PMID- 34277879
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 9
IP  - 6
DP  - 2021 Jun
TI  - Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich 
      Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and 
      Meta-analysis.
PG  - 23259671211011948
LID - 10.1177/23259671211011948 [doi]
LID - 23259671211011948
AB  - BACKGROUND: Platelet-rich plasma (PRP) has gained attention as a therapeutic 
      option for knee osteoarthritis; however, its efficacy varies widely. Leukocytes 
      in PRP raise the concern of aggravating proinflammatory activity. To date, PRP 
      has rarely been investigated with regard to leukocyte concentration. PURPOSE: To 
      provide clinical evidence of the intra-articular injection of PRPs containing 
      different leukocyte concentrations. STUDY DESIGN: Systematic review; Level of 
      evidence, 4. METHODS: We systematically searched the MEDLINE, Embase, Cochrane 
      Library, CINAHL, and Scopus databases. PRP was classified into leukocyte-poor 
      (LP-PRP) and leukocyte-rich (LR-PRP). Clinical outcomes including Western Ontario 
      and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) 
      for pain score, International Knee Documentation Committee (IKDC) subjective 
      score, and adverse reactions were evaluated. The Methodological Index for 
      Non-Randomized Studies criteria were used for quality assessment. RESULTS: 
      Included were 32 studies with an evidence level between 1 and 4. Both LP-PRP and 
      LR-PRP showed improvements above the minimal clinically important difference 
      (MCID) in VAS pain score. No significant intergroup difference was seen at 3, 6, 
      or 12 months of follow-up. Regarding function, both LP-PRP and LR-PRP showed 
      improvements above the MCID in the WOMAC and IKDC scores, with no significant 
      difference between the groups. Adverse reactions for pain were significantly 
      higher in LR-PRP than in LP-PRP (odds ratio, 1.64; 95% confidence interval, 
      1.29-2.10; P = .01). After intra-articular PRP injection, LR-PRP showed a 
      significantly higher rate of swelling than LP-PRP (odds ratio, 1.56; 95% 
      confidence interval, 1.22-1.99; P = .02). The mean Methodological Index for 
      Non-Randomized Studies score of the included studies was 18.6 (range, 10-24). 
      CONCLUSION: Intra-articular PRP injection resulted in improvements above the MCID 
      in terms of pain and function in patients with knee osteoarthritis up to 12 
      months. The risk of local adverse reactions appeared to be increased after LR-PRP 
      compared with LP-PRP injection. The findings of this review can support the 
      potential use of intra-articular PRP injection for the treatment of knee 
      osteoarthritis. In clinical application, clinicians need to consider selecting a 
      specific type of PRP for knee osteoarthritis.
CI  - (c) The Author(s) 2021.
FAU - Kim, Jun-Ho
AU  - Kim JH
AD  - Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee 
      University Hospital at Gangdong, Seoul, Republic of Korea.
FAU - Park, Yong-Beom
AU  - Park YB
AD  - Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang 
      University College of Medicine, Seoul, Republic of Korea. RINGGOLD: 65542
FAU - Ha, Chul-Won
AU  - Ha CW
AD  - Department of Orthopedic Surgery, Stem Cell & Regenerative Medicine Research 
      Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 
      Seoul, Republic of Korea. RINGGOLD: 35017
FAU - Roh, Young Ju
AU  - Roh YJ
AD  - Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Republic of Korea.
FAU - Park, Jung-Gwan
AU  - Park JG
AD  - Department of Orthopedic Surgery, Madisesang Hospital, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210630
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC8255589
OTO - NOTNLM
OT  - clinical outcome
OT  - knee
OT  - leukocyte
OT  - osteoarthritis
OT  - platelet-rich plasma
COIS- One or more of the authors has declared the following potential conflict of 
      interest or source of funding: This work was supported by the National Research 
      Foundation of Korea grant funded by the Korean government (No. 
      NRF-2019R1G1A1009620). 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- 2021/07/20 06:00
MHDA- 2021/07/20 06:01
PMCR- 2021/06/30
CRDT- 2021/07/19 06:01
PHST- 2020/12/22 00:00 [received]
PHST- 2021/01/25 00:00 [accepted]
PHST- 2021/07/19 06:01 [entrez]
PHST- 2021/07/20 06:00 [pubmed]
PHST- 2021/07/20 06:01 [medline]
PHST- 2021/06/30 00:00 [pmc-release]
AID - 10.1177_23259671211011948 [pii]
AID - 10.1177/23259671211011948 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2021 Jun 30;9(6):23259671211011948. doi: 
      10.1177/23259671211011948. eCollection 2021 Jun.