Intraarticular Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis

Pourcho, Adam M.; Smith, Jay; Wisniewski, Stephen J.; Sellon, Jacob L.

doi:10.1097/phm.0000000000000115

Cited by 79 publications

(53 citation statements)

References 56 publications

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“…More recently, improvement in all WOMAC parameters [27,28], pain scores, clinical and functional scores [29] was reported after three injections of PRP. Intra-articular PRP injections had a better response in younger patients [23,24], more active patients [30] and those with low grade OA [31]. It has been reported that better response rates are evident in OA patients treated with PRP injections than in those treated with hyaluronic acid [24,30,32], although a recent study reported that they have the same efficacy [31].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis

Hassan

El-Shafey

Ahmed

et al. 2015

The Egyptian Rheumatologist

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Osteoarthritis (OA) is the most prevalent form of arthritis in the world. Aim of the work: 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.Results: 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, Please cite this article in press as: Hassan AS et al. Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis, The Egyptian Rheumatologist (2014), http://dx.) and a negative correlation with the IKDC score (r = À0.32, p = 0.03, r = À0.96, p < 0.001 and r = À0.79, p < 0.001 respectively). Conclusion: 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.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis

Hassan

El-Shafey

Ahmed

et al. 2015

The Egyptian Rheumatologist

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“…The leukocyte levels should be chosen in consideration of the application site. For example, leukocyte-poor PRP is suggested to be suitable for intraarticular injections [19,20]. In addition to orthopedics and sports medicine, PRP application has found its way into a variety of treatment solutions in diverse fields of medicine.…”

Section: Introductionmentioning

confidence: 99%

Platelet-Rich Plasma in Tissue Engineering: Hype and Hope

Lang

Loibl²,

Herrmann³

2018

Eur Surg Res

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Background: Platelet-rich plasma (PRP) refers to an enriched platelet suspension in plasma. In addition to the clinical application of PRP in the context of various orthopedic diseases and beyond, PRP and platelet lysate (PL) have been in focus in the field of tissue engineering. In this review, we discuss the application of PRP as a cell culture supplement and as part of tissue engineering strategies, particularly emphasizing current hurdles and ambiguities regarding the efficacy of PRP in these approaches. Summary: As a putative autologous replacement for animal-derived supplements such as fetal calf serum (FCS), PRP has been applied as cell culture supplement for the expansion of stem and progenitor cells for tissue engineering applications and cell therapies. Attributed to the high content of growth factors in platelets, PRP has been shown to promote cell growth, which was mostly superior to standard cultures supplemented with FCS, while the differentiation capacity of progenitor cells seems not to be affected. However, it was also suggested that cultivation of cells with PRP significantly alters the protein expression profile in cells in comparison to FCS, indicating that the influence of PRP on cell behavior should be thoroughly investigated. Moreover, different PRP preparation methods and donor variations have to be considered for the use of PRP under good manufacturing practice conditions. PRP has been used for various tissue engineering applications in the context of bone, cartilage, skin, and soft tissue repair, where most studies were conducted in the field of bone tissue engineering. These approaches take either advantage of the release of chemoattractive, angiogenic, proliferative, and putatively pro-regenerative growth factors from PRP, and/or the hydrogel properties of activated PRP, making it suitable as a cell delivery vehicle. In many of these studies, PRP is combined with biomaterials, cells, and in some cases recombinant growth factors. Although the experimental design often does not allow conclusions on the pro-regenerative effect of PRP itself, most publications report beneficial effects if PRP is added to the tissue-engineered construct. Furthermore, it was demonstrated that the release of growth factors from PRP may be tailored and controlled when PRP is combined with materials able to capture growth factors. Key Messages: Platelet-derived preparations such as PRP and PL represent a promising source of autologous growth factors, which may be applied as cell culture supplement or to promote regeneration in tissue-engineered constructs. Furthermore, activated PRP is a promising candidate as an autologous cell carrier. However, the studies investigating PRP in these contexts often show conflicting results, which most likely can be attributed to the lack of standardized preparation methods, particularly with regard to the platelet content and donor variation of PRP. Ultimately, the use of PRP has to be tailored for the individual application.

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“…The method of PRP preparation also influences platelet concentration and levels of growth factors. PRP used in treatment of osteoarthritis usually contains between 2-and 6-fold normal platelet concentrations, 41 although the optimal protocol for PRP injection in knee OA has not been defined. One study showed that PRP, approximately 6.8-fold above baseline, inhibited the inflammatory processes in human osteoarthritic chondrocytes, 53 whereas a double-blinded, randomized controlled trial using PRP with a platelet concentration of approximately 3-fold above baseline showed benefit over placebo.…”

Section: Discussionmentioning

confidence: 99%

Platelet-Rich Plasma Attenuates 30-kDa Fibronectin Fragment–Induced Chemokine and Matrix Metalloproteinase Expression by Meniscocytes and Articular Chondrocytes

et al. 2015

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Intraarticular Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis

Cited by 79 publications

References 56 publications

Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis

Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis

Platelet-Rich Plasma in Tissue Engineering: Hype and Hope

Platelet-Rich Plasma Attenuates 30-kDa Fibronectin Fragment–Induced Chemokine and Matrix Metalloproteinase Expression by Meniscocytes and Articular Chondrocytes

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