For all the good things PRP therapy can do, it suffers from a handful of inherent weaknesses. One of those weaknesses is a lack of standardization. One doctor will use the therapy in a specific way to treat osteoarthritis; another will use a different kind of procedure to treat a tendon injury. There are even cases of doctors treating the exact same problem using different procedures.
A study out of Australia looked at this issue by analyzing the results of 18 previous studies involving 1,066 participants who received PRP treatment for tendinopathy. If nothing else, their meta-analysis revealed the need for standards among regenerative medicine practitioners.
Researchers concluded that just about every participant in the 18 studies demonstrated some improvement after receiving PRP treatment. But the amount of improvement varied from patient to patient. In their conclusion, the researchers intimated that a better understanding of how treatments are implemented is necessary to understand how to best use PRP treatments.
Details of the Study
The Australian study, published by The American Journal of Sports Medicine this past summer, was intended to be a meta-analysis of existing studies in which autologous PRP treatments were utilized for tendinopathy. Cases involving surgery or additional treatment of non-tendon soft tissue injuries were purposely not included so as to not improperly influence the analysis.
Based on measurements of pain and function at baseline, 12 weeks, six months and 12 months, researchers determined that nearly all the patients benefited in some way from PRP therapy. The standard mean difference was 26.77 (WMOC), whereas the highest improvement was noted at 42.9. The WMOC scale is used to measure the symptoms of musculoskeletal injury based on pain, function, and stiffness.
Researchers also discovered that there were some differences in how different tendons responded to the therapy. This led them to wonder how much tendon type and the specific PRP therapy used to treat it affects outcomes. They suggest that some tendons may respond better or worse to the same kind of treatment, or that there might be different treatments to look at depending on the issue being addressed.
What It All Means
So, what does this all mean? It means that there is still plenty for us to know and learn about PRP therapy. The more we learn, the more we will be able to apply it to all sorts of musculoskeletal injuries and diseases. Ultimately that is the goal of all ongoing regenerative medicine research.
Doctors looking to start offering PRP therapy in the U.S. can receive training from a small handful of companies, including Utah-based Apex Biologix. But what they might learn in a weekend training course is subject to change as more research is done. It could be that the treatment procedures doctors learn this year could be proved less effective than a new treatment method developed next year.
It also means that doctors need to start pushing for more standards. They need to start pushing for research that explores the questions raised by the Australian study. Do different tendons react to the same PRP procedure differently? Are there different ways to apply PRP therapy to different kinds of tissue?
If PRP therapy is going to ever reach its full potential, we are going to have to move beyond the comparatively simple procedures being used today into more complex procedures that take into account a long list of considerations that treatments do not yet account for. In short, we need more standards based on solid, scientific research. We will eventually get there. It’s just a matter of how long it takes.