PMID- 32341925
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220414
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 8
IP  - 4
DP  - 2020 Apr
TI  - Platelet-Rich Plasma Augmentation to Microfracture Provides a Limited Benefit for 
      the Treatment of Cartilage Lesions: A Meta-analysis.
PG  - 2325967120910504
LID - 10.1177/2325967120910504 [doi]
LID - 2325967120910504
AB  - BACKGROUND: Microfracture is the most common first-line option for the treatment 
      of small chondral lesions, although increasing evidence shows that the clinical 
      benefit of microfracture decreases over time. Platelet-rich plasma (PRP) has been 
      suggested as an effective biological augmentation to improve clinical outcomes 
      after microfracture. PURPOSE: To evaluate the clinical evidence regarding the 
      application of PRP, documenting safety and efficacy of this augmentation 
      technique to improve microfracture for the treatment of cartilage lesions. STUDY 
      DESIGN: Systematic review; Level of evidence, 3. METHODS: A systematic review was 
      performed in PubMed, EBSCOhost database, and the Cochrane Library to identify 
      comparative studies evaluating the clinical efficacy of PRP augmentation to 
      microfracture. A meta-analysis was performed on articles that reported results 
      for visual analog scale (VAS) for pain, International Knee Documentation 
      Committee (IKDC), and American Orthopaedic Foot and Ankle Society (AOFAS) scores. 
      Risk of bias was documented through use of the Cochrane Collaboration Risk of 
      Bias 2.0 and Risk of Bias in Non-randomized Studies of Interventions assessment 
      tools. The quality assessment was performed according to the Grading of 
      Recommendations Assessment, Development and Evaluation guidelines. RESULTS: A 
      total of 7 studies met the inclusion criteria and were included in the 
      meta-analysis: 4 randomized controlled trials, 2 prospective comparative studies, 
      and 1 retrospective comparative study, for a total of 234 patients. Of the 7 
      studies included, 4 studies evaluated the effects of PRP treatment in the knee, 
      and 3 studies evaluated effects in the ankle. The analysis of all scores showed a 
      difference favoring PRP treatment in knees (VAS, P = .002 and P < .001 at 12 and 
      24 months, respectively; IKDC, P < .001 at both follow-up points) and ankles 
      (both VAS and AOFAS, P < .001 at 12 months). The improvement offered by PRP did 
      not reach the minimal clinically important difference (MCID). CONCLUSION: PRP 
      provided an improvement to microfracture in knees and ankles at short-term 
      follow-up. However, this improvement did not reach the MCID, and thus it was not 
      clinically perceivable by the patients. Moreover, the overall low evidence and 
      the paucity of high-level studies indicate further research is needed to confirm 
      the potential of PRP augmentation to microfracture for the treatment of cartilage 
      lesions.
CI  - (c) The Author(s) 2020.
FAU - Boffa, Angelo
AU  - Boffa A
AD  - Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 
      Bologna, Italy.
FAU - Previtali, Davide
AU  - Previtali D
AD  - Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, 
      Switzerland.
FAU - Altamura, Sante Alessandro
AU  - Altamura SA
AD  - Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 
      Bologna, Italy.
FAU - Zaffagnini, Stefano
AU  - Zaffagnini S
AD  - Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 
      Bologna, Italy.
FAU - Candrian, Christian
AU  - Candrian C
AD  - Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, 
      Switzerland.
FAU - Filardo, Giuseppe
AU  - Filardo G
AD  - Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, 
      Switzerland.
AD  - Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 
      Bologna, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200421
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC7175068
OTO - NOTNLM
OT  - augmentation
OT  - bone marrow stimulation
OT  - cartilage defect
OT  - microfracture
OT  - osteochondral lesion
OT  - platelet-rich plasma
COIS- One or more of the authors has declared the following potential conflict of 
      interest or source of funding: S.Z. has received institutional support from Fidia 
      Farmaceutici, Cartiheal, IGEA Clinical Biophysics, Biomet, and Kensey Nash; grant 
      support from I+; and royalties from Springer. C.C. has received grants from 
      Medacta, Johnson & Johnson, Lima, Zimmer Biomet, and Open AG. G.F. has received 
      institutional support from Finceramica Faenza, Fidia Farmaceutici, Cartiheal, EOU 
      Medica, IGEA Clinical Biophysics, Biomet, and Kensey Nash. AOSSM checks author 
      disclosures against the Open Payments Database (OPD). AOSSM has not conducted an 
      independent investigation on the OPD and disclaims any liability or 
      responsibility relating thereto.
EDAT- 2020/04/29 06:00
MHDA- 2020/04/29 06:01
PMCR- 2020/04/21
CRDT- 2020/04/29 06:00
PHST- 2020/01/23 00:00 [received]
PHST- 2020/02/01 00:00 [accepted]
PHST- 2020/04/29 06:00 [entrez]
PHST- 2020/04/29 06:00 [pubmed]
PHST- 2020/04/29 06:01 [medline]
PHST- 2020/04/21 00:00 [pmc-release]
AID - 10.1177_2325967120910504 [pii]
AID - 10.1177/2325967120910504 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2020 Apr 21;8(4):2325967120910504. doi: 
      10.1177/2325967120910504. eCollection 2020 Apr.