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Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions
CF 383: Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions Today we’re going to talk about Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions But first, here’s that sweet sweet bumper music
Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!
OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.
You have found yourself smack dab in the middle of Episode #383 Now if you missed last week’s episode, we talked about SMT and disc regression and biopsychosocial factors for hip osteoarthritis. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. We have our new associate chiropractor up and running. Now the job is….how do we get her busy busy the quickest way possible? It’s a race to profitability, right?
Here are some of our ideas. We’d love to hear your suggestions as well if you have lots of experience in building an associate’s schedule. First, we’re going to leverage the fact that she’s from Amarillo so she’s the local hero returning to town. We’ll do that with social media and her high school alumni network. We’ll have her partner with local fitness studios when possible. She’s fit and she’s into fitness so that’s a perfect fit.
We’ll also see if she’s into working with youth sports programs. We’ll do the ‘New Doc In Town’ thing. We’re going to be giving her some of my new patients when appropriate and possible. I say appropriate because a lot of big guys come to me and not too many will be pleased if I stick them with a smaller female. So they’ll have to be a good fit to pass on to her. Visits to PT offices. The problem there is that I’m noticing PTs are offering many of the same services we offer now so they may look at her as competition now rather than a partner.
Lots of rehab and treatment videos. Videos with Q&A with our associate. Lots of ideas but again, if you have a great strategy, I’d love to hear from you at [email protected] Send them my way!
Item #1
The first one this week is called, “Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials” by Ceding et al and published in the American Journal of Sorts Medicine in October of 2024.
Remember, the citations can be found at chiropracticforward.com under this episode.
Oeding JF, Varady NH, Fearington FW, Pareek A, Strickland SM, Nwachukwu BU, Camp CL, Krych AJ. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2024 Oct;52(12):3147-3160. doi: 10.1177/03635465231224463. Epub 2024 Feb 29. PMID: 38420745.
Why They Did It Based in part on the results of randomized controlled trials (RCTs) that suggest a beneficial effect over alternative treatment options, the use of platelet-rich plasma (PRP) for the management of knee osteoarthritis (OA) is widespread and increasing. However, the extent to which these studies are vulnerable to slight variations in the outcomes of patients remains unknown.
Purpose: To evaluate the statistical fragility of conclusions from RCTs that reported outcomes of patients with knee OA who were treated with PRP versus alternative nonoperative management strategies.
How They Did It Systematic review and meta-analysis All RCTs comparing PRP with alternative nonoperative treatment options for knee OA were identified. The fragility index (FI) and reverse FI were applied to assess the robustness of conclusions regarding the efficacy of PRP for knee OA. Meta-analyses were performed to determine the minimum number of patients from ≥1 trials included in the meta-analysis for which a modification on the event status would change the statistical significance of the pooled treatment effect.
What They Found In total, this analysis included outcomes from 1993 patients with Based on random-effects meta-analyses, PRP demonstrated a significantly higher rate of successful outcomes when compared with hyaluronic acid, as well as higher rates of patient-reported symptom relief, not requiring a reintervention after the initial injection treatment, and achieving the minimal clinically important difference (MCID) for pain improvement when compared with all alternative nonoperative treatments.
Wrap It Up Conclusions drawn from individual RCTs evaluating PRP for knee OA demonstrated slight robustness. On meta-analysis, PRP demonstrated a significant advantage over hyaluronic acid as well as improved symptom relief, lower rates of reintervention, and more frequent achievement of the minimal clinically important difference for pain improvement when compared with alternative nonoperative treatment options. Statistically significant pooled treatment effects evaluating PRP for knee OA are more robust than approximately half of all comparable meta-analyses in medicine and health care. Future RCTs and meta-analyses should consider reporting fragility indexes and fragility quotients to facilitate interpretation of results in their proper context.
Item #2
Our last one today is called “Telehealth Mindfulness-Based Interventions for Chronic Pain The LAMP Randomized Clinical Trial” by Burgess et al and published in JAMA Internal Medicine on August 19, 2004.
