Multiple platelet-rich plasma injections are superior to single PRP injections or saline in osteoarthritis of the knee: the 2-year results of a randomized, double-blind, placebo-controlled clinical trial

Yurtbay, Alparslan; Say, Ferhat; Çinka, Hikmet; ERSOY, Ahmet

doi:10.1007/s00402-021-04230-2

Cited by 30 publications

(20 citation statements)

References 56 publications

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“…The most positive change in scores was found in those with K/L grade 2 OA, and the most positive change in range of motion (ROM) was found in those with K/L grade 3 OA. In the PRP groups, knee circumference diminished more at 1 and 6 months (p < 0.05) [38].…”

Section: Randomized Controlled Trialsmentioning

confidence: 89%

“…Multiple doses of PRP augmented the treatment effectiveness and duration. The best outcomes were attained by individuals aged 51-65 years, with lower mechanical axis angle, and by patients with K/L stage 2 OA [38]. However, the study by Bennell et al showed that among patients with symptomatic mild-to-moderate radiographic knee OA, intra-articular injection of PRP did not result in a significant difference in symptoms at 12 months compared with saline injection (placebo) [39].…”

Section: Discussionmentioning

confidence: 99%

“…In a randomized controlled trial with level of evidence I, Yurtbay et al observed that compared with placebo (sodium saline), LR-PRP injections were efficacious in the management of OA [38]. Multiple doses of PRP augmented the treatment efficacy and duration.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

“…In patients with knee OA, LR-PRP demonstrated effectiveness in meaningful end points for functional and patient-reported outcomes at early time points [51]. Table 2 summarizes the efficacy of intra-articular PRP injections in knee OA [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Case Seriesmentioning

confidence: 99%

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

Rodríguez-Merchán

2022

IJMS

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Knee osteoarthritis (OA) is estimated to affect more than 10% of the population, with a lifetime risk of 45%. Contemporary guidelines advise control of body weight, therapeutic physical exercise, drug treatment (oral non-steroidal anti-inflammatory drugs, paracetamol, opioids), and mechanical aids (walking aids, braces, orthoses). Nevertheless, these treatments typically have only short-term benefits. Intra-articular corticosteroids are typically advised, but only for short-term pain alleviation, given that their benefits last only a few weeks. The efficacy of hyaluronic acid is controversial. When the aforesaid options fail, total knee arthroplasty is generally recommended as an efficacious treatment. However, it is costly and can involve medical and postoperative complications. Therefore, determining alternate safe and effective treatments for knee OA is paramount. Platelet-rich plasma (PRP) has lately been investigated for the treatment of knee OA. This article reviews recent knowledge concerning PRP’s molecular mechanisms of action. The effectiveness of intra-articular PRP injections in the knee joint remains controversial, although most recent publications show pain alleviation in the short term. Orthopedic surgeons treating people with knee OA are becoming increasingly interested in PRP, despite indecisive clinical data and basic science information. Further studies comparing PRP with placebo are required.

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Section: Randomized Controlled Trialsmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Randomized Controlled Trialsmentioning

confidence: 99%

Section: Case Seriesmentioning

confidence: 99%

See 2 more Smart Citations

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

Rodríguez-Merchán

2022

IJMS

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“…The PRP injection therapy applied to the knee joints of patients with early-stage primary OA seems to be an effective treatment method for pain control and improvement of function in treated patients, as reported in various studies [ 12 - 15 ]. On the other hand, alternative treatment options for patients who are resistant to PRP injection are limited.…”

Section: Discussionmentioning

confidence: 99%

Platelet Rich Plasma Versus Autologous Conditioned Serum in Osteoarthritis of the Knee: Clinical Results of a Five-Year Retrospective Study

