Several treatments for osteoarthritis exist, including exercise, weight control, bracing, nonsteroidal anti-inflammatories, Tylenol, cortisone shots and viscosupplementation, a procedure that involves injecting a gel-like substance into the knee to supplement the natural lubricant in the joint. A new treatment that is being studied by a small number of doctors is PRP injections. PRP, which is produced from a patient’s own blood, delivers a high concentration of growth factors to arthritic cartilage that can potentially enhance healing.
PRP involves taking a person’s own blood, spinning it in a centrifuge which concentrates the platelets, and injecting the blood back into the patient’s knee. The concentrated blood rich in platelets activates growth factors and stem cells to help repair tissue, calming arthritic symptoms, and decreasing inflammation.
In the study, patients with early osteoarthritis had an injection of PRP, and then monitored for one year. Fifteen patients underwent clinical assessments at baseline, one week, and one, three, six, and 12 months. At these time points, clinicians used validated tools to assess overall knee pain, stiffness and function, as well as a patient's ability to perform various activities of daily living. At baseline and then one year after the PRP injection, physicians also evaluated the knee cartilage with magnetic resonance imaging (MRI), something that has not previously been done by researchers in other PRP studies. The radiologists reading the MRIs did not know whether the examination was performed before or after the PRP treatment.
Previous studies have shown that patients with osteoarthritis can lose roughly five percent of knee cartilage per year, the investigators of this research found that a large majority of patients in their study had no further cartilage loss. Treatment with PRP was also useful in improving pain, stiffness and function.
I have found that a majority of my patients are able to get instant pain relief that lasts for up to 1 year or longer. They are able to perform activities like golf, biking, and running which was not possible prior to the PRP injections. I recommend biologics to patients who have tried other modalities including therapy, oral medications, and viscosupplementation and are not ready to have a knee replacement.
Reference: Halpern B.Clinical and MRI outcomes after Platelet-Rich Plasma Treatment for Knee Osteoarthritis. Clin J Sport Med.2013 May;23(3):238-9.