PRP Joint Injection:

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Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Kon E, et al. (2010)

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The use of platelet-rich plasma for the treatment of osteoarthritis. Jayabalan P, Hagerty S, Cortazzo MH.
Phys Sportsmed. 2014 Sep;42(3):53-62.

- In this article the authors review the evidence for the use of PRP in the treatment of arthritis and the clinical outcomes pertaining to its use.

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The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Khoshbin  A, et al. (2013)  

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Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip.  Sanchez M, et al. (2012)

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Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Battaglia M, et al. Orthopedics. 2013 Dec;36(12):e1501-8.

- Intra-articular injections of PRP are efficacious in terms of functional improvement and pain reduction but are not superior to Hyaluronic Acid in patients with symptomatic hip OsteoArthritis at 12-month follow-up.

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Effect of leukocyte concentration on the efficacy of platelet rich plasma in the treatment of knee osteoarthritis

Riboh JC, et al. American J Of Sports Med.  March 2016. 44(3): 792-800.

- CONCLUSIONS: This is a level 2 Meta-Analysis study of 6 level 1 studies and 3 level 2 studies.  The total number of patients is 1055. Leukocyte poor platelet rich plasma (LP-PRP) resulted in improved functional scores compared to hyaluronic acid or placebo or leukocyte rich platelet rich plasma (LR-PRP).  All 3 groups had similar subjective  IKDC score improvements.

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Efficacy of Intra-articular PRP Injections In Knee Osteoarthritis : A Systematic Review. Meheux, CJ, et al.  Arthroscopy. Mar 2016. 32(3). Pp 495-505.

- CONCLUSIONS: This paper is a level 1 meta-analysis of 6 human, in vivo, Level 1 studies. In patients with symptomatic knee OA, PRP injections resulted in significant clinical improvements up to 12 months postinjection. Clinical and WOMAC scores were better with PRP versus HA from 3-12 months postop. This meta-analysis did not evaluate LP-PRP and LR-PRP or steriods in this study.

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Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Raeissadat SA, et al. Clin Med Insights Arthritis Musculoskelet Disord. 2015 Jan 7;8:1-8.

- This study suggests that PRP injection is better than hyaluronic acid injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee arthritis who have not responded to conventional treatment.

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Does intra articular platelet rich plasma injection improve function, pain, and quality of life in patients with osteoarthritis of the knee?  A randomized clinical trial.  Rayegani SM, et al. Orthop Rev (Pavia). 2014 Sep 18;6(3):5405.

- This randomized clinical study looked at patients with knee arthritis. 31 patients had 2 PRP injections one month apart and 31 patients had no PRP injections.  Both groups had physical therapy.  The PRP group had statistically significant better WOMAC and SF-36 scores 6 months after treatment.

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Stem Cell Joint Injection:

Hip osteoarthritis in dogs: a randomized study using mesenchymal stem cells from adipose tissue and plasma rich in growth factors.  Cuervo B, Rubio M, Sopena J, Dominguez JM, Vilar J, Morales M, Cugat R, Carrillo JM.

- Authors indicate that their findings show that aMesenchymalStemCells and PlasmaRichGrowthFactors are safe and effective in the functional analysis at 1, 3 and 6 months; provide a significant improvement, reducing dog's pain, and improving physical function. With respect to basal levels for every parameter in patients with hip OA, aMSCs showed better results at 6 months.

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Chondrogenic potential of human adult mesenchymal stem cells is independent of age or osteoarthritis etiology

Scharstuhl A, Schewe B, Gaissmaier C, Buhring HJ, Stoop R.

 - The authors examined stem cells derived from the femoral bone marrow of 98 patients with osteoarthritis.  All stem cells harvested could differentiate into chondrogenic lineage (cartilage cells).  They conclude that a therapeutic application of mesenchymal stem cells (MSC) for cartilage regeneration of osteoarthritis lesions seems feasible.

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A dose response analysis of a specific bone marrow concentrate treatment protocol for knee osteoarthritis. Centeno C, et al. (2016) 

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Stem Cell and PRP combined with surgery :

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Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in an equine model. Fortier LA, et al. (2010)

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The effect of platelet rich plasma combined with microfractures on the treatment of chondral defects: an experimental study in a sheep model. Milano G, et al. (2010)

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One-step bone marrow-derived cell transplantation in talar osteochondral lesions: mid-term results. Buda R, et al. (2015

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Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial menisectomy: a randomized, double blind, controlled study.  Vangsness CT, et al. JBJS. 2014 Jan 15;96(2):90-98.

- At 12 months post arthroscopic partial menisectomy, there was evidence of significant meniscus regeneration and improvement in knee pain following single dose treatment with allogeneic mesenchymal stem cells (MSCs).  The largest increase in meniscal volume was seen in patients receiving the lower of two tested doses of MSCs (50,000,000 stem cells)

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Osteonecrosis repair with bone marrow cell therapies: State of the clinical art.  Philippe Hernigou et al. 2014

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