Poof. A seemingly cure-all medical practice is found to have no legs upon which to stand.
According to the January 13 issue of The Journal of the American Medical Association, platelet-rich plasma therapy--thought to significantly decrease healing time for strains, pulls, tears and even fractures--is now found to be no more effective than saltwater.
The procedure, which injects portions of the patient’s concentrated blood directly into an injured area, had become so popular that professional athletes were turning to it for all sorts of injuries. Two Pittsburgh Steelers, Hines Ward and Troy Polamalu, used it before winning the Super Bowl last year, and Tiger Woods has used it with positive results. Professionals in baseball, soccer and other sports—and their amateur and weekend counterparts—have used it and raved about it as well.
The procedure had become so popular that it was even tested out by (self-described skeptical) New York Times medical reporter Gina Kolata, which she didn’t mention in her article yesterday about the new study. When she wrote about the treatment back in July, in Seeking Help for an Injury, at Any Price, she was suffering from a running injury—her tendon that holds the hamstring to the bone was 50 percent torn.
The lure of platelet-rich plasma therapy, known as PRP, is that doctors have believed that it would help regenerate ligament and tendon fibers, shortening the time for rehab. The Times reported that thousands of doctors and about 500 hospitals are offering the treatment.
Now, with news of this study, reports of PRP success are being questioned. The experiment, the first of its kind, studied 54 people with injured Achilles’ tendons who had been suffering for at least two months. Participants had either an injection of platelets or saline, and after six months, patients in both groups had improved, but there was no difference in improvement between the saline and platelet injections.
In her July column, Kolata wrote that although the idea of PRP working made some sense (since injecting blood into an injured body part stimulates the body to start repairing muscle, bone and tissue), she admittedly couldn’t find any studies comparing two versions of the procedure (a person’s whole blood versus platelets), and evidence in support of both were mostly anecdotal. But there were plenty of athletes, team doctors and hospital doctors willing to vouch for it. (An article last February in the Times quoted a team doctor who said his Major League Soccer players needed 25 to 30 percent less recovery time for an injury after PRP.)
Nevertheless, Kolata received the treatment, using her own blood (instead of platelets), and her insurer paid for it. She reported in an article earlier this month about physical therapy, (Treat Me, but No Tricks Please) that between the radiologist’s fee, an ultrasound and injection, the cost was $2,200. She noted that no matter the results, she would never know whether the injection made a difference or if her taking a break from running did the trick.
As Kolata said in her piece last summer, it’s a story “that showed me why and how health care costs can easily go out of control.”
And now we know that expensive health care fads—if that’s indeed what this was, and if future studies will support what this one found—can go out of control, too. Of course there are more studies to be done, but this first study alone should give us pause. Perhaps it’s obvious that we shouldn’t pay heed to medical endorsements from professional athletes, but physicians? Have patients and insurance companies just spent millions of dollars on treatment that wasn’t necessary?