Orthopedic PRP
    Orthopedic PRP
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    Hand and Foot/Ankle
    Level 2 Evidence
    Meta-Analysis
    Hand and Foot OA (Small Joint)
    Significant Benefit

    PRP for Hand and Foot OA: Systematic Review and Meta-Analysis

    Evans A · Journal of Orthopaedics (2020)

    DOI: 10.1016/j.jor.2020.01.037

    This systematic review uniquely focused on PRP for osteoarthritis and osteochondral lesions of the hand and foot, areas largely neglected by the PRP literature which overwhelmingly focuses on the knee. Nine studies were included covering thumb CMC OA, ankle OA, and talar osteochondral lesions. The majority used LP-PRP (7/9 studies), and two activated PRP with calcium chloride. Results consistently showed improvement in pain and function scores, with PRP appearing superior to HA and corticosteroid comparators.

    Clinical Relevance

    Important for clinicians managing small joint OA where treatment options are limited. Small joints have less cartilage volume and different biomechanics than the knee, making the positive findings here particularly relevant. LP-PRP appears to be the preferred formulation for these applications.

    Key Takeaways

    • First systematic review dedicated to PRP in hand and foot OA
    • 9 studies covering hand OA, ankle OA, and talar osteochondral lesions
    • LP-PRP was the predominant formulation (7/9 studies)
    • PRP appeared superior to HA, corticosteroid, and saline comparators
    • Mean 2 injections separated by 1-2 weeks
    • Limited by small sample sizes and heterogeneity
    • Establishes PRP evidence beyond knee and large joints

    Key Findings

    PRP may be superior to other intra-articular injections for improving pain and function in small joint OA. Hand OA (3 studies) and ankle/talar lesions (6 studies) both showed positive trends. LP-PRP used in majority (7/9). Evidence limited by small samples and few RCTs.

    Clinical Context

    Study Design

    Systematic Review and Meta-Analysis

    Condition

    Small Joint Osteoarthritis and Osteochondral Lesions

    Control Group

    HA, Saline, Corticosteroids (various)

    Primary Outcome

    VAS, DASH, AOFAS

    PRP Protocol & Intervention

    Preparation System

    Various

    Leukocyte Status

    7 of 9 studies used LP-PRP

    Activation Method

    2 studies used calcium chloride

    Injection Interval

    1-2 weeks

    Guidance Method

    Variable

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