Platelet-Rich Plasma JAMA Article: Findings and Considerations

A study from researchers in the Netherlands declared Platelet-Rich Plasma ineffective in healing moderate Achilles tendinopathy. Researchers had 54 patients gauge pain levels at 6, 12 and 24 weeks following treatment. One patient group was given a PRP injection and the other, a saline injection (placebo). The study published in JAMA (Journal of the American Medical Association) by de Vos et al, concluded PRP is no more effective than saline when both groups added therapeutic exercises into their recovery routines.

The study has received extensive media coverage and cited PRP as ineffective. It is important to view the controls of the study before conclusions are made however.

This study’s data does support PRP’s ineffectiveness after a 6 month period in only moderate Achilles tendinopathy. It does not include either minor or severe cases. A more recent study presented in Madrid to the EFORT (European Ferederation of National Associations of Orthopedics and Traumatology) Congress, declared PRP effective in healing severe cases of Achilles tendinosis in patients who failed conventional treatments for 8 consecutive months.

The JAMA study was also published at its midpoint. Researchers will follow up on patients’ recovery in 6 months and it is possible PRP patients will continue to improve and the placebo group will not.

Importantly, no data is available on platelet concentrations given to the PRP group. As this study is one of many to come determining the proper use of PRP, platelet concentration levels in PRP groups will be crucial to disclose to determine optimal use.

Patients receiving PRP to treat plantar fasciitis and Achilles tendinopathy have benefited from the use of a protective boot or a short period of immobilization following injection to prevent further trauma to the injury. This preventative component was included in the recent study presented in Madrid. There is no data available on whether these protective measures were taken during the JAMA study.

Legitimate studies are very important to further understand PRP’s optimal uses and this study should be recognized as such. It is however incomplete and significant conclusions should not be drawn about PRP’s effectiveness based on the study’s current findings.

In a recent online column, Chicago Tribune writer William Hageman included commentary from the study’s main author Dr. Johannes Tol. “This negative result does not write off platelet injections altogether because the therapy could have different effects on different injuries,” wrote Dr. Johannes Tol. “Indeed, studies are currently under way to assess the effectiveness of PRP for treating knee, rotator cuff tendon injuries and plantar fasciitis.”

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