Patient-Reported Outcomes Following Platelet-Rich Plasma Injections in Treating Osteochondral Lesions of the Talus: A Critically Appraised Topic

Clinical Scenario: Osteochondral lesions (OCLs) of the talus can result from ankle sprains which are the most common injury in the physically active. Recently, platelet-rich plasma (PRP) has been used to develop an innovate treatment for OCLs of the talus. Clinical Question: Do PRP injections improve self-reported pain and ankle function in patients with OCL of the talus? Summary of Key Findings: 3 randomized controlled trials were included. One of the studies compared a single dose of PRP to a single dose of hyaluronic acid (HA) or saline when added as an adjunct to microfracture surgery. Another study compared a group receiving a single dose of PRP after microfracture surgery to a group that only received microfracture surgery. The last study compared a series of 3 PRP injections to a series of 3 HA injections. In all 3 studies PRP appeared to be more effective in pain and function outcomes than comparison treatments. The superior outcomes of PRP were demonstrated at times as short as 4 weeks and as long as 25 months. Clinical Bottom Line: There is moderate to strong evidence that PRP produces favorable, short-term, pain and function results compared to HA, saline, and/or microfracture surgery alone. Strength of Recommendation: Level 2.