The immature platelet fraction affects the efficacy of platelet rich plasma therapy for knee osteoarthritis

Abstract

Introduction Platelet-rich plasma (PRP) therapy is used to treat pathological conditions such as degenerative inflammatory diseases including osteoarthritis (OA) by enhancing tissue repair and promoting anti-inflammatory effects. Although PRP therapy for patients with knee OA improved pain and functional scores, the association of clinical outcomes and quality of PRP including cell composition and concentration is unclear. Methods Therefore, this study analyzed blood cell counts, including the immature platelet fraction (IPF), in peripheral blood and PRP of 144 patients with knee OA who underwent PRP therapy. The mean leukocyte and platelet concentrations in whole blood and PRP were analyzed using an XN-1000 automated hematology analyzer. Visual analogue scale (VAS) scores and knee injury and osteoarthritis outcome scores (KOOS) before and 1 month after a single PRP injection were also determined. Results Higher platelet and lower leukocyte concentration rates were observed in PRP compared with whole blood. The platelet concentration in whole blood was negatively correlated with VAS improvement. The percentage of IPF (IPF%) in whole blood was positively correlated with VAS improvement and KOOS (pain) improvement, whereas the IPF% in PRP tended to correlate with VAS improvement. Furthermore, multivariate logistic regression demonstrated the high IPF% in whole blood was significantly associated with VAS improvement. The low percentage of neutrophil (neutrophil%) in PRP was significantly associated with the VAS improvement and KOOS (ADL) improvement. Conclusions Therefore, PRP efficacy for OA might depend on the patient's biological status.

Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: A retrospective analysis of patients optimally managed in dedicated centers

“…The determinant contribution of Hy Tissue Tube 50 to efficacy could not be statistically demonstrated, but results deserve to be more extensively assessed in dedicated analysis with a higher number of patients with long term follow-up. However, we strongly believe that, more sophisticated surrogate markers of PRP bioactivity are needed to anticipate PRP-associated clinical efficacy, as recently suggested [ [45] , [46] , [47] ].…”

“…From a medico-economic perspective, repetition of PRP injections could be rather reserved to responder patients with reappearance of KOA symptoms with the aim to delay or avoid knee arthroplasty, as recently demonstrated by Sanchez et al. [ 47 ]. This raises the question of final price for PRP injection which vary from US$300 to US$600 in our dedicated centers while different studies reported a range from US$500 to US$2500 [ 54 ].…”

Freeze‐dried noncoagulating platelet‐derived factor concentrate is a safe and effective treatment for early knee osteoarthritis

“…Previous evaluations of PRP effectiveness in similar cohorts (Japanese patients suffering from symptomatic knee OA) have been limited by small sample sizes, short follow-up duration, and variable PRP preparation methodologies [5,[12][13][14][15]. Previous studies have reported OMER-ACT-OARSI responder achievement of 58-78% of injected knees at between 1 and 24 months [5,10].…”

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

“…Moreover, multivariate logistic regression showed that a high IPF% in whole blood was significantly associated with VAS amelioration. A low percentage of neutrophils in PRP was significantly associated with VAS amelioration and KOOS amelioration [59].…”