brand logo

Am Fam Physician. 2022;105(4):online

Clinical Question

Are platelet-rich plasma injections effective for alleviating pain and improving function in adults with symptomatic ankle osteoarthritis?

Bottom Line

This study found no evidence that supports a benefit of platelet-rich plasma injections compared with saline placebo injections for improving function or reducing pain in adults with symptomatic ankle osteoarthritis. (Level of Evidence = 1b)

Synopsis

There have been no published randomized trials evaluating the effectiveness of platelet-rich plasma injections for ankle osteoarthritis. The investigators identified 100 adults, 18 years or older, who presented to orthopedic and sports medicine outpatient clinics with a score of at least 40 for ankle pain severity on a visual analog scale (range = 0 to 100, where 100 is the most severe pain) and definitive radiographic evidence of tibiotalar osteoarthritis. Patients randomly received (concealed allocation assignment) two ultrasound-guided intra-articular injections of platelet-rich plasma six weeks apart (leukocyte poor; prepared with a widely used standard system) or matched saline as placebo. The patients also received lifestyle and exercise counseling. The individuals who assessed outcomes using a standard validated scoring tool for ankle osteoarthritis remained masked to treatment group assignment. Complete follow-up occurred for 100% of patients at 26 weeks. Using intention-to-treat analysis, mean improvement scores were similar in the platelet-rich plasma and placebo groups (10 vs. 11 points, respectively, on the American Orthopaedic Foot and Ankle Society scale of 0 to 100, where higher scores indicate improved function and reduced pain). No significant differences between groups occurred in any of the multiple secondary outcomes reported.

Study design: Randomized controlled trial (double-blinded)

Funding source: Foundation

Allocation: Concealed

Setting: Outpatient (specialty)

Reference: Paget LDA, Reurink G, de Vos RJ, et al. PRIMA Study GroupEffect of platelet-rich plasma injections vs placebo on ankle symptoms and function in patients with ankle osteoarthritis: a randomized clinical trial. JAMA. 2021;326(16):1595–1605.

Already a member/subscriber?  Log In

Subscribe

From $145
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available
Subscribe

Issue Access

$59.95
  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available

Article Only

$25.95
  • Immediate, unlimited access to just this article
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, editor-in-chief.

A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.

Continue Reading

More in AFP

More in Pubmed

Copyright © 2022 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.