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New systematic review highlights the promise of peptides but warns caution in the face of mostly low quality evidence.
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Fracture healing. Tendon ruptures. Ligament tears. These are just some of the many indications being touted in support of BPC-157 -- more colloquially known as peptides.
Peptides have taken the orthopaedic sports medicine community by storm, and in doing so greatly divided opinions. While there are strong claims of clinical efficacy anecdotally, evidence on the topic has been scattered, with no consensus or synthesis to guide clinical decision-making. A recent review article aimed to synthesize the evidence on the topic to fill this gap in knowledge.
As of July 2024, there have been 36 studies on BPC-157 use in orthopaedic sports medicine: 35 preclinical (mostly in rats) and one clinical.
In preclinical studies, BPC-157 has been found to improve musculoskeletal structure, fracture healing, and inflammation. The single clinical study found a 58% response rate in pain outcomes among human patients with knee pain.
Mechanisms of action are likely multifactorial, including the up-regulation of cell growth, promotion of vasodilation and angiogenesis, and down-regulation of inflammation.
Preclinical studies show no evidence of adverse events.
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Bottom Line: While there is some promise, most of the scientific evidence on peptides for sports medicine conditions is preclinical in nature. With few clinical studies, and little to no standardization in manufacturing or treatment protocols, the verdict on its effectiveness is still very much out.
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Read our full OE Original on Peptides here →
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Meta-analysis data finds no clinical benefit of PRP use in patients recovering from ACL reconstruction after 12 months.
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When it comes to biologics, platelet-rich plasma (PRP) is among the most popular. Orthopaedic surgeons have been increasingly using it, and studying it, for a variety of indications including in ACL reconstruction patients. Several randomized trials have been conducted exploring the ability of PRP injections to improve healing and subsequently improve recovery. A synthesis of the existing literature will help to confidently ascertain its clinical efficacy.
Nine studies including 502 patients who underwent ACL reconstruction were included in this systematic review and meta-analysis comparing PRP use and no treatment across a variety of functional outcomes.
While PRP use was associated with a small improvement in International Knee Documentation Committee (IKDC) score (p=0.03), the difference was not clinically meaningful.
No differences in Tegner or Lysholm scores, other measures of function, were observed between PRP and non-PRP groups.
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Bottom Line: PRP does not appear to have any clinical utility as it relates to post-operative functional recovery for patients recovering from ACL reconstruction.
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Full Analysis →
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Reviews and meta-analyses are the highest level of evidence in clinical research, and for good reason -- why make clinical decisions based off the results of one study, when you can base your decision-making on the results of all studies on the topic?
This logic is central to importance of JBJS Reviews, one of the sister journals of the JBJS brands.
In this edition of The Pulse, Mohit Bhandari and Marc Swiontkowski sit down with the editor of JBJS Reviews, Sanjeev Sabharwal, for a discussion on how the journal will evolve in the age of AI whilst upholding the scientific imperative for validity and reliability.
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Watch Now →
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Mesenchymal Stem Cells Injection Is More Effective Than Hyaluronic Acid Injection in the Treatment of Knee Osteoarthritis With Similar Safety: A Systematic Review and Meta-analysis — In patients with knee osteoarthritis, does intra-articular mesenchymal stem cell injection compared with intra-articular hyaluronic acid injection improve pain, function, cartilage repair, and safety outcomes?
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Bone Marrow Aspirate Concentrate May Decrease Reoperation in Osteochondral Allograft Transplantation: A Prospective, Randomized, Double-Blind Investigation — In adults undergoing osteochondral allograft transplantation of the knee, does graft augmentation with BMAC compared with osteochondral allograft transplantation without BMAC improve graft integration and reduce reoperation rates over 2 years?
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Intraarticular injection of the stromal vascular fraction for the treatment of knee osteoarthritis a prospective randomized controlled clinical trial — In adults with unilateral knee osteoarthritis of Kellgren–Lawrence grade III or lower, does intra-articular SVF injection alone, SVF + control, or control alone result in greater improvement in pain,
stiffness, function, and range of motion?
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Two ways to inform your clinical decisions |
FastTrack — what your peers are reading across the networkOE Signal — personalized weekly evidence based on your interests |
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