The debate continues over the efficacy of platelet-rich plasma (PRP) injections for treating sports injuries. Meanwhile, doctors on both sides of the debate are calling for more research to settle the question. That research is being conducted, but there are a number of stumbling blocks getting in the way of concrete results.
It is clear that PRP therapy is not going to fade away anytime soon. Furthermore, it can take as many as 15 to 20 years for a new medical treatment to be proven either good or bad. This suggests that PRP therapy still has quite a long shelf life remaining. So where does that leave clinicians? It leaves them with anecdotal evidence.
The idea of using anecdotal evidence as a means of justifying PRP injections is not as radical as it sounds. Once you understand the stumbling blocks now inhibiting PRP research, you also begin to understand how important anecdotal evidence really is to the discussion.
Here are three of the major stumbling blocks to PRP research:
1. A Lack of Valid Measurements
For any randomized, controlled study to return hard data there has to be a valid means of measuring results. Studying the effects of smoking offers a good illustration. It is very easy to measure the effects of cigarette smoke on lung function using both imaging equipment and tissue samples. It is not so easy for PRP injections.
The problem with measuring PRP efficacy is that we still do not fully understand the mechanisms behind the treatments. We have a rough idea, but it is very difficult to know whether healing in a given patient is the result of PRP injections or a healing process that would have occurred even without injections.
2. Unequal Comparisons to Other Procedures
Another component of randomized, controlled studies is being able to compare data against other procedures. In this case, we would like to be able to compare the results of PRP injections with surgery. But the two procedures are unequal. PRP injections are intended to promote natural healing while surgery is a means of mechanically putting things back together.
Because the goals of PRP injections and surgery are completely different, comparing the results does not give a true picture of whether one is better than the other.
3. Differences between Acute and Chronic Injury
Last but not least is the very real difference between acute and chronic injury. It is generally accepted that PRP injections are more effective for acute injuries, yet there are some clinicians who believe that they are equally effective for treating chronic conditions.
Here’s the issue from a research standpoint: there is a point at which acute treatments catch up with chronic treatments. At that point, improvement seems to level off to some degree. Does that mean the treatment does not work? No, it doesn’t. But it does make it very difficult to measure the long-term results of PRP injections as a primary treatment.
Clinicians Still Embracing PRP
Despite a lack of significant clinical evidence, clinicians are still embracing PRP injections to treat sports injuries. Apex Biologix, a Utah company that provides clinicians with equipment and supplies, says they have seen a steady increase in their business in recent months. So has their sister company, the Advanced Regenerative Medicine Institute (ARMI). ARMI provides training to clinicians hoping to add PRP and stem cell therapies to their practices.
Research into PRP will continue for the foreseeable future. Whether or not researchers overcome the obstacles they currently face remains to be seen. If they do not, we may just have to rely on anecdotal evidence.