Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “platelet-rich plasma injections are effective at reducing pain in adults with knee osteoarthritis?”

STUDY DESIGN: A systematic review of two double-blind, randomized controlled trials (RCTs) and one single-blind randomized controlled trial published after 2015. All studies were published in English.

DATA SOURCES: The two double-blind randomized controlled trials and one single-blind randomized controlled trial were found via PubMed. All sources were published in peer-reviewed journals and were chosen based on their relevance to the clinical question.

OUTCOMES MEASURED: Pain reduction was the outcome measured in all three studies using the WOMAC pain scale. In this systematic review, the level of pain was evaluated at baseline and 24 weeks (6 months).

RESULTS: In the double-blind RCT conducted by Cole et.al (Am J Sports Med. 2017;45(2):339-346. doi: 10.1177/0363546516665809), there was reduction in pain with platelet-rich plasma injections with a mean change from baseline of 2.89. However, no statistical significance was noted in this study. In the single-blind RCT by Lisi et al. (Clin Rehabil. 2018;32(3):330-339. doi: 10.1177/0269215517724193), reduction of pain was noted with a median change from baseline of 4, but no statistical effect was noted. Lastly, in the double-blind RCT by in Rahimzadeh et al. (Clin Interv Aging. 2018;13:73-79. doi:10.2147/CIA.S147757), there was reduction in pain with a mean change from baseline of 8.6, as well as statistical significance with a p-value of <0.001.

CONCLUSION: While clinical reduction was demonstrated by all three studies based on the decrease in mean change from baseline, statistical significance was not noted in the studies conducted by Cole et al. (Am J Sports Med. 2017;45(2):339-346. doi: 10.1177/0363546516665809) and Lisi et al. (Clin Rehabil. 2018;32(3):330-339. doi: 10.1177/0269215517724193). Thus, the results of this review are inconclusive. Future studies need to be designed in order to showcase statistical significance with the use of platelet-rich plasma injections in reducing pain in those with knee OA.

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