A single intraarticular platelet-rich plasma improves pain and function for patients with early knee osteoarthritis: Analyses by radiographic severity and age

Abstract

BACKGROUND: Most studies use platelet-rich plasma (PRP) requiring multiple intraarticular injections for knee osteoarthritis (OA). OBJECTIVE: To investigate the efficacy of a single intraarticular PRP injection for patients with early knee OA and consider subgroup analyses of radiographic severity and age, respectively. METHODS: Forty-one patients with knee OA (Kellgren-Lawrence grade 1–2) received a single PRP injection into the target knee and were assessed at baseline and 1, 3, and 6 months postinjection. The primary outcome was the mean change from baseline in the visual analog scale (VAS) pain (0–100 mm) at 6 months postinjection. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, single leg stance test (SLS), use of rescue analgesics and patients’ satisfaction. RESULTS: Thirty-eight patients completed the study. The mean pain VAS decreased significantly from 45.6 ± 13.0 mm at baseline to 16.9 ± 13.4 mm, 14.0 ± 13.1 mm and 15.5 ± 14.0 mm at 1, 3 and 6-month follow-ups (p< 0.001 for all). Significant improvements in WOMAC, Lequesne index, SLS and consumption of analgesics from baseline (p< 0.001 for all) were noted at each follow-up. Patients’ satisfaction was high. No serious adverse events occurred. Subgroup analyses revealed that patients with grade 1 OA showed significantly greater VAS pain reduction at 3 months (p= 0.006) and 6 months (p= 0.005) than patients with grade 2 OA. The older-age group (age > 60) showed significantly greater improvements in VAS pain, WOMAC function subscale scores and total scores at 6-month postinjection, compared with the younger age-group (age ≤ 60). The younger-age group reported better satisfaction at 1 and 3-month postinjection. CONCLUSIONS: One injection of PRP improved pain and function for 6 months for patients with early knee OA. This study supports putting the one-injection regimen into clinical practice. Further research is needed for more definite conclusions.

The mechanism of action of platelet-rich plasma for knee osteoarthritis: a systematic review

“…The effects of PRP on cell proliferation and ECM formation could lead to restoring cartilage damage in the early stages of OA. Recent evidence has suggested that PRP therapy is clinically more effective in patients with mild or moderate knee OA 73,74 . It is very difficult for PRP to restore the damage generated in the cartilage or synovium in people with more severe OA.…”

Intra-Articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Degree of Efficacy

“…Sun et al studied the effectiveness of a single intra-articular PRP injection for patients with early knee OA and considered subgroup analyses of radiographic severity and age [47]. Forty-one patients with knee OA (K/L grade 1-2) were given a single PRP injection into the knee and were evaluated at baseline and at 1, 3, and 6 months after injection.…”

“…Therefore, this study supported putting the one-injection regimen into clinical practice. However, Sun et al stated that further research is required for more definitive conclusions [47].…”

“…In patients with knee OA, LR-PRP demonstrated effectiveness in meaningful end points for functional and patient-reported outcomes at early time points [51]. Table 2 summarizes the efficacy of intra-articular PRP injections in knee OA [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Consecutive injections of leukocyte-rich platelet-rich plasma are effective in not only mild but also severe knee degeneration

“… 1 PRP appears to have no therapeutic effect when the degree of degeneration is severe. 2 , 3 , 4 , 5 , 6 , 7 However, consecutive leukocyte-rich PRP (LR-PRP) injections have been shown to have therapeutic effects, regardless of the degree of degeneration, 8 , 9 suggesting the benefits of consecutive LR-PRP injections for patients with severe knee degeneration.…”