Table 3.
Efficacy of platelet concentrates on different musculoskeletal conditions with application conditions shown based on published controlled clinical studies with Level of evidence of I/ II.
| Use (Number of studies) | Effectiveness | Application conditions |
Major AE | Remarks for localisation | ||||
|---|---|---|---|---|---|---|---|---|
| Leucocyte reduction | Activation | Localisation | Repeated application | |||||
| Osteoarthritis (18) | +ve | 16 | 5/16 | 10/16 | 16/16 | 15/16 | 0 | PC is injected intra-articularly so they are confined in a small space to action. |
| null | 2 | 0/2 | 1/2 | 2/2 | 2/2 | 0 | ||
| −ve | 0 | / | / | / | / | / | ||
| Tendinopathies (23) | +ve | 11 | 1/11 | 3/11 | 0/11 | 3/11 | 0 | Intratendinous injection is not regarded as localisation |
| null | 11 | 2/11 | 1/11 | 0/11 | 3/11 | 0 | ||
| −ve | 1 | 0/1 | 0/1 | 0/1 | 0/1 | 0 | ||
| Rotator cuff tear (17) | +ve | 7 | 3/7 | 7/7 | 6/7 | 0/7 | 0 | Localization in rotator cuff tear refers to clot formation of PC in the tear site or tendon–bone interface |
| null | 9 | 8/9 | 6/9 | 2/9 | 1/9 | 1 | ||
| −ve | 1 | 1/1 | 1/1 | 1/1 | 0/1 | 0 | ||
| ACL surgery (9) | +ve | 5 | 1/5 | 4/5 | 4/5 | 0/5 | 2 | Localization in ACL reconstruction refers to clot formation of PC on the graft or in bone tunnel |
| null | 4 | 1/4 | 3/4 | 1/4 | 0/4 | 0 | ||
| −ve | 0 | / | / | / | / | / | ||
| Fracture/bone graft (3) | +ve | 2 | 1/2 | 2/2 | 2/2 | 0/2 | 0 | PC was mixed with the bone graft material to fill the fracture site. |
| null | 1 | 0/1 | 1/1 | 1/1 | 0/1 | 0 | ||
| −ve | 0 | / | / | / | / | / | ||
Note:
Effectiveness: A report with statistically significant positive/negative result in any of the measured outcomes is regarded as positive/negative.
Leucocyte reduction: This refers to the use of leucocyte reduction filter or single spin indicating clear precaution to avoid buffy coat in preparation process.
Activation: This refers to the activation of platelet concentrates before application.
Localisation: This refers to the use of carrier, solid form of platelet concentrates or platelet concentrates applied in confined area in respect to the injured site. (Please refer to the individual remarks.)
Repeated application: This refers to any repeated application of platelet concentrates regardless of frequency.
Major adverse effect: This includes the report of any major complications in platelet concentrates group: allergy, infection. Minor side effect is not included: mild swelling, self-resolved pain, local heating.
ACL = anterior cruciate ligament; AE = adverse effects; PC = platelet concentrates.