Platelet-Rich Plasma Therapy for Knee Joint Problems: Review of the Literature, Current Practice and Legal Perspectives in Korea
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Platelet-rich plasma (PRP) is a concentrate extract of platelets from autologous blood, and represents a possible treatment option for the stimulation and acceleration of soft-tissue healing and regeneration in orthopedics. Currently, the availability of devices for outpatient preparation and delivery contributes to the increase in the clinical use of PRP therapy in practical setting of orthopedic fields. However, there is still paucity of scientific evidence in the literature to prove efficacy of PRP therapy for the treatment of ligament or tendon problems around the knee joint. Moreover, strong evidence from well-designed clinical trials to support the PRP therapy for osteoarthritis of the knee joint is yet scanty in the literature. Scientific studies need to be performed to assess clinical indications, efficacy, and safety of PRP, and this will require high powered randomized controlled trials. Nonetheless, some hospitals exaggeratedly advertise PRP procedures as the ultimate treatment and a novel technology with abundant scientific evidence for the treatment of knee problems. As a matter of fact, PRP protocols are currently approved only for use in clinical trials and research, and are not allowed for treatment purpose by any institutions in Korea. At present, clinical use of PRP therapy for ligament or tendon problems or osteoarthritis of knee joint is defined as illegal medical practice, regardless of whether it is performed as a sole procedure or as a part of prolotherapy, because the safety and validity are not yet approved by the Ministry of Health and Welfare and Health Insurance Review and Assessment Service. Practicing physicians should remember that injection of PRP to patients by imposing medical charge is still illegal as per the current medical law in Korea.
Abstract
Platelet-rich plasma (PRP) is a concentrate extract of platelets from autologous blood, and represents a possible treatment option for the stimulation and acceleration of soft-tissue healing and regeneration in orthopedics. Currently, the availability of devices for outpatient preparation and delivery contributes to the increase in the clinical use of PRP therapy in practical setting of orthopedic fields. However, there is still paucity of scientific evidence in the literature to prove efficacy of PRP therapy for the treatment of ligament or tendon problems around the knee joint. Moreover, strong evidence from well-designed clinical trials to support the PRP therapy for osteoarthritis of the knee joint is yet scanty in the literature. Scientific studies need to be performed to assess clinical indications, efficacy, and safety of PRP, and this will require high powered randomized controlled trials. Nonetheless, some hospitals exaggeratedly advertise PRP procedures as the ultimate treatment and a novel technology with abundant scientific evidence for the treatment of knee problems. As a matter of fact, PRP protocols are currently approved only for use in clinical trials and research, and are not allowed for treatment purpose by any institutions in Korea. At present, clinical use of PRP therapy for ligament or tendon problems or osteoarthritis of knee joint is defined as illegal medical practice, regardless of whether it is performed as a sole procedure or as a part of prolotherapy, because the safety and validity are not yet approved by the Ministry of Health and Welfare and Health Insurance Review and Assessment Service. Practicing physicians should remember that injection of PRP to patients by imposing medical charge is still illegal as per the current medical law in Korea.