Burgess DJ, Calvert C, Hagel Campbell EM, et al. Telehealth Mindfulness-Based Interventions for Chronic Pain: The LAMP Randomized Clinical Trial. JAMA Intern Med. 2024;184(10):1163–1173. doi:10.1001/jamainternmed.2024.3940
Why They Did It Importance Although mindfulness-based interventions (MBIs) are evidence-based treatments for chronic pain and comorbid conditions, implementing them at scale poses many challenges, such as the need for dedicated space and trained instructors.
Objective To examine group and self-paced, scalable, telehealth mindfulness-based interventions, for veterans with chronic pain, compared to usual care.
How They Did It This was a randomized clinical trial of veterans with moderate to severe chronic pain, recruited from 3 Veterans Affairs facilities from November 2020 to May 2022. Follow-up was completed in August 2023.
Interventions Two 8-week telehealth mindfulness-based interventions (group and self-paced) were compared to usual care (control). The group mindfulness-based interventions was done via videoconference with prerecorded mindfulness education and skill training videos by an experienced instructor, accompanied by facilitated discussions. The self-paced mindfulness-based interventions was similar but completed asynchronously and supplemented by 3 individual facilitator calls. The primary outcome was pain-related function using the Brief Pain Inventory interference scale at 3 time points: 10 weeks, 6 months, and 1 year. Secondary outcomes included biopsychosocial outcomes: pain intensity, physical function, anxiety, fatigue, sleep disturbance, participation in social roles and activities, depression, patient ratings of improvement of pain, and posttraumatic stress disorder.
What They Found
Wrap It Up
In this randomized clinical trial, scalable telehealth mindfulness-based interventions improved pain-related function and biopsychosocial outcomes compared to usual care among veterans with chronic pain. Relatively low-resource telehealth-based mindfulness-based interventions could help accelerate and improve the implementation of nonpharmacological pain treatment in health care systems.
Alright, that’s it.
Keep on keepin’ on.
Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.
Store Remember the evidence-informed brochures and posters at chiropracticforward.com.
Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!
Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!
Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.
Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
Website http://www.chiropracticforward.com
Social Media Links https://www.facebook.com/chiropracticforward/
Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/
Twitter https://twitter.com/Chiro_Forward
YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q
iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2
Player FM Link https://player.fm/series/2291021
Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/
About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
The post Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions appeared first on Chiropractic Forward.
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By The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy
4.9
3434 ratings
CF 383: Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions Today we’re going to talk about Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions But first, here’s that sweet sweet bumper music
Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!
OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.
You have found yourself smack dab in the middle of Episode #383 Now if you missed last week’s episode, we talked about SMT and disc regression and biopsychosocial factors for hip osteoarthritis. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. We have our new associate chiropractor up and running. Now the job is….how do we get her busy busy the quickest way possible? It’s a race to profitability, right?
Here are some of our ideas. We’d love to hear your suggestions as well if you have lots of experience in building an associate’s schedule. First, we’re going to leverage the fact that she’s from Amarillo so she’s the local hero returning to town. We’ll do that with social media and her high school alumni network. We’ll have her partner with local fitness studios when possible. She’s fit and she’s into fitness so that’s a perfect fit.
We’ll also see if she’s into working with youth sports programs. We’ll do the ‘New Doc In Town’ thing. We’re going to be giving her some of my new patients when appropriate and possible. I say appropriate because a lot of big guys come to me and not too many will be pleased if I stick them with a smaller female. So they’ll have to be a good fit to pass on to her. Visits to PT offices. The problem there is that I’m noticing PTs are offering many of the same services we offer now so they may look at her as competition now rather than a partner.
Lots of rehab and treatment videos. Videos with Q&A with our associate. Lots of ideas but again, if you have a great strategy, I’d love to hear from you at [email protected] Send them my way!
Item #1
The first one this week is called, “Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials” by Ceding et al and published in the American Journal of Sorts Medicine in October of 2024.
Remember, the citations can be found at chiropracticforward.com under this episode.
Oeding JF, Varady NH, Fearington FW, Pareek A, Strickland SM, Nwachukwu BU, Camp CL, Krych AJ. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2024 Oct;52(12):3147-3160. doi: 10.1177/03635465231224463. Epub 2024 Feb 29. PMID: 38420745.
Why They Did It Based in part on the results of randomized controlled trials (RCTs) that suggest a beneficial effect over alternative treatment options, the use of platelet-rich plasma (PRP) for the management of knee osteoarthritis (OA) is widespread and increasing. However, the extent to which these studies are vulnerable to slight variations in the outcomes of patients remains unknown.
