SLR - February 2024 - Welsh
Title: Platelet-Rich Plasma Injections Did Not Improve Pain and Function at 52 Weeks in Patients with Ankle OsteoarthritisReference: Paget LDA, Reurink G, de Vos RJ, Weir A, Moen MH, Bierma-Zeinstra SMA, Stufkens SAS, Goedegebuure S, Krips R, Maas M, Meuffels DE, Nolte PA, Runhaar J, Kerkhoffs GMMJ, Tol JL. Platelet-rich plasma injections for the treatment of ankle osteoarthritis. Am J Sports Med. 2023 Aug;51(10):2625-34
Level of Evidence: Randomized Control Trial, Level 2
Reviewed By: Rachel Welsh DPM PGY-1
Residency Program: Mount Auburn Hospital
Podiatric Relevance: This is interesting to a podiatric surgeon because it is trying to answer the question: do patients who have osteoarthritis of the ankle benefit from Injecting the ankle with PRP. They then follow these patients for 52 months to see their symptom progression.
Methods: Study design is a randomized control trial where the patient's ankles were radiographed (AP and Lateral) and those who scored greater than 40 out of 100 on a ankle pain severity scale and had a grade greater than 2 talocrural osteoarthritis on the van Dijk scale were included in the study, those who did not were excluded. Thus leaving 98 patient's who are followed up for 52 weeks. The patients were in 2 groups either a PRP group or a placebo group 2 mL were injected into the ankle under ultrasound. Of note, the specific placebo agent was not identified. These patients were selected at random. The patient's primary outcomes and pain scores were reported with the American orthopedic foot and ankle Society score at 52 weeks.
Results: The main outcomes and results at 52 weeks were reported using the American orthopedic foot and ankle Society score and they found that the PRP group in the placebo group were very similar and there was very little difference between the two. Meaning that PRP was not superior to placebo.
Conclusions: The main conclusion that I drew from this article was that patients who have osteoarthritis of the ankle do not improve with PRP injections. This article demonstrates that pain and overall function did not improve with PRP at 52 weeks. This article does help my clinical judgment in my practice because it would make me less likely to consider PRP as a first-line treatment for patients with ankle osteoarthritis.