platelet rich placebo

Platelet-rich plasma (PRP) pops up from time to time in my twitter timeline, both from my baseball feed and my science feed. I would be very skeptical of a therapy made famous by Kim Kardashian, namely the vampire facial. The vampire facial uses PRP to promote collagen growth to achieve a more youthful look. But of course aesthetic treatments and medical treatments are very different, so I shouldn’t let my Kardashian bias influence my view of PRP as a cure-all for many sports injuries. A selling point for athletes: “One great benefit of PRP is that it is a completely natural procedure, since it uses your own blood. No injecting of foreign materials required!” (Yes, that quote is from another story about vampire facials, but hey, all natural is all natural!)

I was looking at a new-ish meta-analysis regarding the use of PRP for the treatment of knee osteoarthritis, when I ran across this meta-analysis regarding the use of PRP in conjunction with arthroscopic rotator cuff surgery. The conclusion:

The current highest level of evidence suggests that PRP use at the time of arthroscopic rotator cuff repair does not universally improve retear rates or affect clinical outcome scores. However, the effects of PRP use on retear rates trend toward beneficial outcomes if evaluated in the context of the following specific variables: use of a solid PRP matrix; application of PRP at the tendon-bone interface; in double-row repairs; and with small- and/or medium-sized rotator cuff tears.

Two big things:

  • they’re using PRP in conjunction with surgery
  • not all PRP is created equal

Obviously there’s a lot of literature out there regarding PRP, and it’s hard to sift through it all. This paper touches upon some of the reasons why it’s so hard to evaluate the efficacy of PRP. There’s no one-size-fits-all approach, as there are number of variables involved: how the PRP is applied, i.e., the formulation; where the PRP is applied; and of course, the severity of the condition being treated and the patient being treated. And whether or not PRP is cost effective is yet another question. So when people ask if PRP is effective, it’s hard to give a definitive answer. The PRP literature rabbit hole is huge. Like, a rabbit hole made by a killer rabbit huge.

Of course, that’s not going to stop people from trying to sell PRP as a way to freshen up your eyebrows.

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