Platelet-Rich Plasma Treatment in Symptomatic Patients With Knee Osteoarthritis

Abstract

Background:With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treat cartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA).Purpose:To determine the effectiveness of intra-articular PRP injections in active patients with knee OA and to evaluate clinical outcomes in patients with and without previous surgical treatment for cartilage lesions.Study Design:Case series.Materials and Methods:Fifty patients with knee OA were followed for a minimum of 12 months. All were treated with 2 intra-articular injections of autologous PRP. Twenty-five patients had undergone a previous operative intervention for cartilage lesions, whereas 25 had not. Operated patients had undergone either cartilage shaving or microfracture. Multiple evaluative scores were collected at pretreatment and at 6 and 12 months posttreatment. The required sample of patients was determined beforehand by using statistical power analysis; International Knee Documentation Committee (subjective) score was defined as the primary parameter. A P value of less than 0.05 was considered statistically significant. General linear model–repeated measure test evaluated within-time improvement for each variable for all patients. Post hoc test with Bonferroni adjustment for multiple comparisons was performed to investigate the significance in improvement within time evaluations for each variable for the total sample. The differences in improvement between operated and nonoperated patients were also investigated, as were those between sexes.Results:All patients showed significant improvement in all scores at 6 and 12 months (P < 0.01) and returned to previous activities. No significant difference in improvement was found between the evaluated subgroups (P < 0.01).Conclusions:The PRP treatment showed positive effects in patients with knee OA. Operated and nonoperated patients showed significant improvement by means of diminishing pain and improved symptoms and quality of life.Clinical Relevance:There are only a few studies of PRP treatment for cartilage on osteoarthritic knees. Different PRP products might be more or less appropriate to treat different types of tissues and pathologies. The clinical efficacy of PRP remains under debate, and a standardized protocol has not yet been established.

Protective Effect of Intravesical Platelet-Rich Plasma on Cyclophosphamide-Induced Hemorrhagic Cystitis

“…PRP is mostly used for wound healing in orthopedic and plastic surgery clinics. Many studies have shown that PRP preparation increases the platelets count at least two-to six-fold from the baseline value [22].…”

Effectiveness of Platelet-Rich Plasma in the Treatment of Moderate Knee Osteoarthritis

“…The injection of autologous PRP into the joint space and surrounding painful soft tissues delivers a concentrated dose of these growth factors, which enhance the healing process and reduce pain. [8] Several studies have shown that PRP injections in osteoarthritis patients is effective in controlling pain and improving mobility however, [17][18][19] there is no consensus on eligible patient selection, the number and frequency of injections, the preparation technique, or the appropriate platelet concentration. [4] In the present study the effects of PRP administration to control the disease activity of grade 3 knee OA either with one injection, two injections two weeks apart, or three injections separated by 2-week intervals on the patients' pain, quality of life and physical activity levels were investigated.…”

The use of platelet-rich plasma in the nonsurgical management of sports injuries: hype or hope?

“…28 Patients with few options for the treatment of OA that has a significant impact on quality of life have sought out alternative and emerging treatments and have embraced the concept of a biologic treatment for this disease. PRP and other biologics have long been used in race horses with OA, and there are basic science studies suggesting why it use may be efficacious; however, there are currently only 8 studies on the clinical use of PRP in OA in humans [28][29][30][31][32][33][34][35] (Table 3) and all these studies have examined the effect of PRP in the osteoarthritic knee. None has reported any major adverse effect with the use of PRP and all have reported modest benefit on validated functional outcome scales.…”