Purpose: To evaluate the statistical fragility of conclusions from RCTs that reported outcomes of patients with knee OA who were treated with PRP versus alternative nonoperative management strategies.
How They Did It Systematic review and meta-analysis All RCTs comparing PRP with alternative nonoperative treatment options for knee OA were identified. The fragility index (FI) and reverse FI were applied to assess the robustness of conclusions regarding the efficacy of PRP for knee OA. Meta-analyses were performed to determine the minimum number of patients from ≥1 trials included in the meta-analysis for which a modification on the event status would change the statistical significance of the pooled treatment effect.
What They Found In total, this analysis included outcomes from 1993 patients with Based on random-effects meta-analyses, PRP demonstrated a significantly higher rate of successful outcomes when compared with hyaluronic acid, as well as higher rates of patient-reported symptom relief, not requiring a reintervention after the initial injection treatment, and achieving the minimal clinically important difference (MCID) for pain improvement when compared with all alternative nonoperative treatments.
Wrap It Up Conclusions drawn from individual RCTs evaluating PRP for knee OA demonstrated slight robustness. On meta-analysis, PRP demonstrated a significant advantage over hyaluronic acid as well as improved symptom relief, lower rates of reintervention, and more frequent achievement of the minimal clinically important difference for pain improvement when compared with alternative nonoperative treatment options. Statistically significant pooled treatment effects evaluating PRP for knee OA are more robust than approximately half of all comparable meta-analyses in medicine and health care. Future RCTs and meta-analyses should consider reporting fragility indexes and fragility quotients to facilitate interpretation of results in their proper context.
Item #2
Our last one today is called “Telehealth Mindfulness-Based Interventions for Chronic Pain The LAMP Randomized Clinical Trial” by Burgess et al and published in JAMA Internal Medicine on August 19, 2004.
Burgess DJ, Calvert C, Hagel Campbell EM, et al. Telehealth Mindfulness-Based Interventions for Chronic Pain: The LAMP Randomized Clinical Trial. JAMA Intern Med. 2024;184(10):1163–1173. doi:10.1001/jamainternmed.2024.3940
Why They Did It Importance Although mindfulness-based interventions (MBIs) are evidence-based treatments for chronic pain and comorbid conditions, implementing them at scale poses many challenges, such as the need for dedicated space and trained instructors.
Objective To examine group and self-paced, scalable, telehealth mindfulness-based interventions, for veterans with chronic pain, compared to usual care.
How They Did It This was a randomized clinical trial of veterans with moderate to severe chronic pain, recruited from 3 Veterans Affairs facilities from November 2020 to May 2022. Follow-up was completed in August 2023.
Interventions Two 8-week telehealth mindfulness-based interventions (group and self-paced) were compared to usual care (control). The group mindfulness-based interventions was done via videoconference with prerecorded mindfulness education and skill training videos by an experienced instructor, accompanied by facilitated discussions. The self-paced mindfulness-based interventions was similar but completed asynchronously and supplemented by 3 individual facilitator calls. The primary outcome was pain-related function using the Brief Pain Inventory interference scale at 3 time points: 10 weeks, 6 months, and 1 year. Secondary outcomes included biopsychosocial outcomes: pain intensity, physical function, anxiety, fatigue, sleep disturbance, participation in social roles and activities, depression, patient ratings of improvement of pain, and posttraumatic stress disorder.
What They Found
Wrap It Up
In this randomized clinical trial, scalable telehealth mindfulness-based interventions improved pain-related function and biopsychosocial outcomes compared to usual care among veterans with chronic pain. Relatively low-resource telehealth-based mindfulness-based interventions could help accelerate and improve the implementation of nonpharmacological pain treatment in health care systems.
Alright, that’s it.
Keep on keepin’ on.
Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.
Store Remember the evidence-informed brochures and posters at chiropracticforward.com.
Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!
Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!
Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.
Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
Website http://www.chiropracticforward.com
Social Media Links https://www.facebook.com/chiropracticforward/
Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/
Twitter https://twitter.com/Chiro_Forward
YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q
iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2
Player FM Link https://player.fm/series/2291021
Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/
About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
The post Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions appeared first on Chiropractic Forward.