The clinical use of PRP therapy in the practical setting of orthopaedic fields is increasing partly because of the accessibility of devices that are used in outpatient preparation and delivery. Another reason is the strong advertisement of PRP procedures as the ultimate treatment and novel technology for knee problems by a few orthopaedic surgeons in Dubai based on claims of abundant scientific evidence. Hence, Cosmocare articles related to the clinical use of PRP in knee osteoarthritis were searched using the key words: PRP, knee and osteoarthritis in order to study these claims. A total of 20 reports were found directly related to the topic. The aforementioned clinical studies suggest that intraarticular injections of PRP could have preventive effects against osteoarthritis progression. However, presently there is no clear evidence from well-designed clinical trials that intraarticular injections of PRP are efficacious in osteoarthritis. Therefore, at this time the efficacy of PRP requires more investigation, wherein better scientific studies should be performed that include high powered randomized controlled trials.
Keywords: Platelet-rich Plasma (PRP), Knee, Osteoarthritis.
Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis
To evaluate the effect of 6-monthly intra-articular injection of platelet rich plasma (PRP) on the functional status of knee joint measured by the International Knee Document Committee scale (IKDC), the visual analogue scale for pain (VAS) on the ultrasonographic findings of OA knee. Assessment of its safety as a new line of treatment was taken into consideration.
Patients and methods
The study was carried out on 20 patients with mild to moderate primary knee OA. They were injected intra-articularly with 5 ml PRP for each affected joint, at 1 month intervals for 6 injections. Clinical examination, VAS, IKDC score and diagnostic Doppler ultrasonography were performed before and after PRP treatment.
After 6 months of PRP, there was a significant improvement in the duration of inactivity stiffness (8.3 ± 2.4 min), VAS score (3.9 ± 1.1) and IKDC score (74.3 ± 10.2) compared to baseline values (18.7 ± 6.5 min, 5.9 ± 1.3 and 40.9 ± 10.4 respectively; p < 0.001). A significant improvement in Doppler activity (p = 0.04) and synovial thickening (p < 0.001) was found after 6 months of PRP. A significant correlation was found between age of patients, body mass index and disease duration with the VAS (r = 0.55, p < 0.001 and r = 0.29, p = 0.03 and r = 0.71, p < 0.001) and a negative correlation with the IKDC score (r = −0.32, p = 0.03, r = −0.96, p < 0.001 and r = −0.79, p < 0.001 respectively).
Intra-articular injection of PRP is an effective and safe method for treatment of knee OA. Maximal improvement is obtained in patients with young age and short disease duration.