PMID- 36943456 OWN - NLM STAT- MEDLINE DCOM- 20230717 LR - 20231205 IS - 1432-5195 (Electronic) IS - 0341-2695 (Linking) VI - 47 IP - 8 DP - 2023 Aug TI - Safety and efficacy of intra-articular injection of platelet-rich plasma for the treatment of ankle osteoarthritis: a systematic review and meta-analysis. PG - 1963-1974 LID - 10.1007/s00264-023-05773-2 [doi] AB - PURPOSE: To evaluate the safety and efficacy of platelet-rich plasma (PRP) intra-articular injective treatments for ankle osteoarthritis (OA). METHODS: A systematic literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in PubMed, Scopus, Embase, Google Scholar, and the Cochrane library until May 2022. Both randomized and non-randomized studies were included with the assessment of the risk of bias. We recorded the participant's age, gender, type of PRP, injection volume, the kit used, and activating agent. We subsequently assessed the short-term and long-term efficacy of PRP using the functional scores and visual analog scale (VAS). RESULTS: We included four studies with a total of 127 patients, with a mean age of 56.1 years. 47.2% were male (60/127), according to eligibility criteria. There were three cohort studies and one randomized controlled trial (RCT) study, and no study reported severe adverse events. All included studies used the Leukocyte-poor PRP. Short-term follow-up results suggested significant improvement of the American Orthopaedic Foot and Ankle Society (AOFAS) score in the PRP injection group compared to the control group (n = 87 patients; MD: 6.94 [95% CI: 3.59, 10.29]; P < 0.01). Consistently, there was a statistical difference in AOFAS score between PRP injection and control groups in the final follow-up (>/= 6 months) (n = 87 patients; MD: 9.63 [95% CI: 6.31, 12.94]; P < 0.01). Furthermore, we found a significant reduction in VAS scores in the PRP groups at both the short-term follow-up (n = 59 patients; MD, - 1.90 [95% CI, - 2.54, - 1.26]; P < 0.01) and the >/= six months follow-up (n = 79 patients; MD, - 3.07 [95% CI, - 5.08, - 1.05]; P < 0.01). The improvement of AOFAS and VAS scores at >/= six months follow-up reached the minimal clinically important difference (MCID). Nevertheless, the treatment effect of AOFAS and VAS scores offered by PRP at short-term follow-up did not exceed the MCID. Substantial heterogeneity was reported at the >/= six months follow-up in VAS scores (I(2): 93%, P < 0.01). CONCLUSION: This meta-analysis supports the safety of PRP intra-articular injection for ankle OA. The improvements of AOFAS and VAS scores in the PRP group at short-term follow-up do not exceed the MCID to be clinically significant. PRP injection provides significant improvement of AOFAS score and reduced pain at >/= six months follow-up. The efficacy of PRP should be interpreted with caution regarding the high heterogeneity and the scarcity of available literature, which urges large-scale RCTs with longer follow-up to confirm the potential efficacy of PRP injection for ankle OA. CI - (c) 2023. The Author(s) under exclusive licence to SICOT aisbl. FAU - Ding, Sheng-Long AU - Ding SL AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. FAU - Ji, Lin-Feng AU - Ji LF AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. FAU - Zhang, Ming-Zhu AU - Zhang MZ AUID- ORCID: 0000-0002-6975-4965 AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. michaelzhang120@hotmail.com. FAU - Xiong, Wei AU - Xiong W AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. FAU - Sun, Cheng-Yi AU - Sun CY AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. FAU - Han, Ze-Yu AU - Han ZY AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. FAU - Wang, Chao AU - Wang C AD - Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, No.1, Dong Jiao Min Lane, Dong Cheng District, Beijing, 100730, People's Republic of China. LA - eng GR - Grant No. 81773091/National Natural Science Foundation of China/ GR - Grant No. 7212020/Natural Science Foundation of Beijing Municipality/ GR - Grant No. KM202110025013/Science and Technology Planning Project of Beijing Municipal Education/ GR - Grant No. 2020A43/Beijing Municipal Excellent Talents Foundation/ PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20230321 PL - Germany TA - Int Orthop JT - International orthopaedics JID - 7705431 RN - 9004-61-9 (Hyaluronic Acid) SB - IM CIN - Int Orthop. 2024 Jan;48(1):319-320. PMID: 38051385 MH - Male MH - Humans MH - Middle Aged MH - Female MH - Ankle MH - *Osteoarthritis/therapy MH - Pain MH - Injections, Intra-Articular MH - *Platelet-Rich Plasma MH - Treatment Outcome MH - Hyaluronic Acid MH - *Osteoarthritis, Knee OTO - NOTNLM OT - Ankle osteoarthritis OT - Arthritis OT - Intra-articular injection OT - Meta-analysis OT - Platelet-rich plasma EDAT- 2023/03/22 06:00 MHDA- 2023/07/17 06:42 CRDT- 2023/03/21 12:13 PHST- 2022/12/07 00:00 [received] PHST- 2023/03/10 00:00 [accepted] PHST- 2023/07/17 06:42 [medline] PHST- 2023/03/22 06:00 [pubmed] PHST- 2023/03/21 12:13 [entrez] AID - 10.1007/s00264-023-05773-2 [pii] AID - 10.1007/s00264-023-05773-2 [doi] PST - ppublish SO - Int Orthop. 2023 Aug;47(8):1963-1974. doi: 10.1007/s00264-023-05773-2. Epub 2023 Mar 21.