Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis

Liam D.A. Paget*, Gustaaf Reurink, Robert Jan de Vos, Adam Weir, Maarten H. Moen, Sita M.A. Bierma-Zeinstra, Sjoerd A.S. Stufkens, Rover Krips, Mario Maas, Duncan E. Meuffels, Gino M.M.J. Kerkhoffs, Johannes L. Tol, Peter A. Nolte

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis. Purpose: To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks. Results: Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot & Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P =.31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures. Conclusion: For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections. Registration: NTR7261 (Netherlands Trial Register).

Original languageEnglish
Pages (from-to)2625-2634
Number of pages10
JournalAmerican Journal of Sports Medicine
Volume51
Issue number10
Early online date7 Jul 2023
DOIs
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by a grant from the Dutch Arthritis Society. The Dutch Arthritis Society (a nonprofit patient organization) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The platelet-rich plasma centrifugation system was on loan from Arthrex (Arthrex Medizinische Instrumente GmbH), as is customary under usual care. G.R. has received research support from Arthrex. A.W. has received research support from Arthrex and Biomet. S.M.A.B.-Z. has received consulting fees from Pfizer. G.M.M.J.K. has received research support from Arthrex. J.L.T. has received research support from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Publisher Copyright:
© 2023 The Author(s).

Funding

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by a grant from the Dutch Arthritis Society. The Dutch Arthritis Society (a nonprofit patient organization) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The platelet-rich plasma centrifugation system was on loan from Arthrex (Arthrex Medizinische Instrumente GmbH), as is customary under usual care. G.R. has received research support from Arthrex. A.W. has received research support from Arthrex and Biomet. S.M.A.B.-Z. has received consulting fees from Pfizer. G.M.M.J.K. has received research support from Arthrex. J.L.T. has received research support from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Keywords

  • ankle osteoarthritis
  • orthopaedic sports medicine
  • osteoarthritis
  • platelet-rich plasma
  • sports medicine

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