Bashir, MD; Alberto J. Panero, DO; Andrew L. Sherman, MD; “The Emerging Use of Platelet-Rich Plasma in Musculoskeletal Medicine”, The Journal of the American Osteopathic Association: JAOA; January, 2015, Vol. 115, Number 1, pg. 24-31
The authors of the above journal article did a search on PubMed for all clinical trials involving PRP application in tendon, ligament and cartilage disorders. Surgical reports were excluded as the focus was to review the use of PRP in nonsurgical musculoskeletal medicine. Eleven studies were identified and most were published in 2010 or 2011.
In 2010 JAMA published the first widely recognized study that used an adequate control group and was randomized. This study found no evidence of improvement in Achilles tendinopathy in the PRP therapy group vs. the control group.
Later in 2010, another randomized controlled study in the Netherlands involved 100 patients with chronic lateral epicondylitis who were randomized to a PRP or corticosteroid injection and were followed for one year. “A 25% reduction in visual analog scale (VAS) score or Disabilities of the Arm, Shoulder and Hand (DASH) score without a reintervention after 1 year defined a successful treatment. Scores on VAS revealed that results in 24 of the 49 patients (49%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful (P<.001). The DASH scores were similar, with successful treatment in 25 of the 49 (51%) in the corticosteroid group and 37 or the 51 patients (73%) in the PRP group (P=.005). Initially, the corticosteroid group showed improvement that then declined, whereas the PRP group progressively improved.”
A 2-year follow-up study was conducted to analyze further long-term benefits and found the corticosteroid group showed a decline, whereas the PRP group’s benefit continued to be maintained.
This studies findings are consistent with the concepts behind the phases of acute inflammation for healing musculoskeletal injuries in that fibroblasts lay down new collagen tissue that then with use develops tensile strength and function improves. As we know, corticosteroids block this natural response and degenerate tissue further. This study demonstrates the short term improvement of corticosteroids followed by a decline, where as, PRP demonstrates more long term improvement.