Results of Randomized Controlled Trials of Platelet-Rich Plasma in Lower-Extremity Tendinopathy Are Not Influenced by Industry Sponsorship

Brett M Biedermann; Amir Fathi; Jacob L Kotlier; Chris J Lamb; Aamir Ahmad; Ioanna K Bolia; Cory Mayfield; Frank A Petrigliano; Joseph N Liu

doi:10.1016/j.arthro.2024.04.015

Results of Randomized Controlled Trials of Platelet-Rich Plasma in Lower-Extremity Tendinopathy Are Not Influenced by Industry Sponsorship

Arthroscopy. 2024 May 3:S0749-8063(24)00301-3. doi: 10.1016/j.arthro.2024.04.015. Online ahead of print.

Authors

Brett M Biedermann¹, Amir Fathi², Jacob L Kotlier², Chris J Lamb², Aamir Ahmad², Ioanna K Bolia², Cory Mayfield², Frank A Petrigliano², Joseph N Liu²

Affiliations

¹ Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.. Electronic address: bbiederm@usc.edu.
² Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.

PMID: 38703920
DOI: 10.1016/j.arthro.2024.04.015

Abstract

Purpose: To determine whether industry affiliation influences the results of randomized controlled trials (RCTs) studying the use of platelet-rich plasma (PRP) for the treatment of patellar or Achilles tendinopathy.

Methods: The PubMed, Scopus, Cochrane, and MEDLINE databases were searched in July 2023 for RCTs investigating PRP for the treatment of patellar or Achilles tendinopathy published between 2009 and July 2023. Industry affiliation was determined by analyzing each study's funding or conflict-of-interest section. Author disclosures were searched in the American Academy of Orthopaedic Surgeons disclosure database and the Centers for Medicare & Medicaid Services open payments database. An industry-affiliated (IA) designation was given if an author had a relevant disclosure or if the company that funded the study manufactured PRP. Otherwise, a non-industry-affiliated (NIA) designation was given. Fisher exact analysis was used to determine whether PRP had a favorable effect, no significant effect, or an unfavorable effect on outcome.

Results: Analysis was performed on 22 studies (10 IA and 12 NIA), with 17 studies (77.3%) reporting a conflict of interest or funding for the research, 4 (18.2%) reporting no conflict of interest, and 1 (4.5%) with no reporting. Of the 22 included studies, 8 (36.4%) reported favorable outcomes regarding PRP use and 14 (63.6%) reported no significant effect. Favorable outcomes were found in 4 of the 10 IA studies (40.0%), whereas no significant effect was reported in 6 (60.0%). The 12 NIA studies included 4 (33.3%) with favorable results and 8 (66.7%) with no significant effect. The comparison between industry affiliation and results reported was not statistically significant (P > .999).

Conclusions: The results of RCTs evaluating the use of PRP in lower-extremity tendinopathy were not influenced by industry sponsorship.

Clinical relevance: Most biomedical research is funded through industry sponsorship. Although this relation is necessary as technologies are developed, it is important to scrutinize studies for evidence of industry bias to understand how this bias may be affecting study results published in the literature.