참고문헌 (40)
- de Vos RJ, "Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial", JAMA, 303, pp.144~149 (2010)
- Foster TE, "Platelet-rich plasma: from basic science to clinical applications", Am J Sports Med, 37, pp.2259~2272 (2009)
- Mehta S, "Platelet rich concentrate: basic science and current clinical applications", J Orthop Trauma, 22, pp.432~438 (2008)
- Kon E, "Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions", Knee Surg Sports Traumatol Arthrosc, 18, pp.472~479 (2010)
- Sanchez M, "Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study", Clin Exp Rheumatol, 26, pp.910~913 (2008)
- Felder-Puig R, "Chemonucleolysis and intradiscal electrothermal therapy: what is the current evidence?", Rofo, 181, pp.936~944 (2009)
- Sisto DJ, "UniSpacer arthroplasty of the knee", J Bone Joint Surg Am, 87, pp.1706~1711 (2005)
- Pak J., "Regeneration of human bones in hip osteonecrosis and human cartilage in knee osteoarthritis with autologous adipose-tissue-derived stem cells: a case series", J Med Case Reports, 5, pp.296~ (2011)
- Engebretsen L, "IOC consensus paper on the use of platelet-rich plasma in sports medicine", Br J Sports Med, 44, pp.1072~1081 (2010)
- Hall MP, "Platelet-rich plasma: current concepts and application in sports medicine", J Am Acad Orthop Surg, 17, pp.602~608 (2009)
- Lopez-Vidriero E, "The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment", Arthroscopy, 26, pp.269~278 (2010)
- Mehta V, "Platelet-rich plasma: a review of the science and possible clinical applications", Orthopedics, 33, pp.111~ (2010)
- ÓPaoloni J, "Platelet-rich plasma treatment for ligament and tendon injuries", Clin J Sport Med, 21, pp.37~45 (2011)
- Kajikawa Y, "Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing", J Cell Physiol, 215, pp.837~845 (2008)
- Anitua E, "Reciprocal actions of platelet-secreted TGF-beta1 on the production of VEGF and HGF by human tendon cells", Plast Reconstr Surg, 119, pp.950~959 (2007)
- Murray MM, "Platelet-rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: an in vivo study", J Orthop Res, 27, pp.639~645 (2009)
- Molloy T, "The roles of growth factors in tendon and ligament healing", Sports Med, 33, pp.381~394 (2003)
- Filardo G, "Use of platelet-rich plasma for the treatment of refractory jumper’s knee", Int Orthop, 34, pp.909~915 (2010)
- Coombes BK, "and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials", Lancet, 376, pp.1751~1767 (2010)
- Hart L, "Corticosteroid and other injections in the management of tendinopathies: a review", Clin J Sport Med, 21, pp.540~541 (2011)
- de Vos RJ, "Autologous growth factor injections in chronic tendinopathy: a systematic review", Br Med Bull, 95, pp.63~77 (2010)
- Sanchez M, "Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology", Arthroscopy, 26, pp.470~480 (2010)
- Cervellin M, "Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study", Knee Surg Sports Traumatol Arthrosc, 20, pp.114~120 (2012)
- Vogrin M, "Effects of a platelet gel on early graft revascularization after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind, clinical trial", Eur Surg Res, 45, pp.77~85 (2010)
- Nin JR, "Has platelet-rich plasma any role in anterior cruciate ligament allograft healing?", Arthroscopy, 25, pp.1206~1213 (2009)
- Orrego M, "Effects of platelet concentrate and a bone plug on the healing of hamstring tendons in a bone tunnel", Arthroscopy, 24, pp.1373~1380 (2008)
- Silva A, "Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing?", Knee Surg Sports Traumatol Arthrosc, 17, pp.676~682 (2009)
- Woodell-May J, "Autologous protein solution inhibits MMP-13 production by IL-1beta and TNFalpha-stimulated human articular chondrocytes", J Orthop Res, 29, pp.1320~1326 (2011)
- van Buul GM, "Weinans H, Bernsen MR, van Osch GJ. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes", Am J Sports Med, 39, pp.2362~2370 (2011)
- Milano G, "The effect of platelet rich plasma combined with microfractures on the treatment of chondral defects: an experimental study in a sheep model", Osteoarthritis Cartilage, 18, pp.971~980 (2010)
- Dhollander AA, "Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report", Knee Surg Sports Traumatol Arthrosc, 19, pp.536~542 (2011)
- Sampson S, "Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study", Am J Phys Med Rehabil, 89, pp.961~969 (2010)
- Wang-Saegusa A, "Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life", Arch Orthop Trauma Surg, 131, pp.311~317 (2011)
- Filardo G, "Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis", Knee Surg Sports Traumatol Arthrosc, 19, pp.528~535 (2011)
- Napolitano M, "Autologous platelet gel for tissue regeneration in degenerative disorders of the knee", Blood Transfus, 10, pp.72~77 (2012)
- Anitua E, "Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients", Rheumatology, 46, pp.1769~1772 (2007)
- Kon E, "Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis", Arthroscopy, 27, pp.1490~1501 (2011)
- Spakova T, "Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid", Am J Phys Med Rehabil, 91, pp.411~417 (2012)
- "Practical guidelines for using PRP in the orthopaedic office" (2012)[URL]
- "Clinical coverage guideline: autologous blood-derived growth factors" (2012)[URL]
