Platelet-Rich Plasma (PRP) for Osteoarthritis: A Pilot Study Summary
Osteoarthritis (OA), especially of the knee, is a growing health concern among older adults, with rising prevalence and limited treatment options. Traditional therapies, such as pain management and joint injections, only offer partial relief, without reversing the damage to joint cartilage. In recent years, Platelet-Rich Plasma (PRP) has emerged as a promising treatment due to its concentration of growth factors that may support cartilage repair and improve joint function.
A pilot study conducted by the Rizzoli Orthopedic Institute in Italy aimed to evaluate the safety and effectiveness of PRP in treating knee osteoarthritis, specifically focusing on cartilage repair.
Study Method:
• Participants: 91 adults with knee osteoarthritis (115 knees treated).
• Age: Average 45 years.
• Lesion Staging: 33 knees had early-stage lesions, and 24 had advanced-stage lesions.
• Treatment: PRP injections (600% above normal platelet concentration) every 21 days for 3 doses.
• Assessment: Evaluations at baseline, 2 months, 6 months, and 12 months post-treatment using the International Knee Documentation Committee (IKDC) questionnaire, physical exams, and X-ray findings.
Safety Results:
• No major adverse events.
• Mild pain and swelling at the injection site were reported, which resolved within two weeks in most cases.
• One case of marked pain and swelling was observed but resolved after two weeks.
Effectiveness Results:
• Overall Improvement: Significant clinical improvements were observed at 6 and 12 months.
• IKDC Scores: Physician-scored scores increased from 46.1% before treatment to 73% at 6 months and 66.9% at 12 months.
• Pain Reduction: Patient-reported pain scores improved at 2, 6, and 12 months, although there was a slight decline over time.
• Age-Related Variations: Older patients (above 65) had lower scores, likely due to more advanced lesions, but 30% of older patients reported significant improvements.
• Patient Satisfaction: 80% of patients were satisfied with the results.
Discussion:
PRP works by harnessing the growth factors found in the patient’s own blood, which play a critical role in cell regeneration and tissue repair. Key growth factors involved in cartilage repair include:
• TGF-β: Promotes chondrocyte development and cartilage matrix growth.
• PDGF: Supports chondrocyte production and cartilage maintenance.
• Insulin Growth Factor: Enhances cartilage-building processes and supports other growth factors.
These growth factors work synergistically to stimulate cartilage repair and reduce inflammation.
Conclusions:
PRP is a safe, minimally invasive, and relatively inexpensive treatment option for knee osteoarthritis. The pilot study showed significant clinical improvements in pain, joint function, and cartilage healing after PRP treatment. With no severe adverse reactions and positive outcomes, PRP presents a promising treatment for degenerative cartilage lesions, although further research with control groups is needed for more robust conclusions.
Reference:
Kon, E., Buda, R., Filardo, G., et al. (2009). Platelet-rich plasma: Intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surgery, Sports Traumatology, Arthroscopy, DOI: 10.1007/s00167-009-0940-8