Yurtbay¹,

Say²

2022

Cureus

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Objectives: There is no consensus on the effectiveness of platelet-rich plasma (PRP) and autologous conditioned serum (ACS) in the treatment of knee osteoarthritis (OA). Also, the group of patients who will benefit most from this treatment is not clear. This study aims to understand the effects of two treatment modalities: ACS and PRP on pain and clinical scores in the treatment of OA. For this reason, we compared the long-term (five-year follow up) clinical results of the patients to whom these two treatment methods were applied. Materials and methods: Eighty-two knee osteoarthritis cases, selected from a database prospectively maintained in our tertiary university hospital after institutional ethics committee approval, examined between January 2013 and September 2020 and treated with ACS and PRP by the same orthobiological treatment team, were retrospectively analyzed. The clinical results of group A (n=40) treated with ACS and group B (n=42) treated with PRP were statistically analyzed. Clinical evaluations were made pre-injection and at one, six, 12, 24 and 60 months post-treatment, using the knee injury and osteoarthritis result score (KOOS) for the evaluation of function and a visual analog scale (VAS) for the evaluation of pain. Results: Side effects were noted in two patients (5%) in group A and 16 patients (38.1%) in group B. More side effects were seen in group B compared to group A (p<0.001). The better VAS scores in both groups were detected in the sixth and 12th months. When VAS scores were examined, better results were obtained in group A in the 12th and 24th months (p<0.05). When KOOS scores were examined, the superiority of ACS to PRP at 12 and 24 months was shown in KOOS.S, KOOS.P and KOOS.ADL scores (p<0.05). There was no statistically significant difference between the two groups in terms of all scores and baseline scores at 60 months. Conclusion: The effectiveness of ACS and PRP treatments can last up to two years. After two years, the effectiveness of both treatments decreases. Comparing the two treatments, ACS treatment showed better results on VAS and KOOS scores compared to PRP treatment.

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The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA‐ORBIT consensus. Part 1—Blood‐derived products (platelet‐rich plasma)

Laver,

Filardo,

Sanchez

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) consensus is to provide recommendations based on evidence and expert opinion to improve indications, decision‐making and administration‐related aspects when using blood‐derived orthobiologics (for simplicity indicated as PRP—platelet‐rich plasma—with PRP being the most common product) for the management of knee osteoarthritis (OA).MethodsLeading European expert clinicians and scientists were divided into a steering group, a rating group and a peer review group. The steering group prepared 28 question—statement sets divided into three sections: PRP rationale and indications, PRP preparation and characterisation and PRP protocol. The quality of the statements received grades of recommendation ranging from A (high‐level scientific support) to B (scientific presumption), C (low‐level scientific support) or D (expert opinion). The question–statement sets were then evaluated by the rating group, and the statements scored from 1 to 9 based on their degree of agreement with the statements produced by the steering group. Once a general consensus was reached between the steering and rating groups, the document was submitted to the peer review group who evaluated the geographic adaptability and approved the document. A final combined meeting of all the members of the consensus was held to produce the official document.ResultsThe literature review on the use of blood‐derived products for knee OA revealed that 9 of 28 questions/statements had the support of high‐level scientific literature, while the other 19 were supported by a medium‐low scientific quality. Three of the 28 recommendations were grade A recommendations: (1) There is enough preclinical and clinical evidence to support the use of PRP in knee OA. This recommendation was considered appropriate with a strong agreement (mean: 8). (2) Clinical evidence has shown the effectiveness of PRP in patients for mild to moderate degrees of knee OA (KL ≤ 3). This recommendation was considered appropriate with a strong agreement (mean: 8.1). (3) PRP injections have been shown to provide a longer effect in comparison to the short‐term effect of CS injections. They also seem to provide a safer use profile with less potential related complications. This recommendation was considered appropriate with a very strong agreement (mean: 8.7). Six statements were grade B recommendations, 7 were grade C and 12 were grade D. The mean rating score was 8.2 ± 0.3.ConclusionsThe consensus group reached a high level of agreement on all the questions/statements despite the lack of clear evidence for some questions. According to the results from this consensus group, given the large body of existing literature and expert opinions, PRP was regarded as a valid treatment option for knee OA and as a possible first‐line injectable treatment option for nonoperative management of knee OA, mainly for KL grades 1–3.Level of EvidenceLevel II.

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Multiple platelet-rich plasma injections are superior to single PRP injections or saline in osteoarthritis of the knee: the 2-year results of a randomized, double-blind, placebo-controlled clinical trial

Cited by 30 publications

References 56 publications

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

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

Platelet Rich Plasma Versus Autologous Conditioned Serum in Osteoarthritis of the Knee: Clinical Results of a Five-Year Retrospective Study

The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA‐ORBIT consensus. Part 1—Blood‐derived products (platelet‐rich plasma)

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