39(10):2130-4. doi: 10.1177/0363546511417113. Epub 2011 Aug 2. PMID: 21813443.

(54) Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PMID: 23893418.

(55) Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PMID: 23893418.

(56) Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PMID: 23893418.

(57) Boesen AP, Hansen R, Boesen MI, Malliaras P, Langberg H. Effect of High-Volume Injection, Platelet-Rich Plasma, and Sham Treatment in Chronic Midportion Achilles Tendinopathy: A Randomized Double-Blinded Prospective Study. Am J Sports Med. 2017 Jul;45(9):2034-2043. doi: 10.1177/0363546517702862. Epub 2017 May 22. PMID: 28530451.

(58) Alsousou J, Thompson M, Harrison P, Willett K, Franklin S. Effect of platelet-rich plasma on healing tissues in acute ruptured Achilles tendon: a human immunohistochemistry study. Lancet. 2015 Feb 26;385 Suppl 1:S19. doi: 10.1016/S0140-6736(15)60334-8. PMID: 26312841.

If you have questions or comments about this blog post, please email us at [email protected]

NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

Latest Intelligence