Welcome to the Regenerative Research Roundup, where we look through recently published research and bring you the best of the best in a quick-to-read digest.
This month, we cover:
PRP for Patellar Tendinopathy;
PRP vs Hyaluronic Acid for Knee OA;
ESSKA Consensus on PRP for Knee OA;
and AI Chatbots and Orthopaedic Surgery Questions
Let's dive in!
Platelet-Rich Plasma for Patellar Tendinopathy: A randomized controlled trial correlating clinical outcomes and quantitative imaging
Radiology Advances // LOE: I
This single-blinded prospective randomized controlled trial compared platelet-rich plasma (PRP), needle tenotomy (NT), and sham injection (SH) in 29 athletes with symptomatic patellar tendinopathy. The study utilized clinical outcomes and quantitative imaging techniques to assess treatment efficacy over 52 weeks.
At 52 weeks, all groups demonstrated significant improvement in pain, with the PRP group showing the most pronounced effect (ΔVAS=-5.9, 95% CI [-7.8, -3.9], p<.001). Notably, only the PRP group experienced a significant increase in ultrasound shear wave speed (SWS) (Δ+2.3 m/s, [0.8, 3.9], p=.003). The change in SWS moderately correlated with pain improvement across all groups (r=-.52, p=.009).
In MRI analysis, the fraction of bound water (FF) increased significantly in all groups, while only the PRP group showed a significant decrease in T2*single (Δ=-8.07 ms, [-14.6, -1.55], p=.014).
These findings suggest that PRP may be more effective than NT or SH for patellar tendinopathy, with quantitative imaging markers potentially useful for assessing treatment response. The study highlights the potential of combining clinical outcomes with advanced imaging techniques in evaluating regenerative treatments.
ACCESS HERE: https://doi.org/10.1093/radadv/umae017
Efficacy of platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: An updated systematic review and meta-analysis
Archives of Orthopaedic and Trauma Surgery // LOE: I
This study aimed to evaluate whether a combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) is more effective and safer than injection alone for treating KOA.
Ten RCTs involving 943 patients were included in the analysis. The statistical findings did not differ between the treatment of PRP + HA and PRP alone, while a discernible enhancement in treatment efficacy was observed when compared to HA monotherapy. The incidence of adverse events was notably lower with PRP + HA than with HA alone (OR, 0.37; 95% CI: 0.19 − 0.69; P = .00) or PRP alone (OR, 0.51; 95% CI, 0.30 − 0.87; P = .01).
Authors concluded that PRP + HA therapy resulted in more pronounced pain and functional improvement in symptomatic KOA patients than HA treatments, and combination therapy may have higher clinical safety than PRP or HA monotherapy.
Platelet‐rich plasma injections for the management of knee osteoarthritis: The ESSKA‐ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios
KNEE // LOE: N/A
The aim of this consensus was to develop evidence‐ and expertbased patient‐focused recommendations on the appropriateness of intraarticular platelet‐rich plasma (PRP) injections in different clinical scenarios of patients with knee osteoarthritis (OA).
The RAND/UCLA Appropriateness Method was used by the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA), as well as the International Cartilage Regeneration and Joint Preservation Society (ICRS) to reach a consensus and produce recommendations for specific patient categories combining best available scientific evidence with the collective judgement of a panel of experts.
This ESSKA‐ICRS consensus established recommendations on the appropriateness or inappropriateness of PRP injections for the treatment of knee OA, providing a useful reference for clinical practice. PRP injections are considered appropriate in patients aged ≤80 years with knee KL 0–III OA grade after failed conservative non‐injective or injective treatments, while they are not considered appropriate as first treatment nor in KL IV OA grade.
ACCESS HERE: https://doi.org/10.1002/ksa.12320
A Blinded Comparison of Three Generative Artificial Intelligence Chatbots for Orthopaedic Surgery Therapeutic Questions
Cureus // LOE: l
Artificial intelligence (AI) and machine learning are transforming scientific research and healthcare. Specifically, generative AI is a form of AI that creates new content based on patterns and information learned from input training data. These LLMs are becoming prominent sources of information for healthcare providers and patients.
This study compared the quality of responses from three chatbots (ChatGPT, Bing Chat, and AskOE) across various orthopaedic surgery therapeutic treatment questions. The primary outcomes were scores on a five-item assessment tool assessing clinical correctness, clinical completeness, safety, usefulness, and references. The secondary outcome was the reviewers’ preferred response for each question.
Across all questions and answers, AskOE was preferred by reviewers to a significantly greater extent than both ChatGPT (P<0.001) and Bing (P<0.001). AskOE also received significantly higher total evaluation scores than both ChatGPT (P<0.001) and Bing (P<0.001).
Further regression analysis showed that clinical correctness, clinical completeness, usefulness, and references were significantly associated with a preference for AskOE. Across all responses, there were four considered as having major errors in response, with three occurring with ChatGPT and one occurring with AskOE.
Ultimately, reviewers significantly preferred AskOE over ChatGPT and Bing Chat across a variety of variables in orthopaedic therapy questions. This technology has important implications in a healthcare setting as it provides access to trustworthy answers in orthopaedic surgery.
ACCESS HERE: https://doi.org/10.7759/cureus.65343
If you have any questions or comments regarding the above research, or are wondering how you can apply it to your regenerative practice, please leave a comment below or shoot me an email at cdowns@mdbiologix.com
Cheers!
Connor
This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and any related subjects. The views and opinions expressed in this post are those of the author and may not reflect the views and opinions of MDBiologix. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if any treatment is right for you.
Comments