Platelet-Rich Plasma Injections for Foot and Ankle Pathologies Have Significantly More Complications Compared With Hyaluronic Acid Injections, Saline Solution Injections, and Dry Needling: A Systematic Review.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

To investigate complications of platelet-rich plasma (PRP) injections for foot and ankle pathologies to better inform clinical decision making. A systematic review of the PubMed, Embase, Web of Science, and Cochrane databases was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify randomized controlled trials documenting complications after PRP injections for foot and ankle pathologies. Condition studied, demographic characteristics, and complications were extracted. Complication rates and the number needed to harm were calculated, and random-effects models were generated to compare complications using odds ratios, with P < .05 indicating significance. Sixteen studies assessing Achilles tendon injuries, plantar fasciitis, ankle osteoarthritis, and osteochondral lesions of the talus were identified, with 674 patients receiving PRP and 749 patients received alternative treatments (corticosteroid injection, saline solution injection, dry needling, hyaluronic acid injection, prolotherapy, and stromal vascular fraction injection). Twelve studies reported no complications. Four studies reported 277 complications in the PRP group (complication rate, 41.1%) and 249 complications in the comparison group (complication rate, 33.7%) (P < .01). Treatment-site pain was the most common complication, occurring at a signific

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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