Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study

Ghai, Babita; Gupta, Vasudha; Jain, Ashish; Goel, Nitika; Chouhan, Devender; Batra, Yatindra Kumar

doi:10.1016/j.bjane.2019.06.005

Cited by 16 publications

(20 citation statements)

References 14 publications

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“…It is important to mention that the combination of any of the tested PRP formulations with MSC or hydrogel microspheres improved the effect of PRP in the cartilage quality, suggesting a preventive effect against OA progression 48,54,55 . On the other hand, no significant articular cartilage surface remodeling was found using LP-PRP in guinea pigs with early knee OA 56 . In canine models of surgically induced OA, LR-PRP showed improved Mankin and O'Driscoll scores with higher cellularity and tissue organization (Table 5) 48,57 .…”

Section: Relevant Outcomesmentioning

confidence: 84%

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

Simental‐Mendía¹,

Acosta-Olivo²,

González-Candelaria³

et al. 2022

RMU

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Background: Platelet-rich plasma (PRP) is a biological intra-articular therapy that has shown good clinical outcomes in patients with knee osteoarthritis (OA) and has been widely studied from in vitro to pre-clinical animal models. We aimed to synthesize non-clinical evidence regarding the different effects related to PRP. Methods: A systematic literature review was conducted in the MEDLINE, EMBASE, and Google Scholar databases in December 2020. Studies were included if they were non-clinical basic science publications describing the effect of PRP treatment, studies focused on knee OA, and articles reporting the use of PRP or a similar platelet-derived product. Included articles were assessed and categorized based on the effect or the mechanism of the action described. The main findings of each study were obtained and analyzed. Results: A total of 41 articles were included to review the outcomes of interest. The most frequently reported mechanism was the modulation of genes involved in synthesizing and degrading the cartilage extracellular matrix (ECM), followed by ECM morphological analysis, inflammation, and cell proliferation. PRP preparations with low and high content of leukocytes were equally reported. Conclusions: The studies reviewed provide evidence for several ways in which PRP can act once it is present in the intra-articular environment. The vast majority of data support a beneficial effect of PRP therapy, especially for leukocyte-poor PRP formulations. The evidence collected gives us a clue as to what the mechanism of action could be. However, the great heterogeneity in the study formulations and models implies further investigation.

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Section: Relevant Outcomesmentioning

confidence: 84%

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

Simental‐Mendía¹,

Acosta-Olivo²,

González-Candelaria³

et al. 2022

RMU

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“…5 PRP is defined as a mixture of autologous plasma that has highly concentrated platelets and associated growth factors including hepatocyte growth factors, vascular endothelial growth factors, platelet-derived growth factors and transforming growth factors with other bioactive components derived after whole blood centrifugation and separation. 6 These have been shown to promote cell recruitment, proliferation, and angiogenesis and further induce a regenerative response by balancing the anabolism and catabolism in the damaged structures, including cartilage, and altering the microenvironment of OA disease progression. 7 PRP injection to the knee joint is minimally invasive, may assist in the repair of the injured tissue, and is currently a management option for knee OA.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma injection for symptomatic relief of disability associated with traumatic knee arthritis: a case report

Yap

Ghazali

2022

MYJA

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Multimodality is the mainstay of osteoarthritis (OA) treatment and intra-articular platelet-rich plasma (PRP) injection is gaining acceptance due to its regenerative properties and being minimally invasive. We present a young woman with Kellgren-Lawrence grade 3 post-traumatic OA in the left knee who refused surgery and opted for pain clinic follow-up. Five PRP injections in intervals of 4 to 9 months were administered in the past 2 years in addition to oral analgesia when necessary. Five ml of PRP was prepared via the double-spin open method and injected under ultrasound guidance to the left knee joint. Visual analogue scale (VAS) for pain was recorded at pre-procedure, and at 1-week and 1-month post-procedure. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was recorded at pre-procedure and 1-month post-procedure. PRP injection successfully reduced the VAS from 5 to 3 at both 1-week and 1-month post-procedure, and resulted in a WOMAC reduction of 54% with improvement in all WOMAC subscales at 1-month post-procedure. Our case showed that PRP injection demonstrated a positive effect on pain relief and physical function improvement in traumatic knee OA.

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“…The most frequent control group used in the studies was hyaluronic acid, followed by corticosteroid, prolotherapy, ozone, peptide, bone marrow aspirate, and saline solution. The included studies were divided into three categories according to their Kellgren-Lawrence OA classification: stage 1-2 with a total of 5 studies [9,29,30,36,37], stage 1-3 with a total of 20 studies [21, 22, 39-48, 23, 24, 27, 28, 31-33, 38], and stage 1-4 with a total of 6 studies [11,25,26,[49][50][51]. Complete information regarding the study characteristics and patients is shown in Table 1.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

The use of platelet-rich plasma in studies with early knee osteoarthritis versus advanced stages of the disease: a systematic review and meta-analysis of 31 randomized clinical trials

Vílchez-Cavazos

Blázquez-Saldaña

Gamboa-Alonso

et al. 2021

Preprint

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Purpose. Reports have concluded that platelet-rich plasma (PRP) is an effective and safe biological approach to treating knee osteoarthritis (OA). However, the efficacy of PRP in advanced stages of the disease is not entirely clear. The purpose of this study was to evaluate whether the use of PRP would be as effective in studies with early-moderate knee OA patients compared to studies including patients with end-stage OA based on the Kellgren-Lawrence classification. Methods. A comprehensive search in MEDLINE, EMBASE, Scopus, and Web of Science was conducted to identify randomized controlled trials (RCTs) comparing the effect of PRP injections versus other intra-articular treatments on pain and functionality. A meta-analysis was conducted using a random-effects model and the generic inverse variance method. Results. We included 31 clinical trials that reported data of 2705 subjects. Meta-analysis revealed an overall significant improvement of both pain (MD, -1.05 [95% CI -1.41 to -0.68]; I2 = 86%; P = < 0.00001) and function (SMD, -0.99 [95% CI -1.34, to -0.65]; I2 = 94%; P = < 0.00001), favoring PRP. Subanalysis for pain and functional improvement showed significant pain relief in studies with 1-3 and 1-4 Kellgren-Lawrence OA stages, and a significant functional improvement in studies with 1-2, 1-3, and 1-4 knee OA stages, favoring PRP. Conclusion. Our results indicate that including patients with advanced knee OA does not seem to affect the outcomes of clinical trials in which the efficacy of PRP in knee OA is assessed.

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Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study

Cited by 16 publications

References 14 publications

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

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

Platelet-rich plasma injection for symptomatic relief of disability associated with traumatic knee arthritis: a case report

The use of platelet-rich plasma in studies with early knee osteoarthritis versus advanced stages of the disease: a systematic review and meta-analysis of 31 randomized clinical trials

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