Knee Osteoarthritis: Is PRP the Answer We're Hoping For?

Knee osteoarthritis (OA) is a common and painful disease that affects millions of people around the world. This condition makes the joint cartilage and bone underneath wear down, which causes pain, stiffness, and less movement. As people get older and more obese, the number of people with knee osteoarthritis (OA) is likely to rise. This means that effective, slightly invasive treatments are needed.

Platelet-rich plasma (PRP) therapy has gotten a lot of interest as a treatment. This article talks about PRP as a possible treatment for knee osteoarthritis and asks if it could be the big step forward we need.

Understanding Knee Osteoarthritis

When you have osteoarthritis, the protective cartilage that covers the ends of your bones wears away over time. This wear and tear lead to pain, swelling, less mobility, and a lower quality of life for the knee. Physical therapy, painkillers like NSAIDs, corticosteroid shots, and finally joint replacement surgery are all common ways to treat arthritis. These methods, on the other hand, often only help temporarily and may cause side effects.

What is platelet-rich plasma (PRP) therapy?

In PRP treatment, a person's own blood is used to help them heal. Platelets are cells that help blood clot and heal. Blood is drawn and treated to concentrate it. This concentrate, which is full of growth factors and other bioactive chemicals, is then put into the joint that hurts. The idea behind this is that these things will help damaged cells heal and lower inflammation.

Clinical Evidence Supporting PRP for Knee OA

A variety of studies have been conducted to assess the efficacy of platelet-rich plasma (PRP) compared to hyaluronic acid (HA) and cortisone injections for treating knee osteoarthritis. Here are the key findings from recent systematic reviews and meta-analyses:

1. PRP vs. HA: Most of the time, PRP injections work better than HA injections at helping people with knee osteoarthritis function better and feel less pain. Several meta-analyses show that PRP works better for pain relief and functional healing, especially over the next few years. However, some studies show that there isn't a big difference between PRP and HA in how well people do right after getting a treatment. This suggests that PRP may be better over time.

2. PRP vs. Cortisone: While there are some similarities between PRP and cortisone shots, they are not as clear-cut. But the studies that have been done so far show that while cortisone may help with pain faster, its benefits don't last as long as those of PRP. PRP, on the other hand, tends to provide long-lasting change over a longer period of time, which could be more helpful for managing osteoarthritis over a long period of time.

3. Combined PRP and HA Therapy: HA and PRP have been used together in some studies, which suggests that this mixture might work better by taking advantage of the good things about both treatments. The combined approach might help structures heal better while lowering pain and increasing function, but the evidence is still developing and isn't all that clear.

4. Safety and Adverse Effects: PRP treatments are associated with a higher incidence of post-injection reactions compared to HA, such as pain and swelling at the injection site. However, these reactions are typically mild and resolve quickly. Overall, PRP is considered a safe treatment option with a low risk of serious adverse effects.

Overall, PRP looks like it could be a good way to treat knee osteoarthritis, especially when it comes to long-term benefits and safety. But, as with all medical treatments, different people can have different outcomes. It's important to talk to a specialist like Dr. Otoño Silva of Interventional Orthopedics of Washington about all of your choices so that the treatment is tailored to your specific needs and conditions.

The Role of Interventional Orthopedics of Washington

PRP is showing more and more promise, but it needs to be used with care and accuracy. Interventional Orthopedics of Washington focuses on new, minimally invasive ways to treat joint problems, such as platelet-rich plasma therapy. As part of their method, they do a full evaluation of each patient to tailor care and improve outcomes.

At Interventional Orthopedics of Washington, doctors use high-tech imaging methods like ultrasound and fluoroscopy to make sure that PRP treatments are done correctly. This accuracy makes sure that the healing substances reach the exact spot where the damage is, which makes the treatment more effective.

Limitations and Future Directions

While promising, PRP is not without limitations:

Standardization Issues: There is no universally accepted protocol for PRP preparation and administration. Variability in platelet concentration and the presence of white blood cells can influence outcomes. When you see Dr. Silva, he will customize your PRP to be as effective as possible. 

Patient Selection: Not all patients with knee OA will respond equally to PRP therapy. Identifying the ideal candidate remains an area of active research. Dr. Silva can provide a candidacy to determine how much and how long you can expect to benefit, but this is not guaranteed as results can vary. 

Long-Term Effects: While short- to medium-term benefits are supported by research, long-term efficacy and safety require further investigation. Unlike a cortisone shot that leaves the tissues the same while providing relief and then wears off, possibly leaving the joint in worse shape, PRP can heal tissues, making them feel better and stronger after each additional round.

Conclusion

One hopeful new way to treat knee osteoarthritis is with platelet-rich plasma therapy. It could be used instead of traditional treatments. When done correctly by professionals like the team at Interventional Orthopedics of Washington, PRP can help with a lot of pain and make joints work better. There needs to be more study, though, to fully understand the long-term benefits and standardize protocols. As we learn more about PRP, it may become the answer we've been looking for to improve the way we treat knee OA.

REFERENCES:

• Sanchez, M., Anitua, E., Azofra, J., Aguirre, J. J., and Andia, I. (2008). Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clinical and Experimental Rheumatology, 26(5), 910–913.

• Patel, S., Dhillon, M. S., Aggarwal, S., Marwaha, N., and Jain, A. (2013). Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. American Journal of Sports Medicine, 41(2), 356-364.

• Filardo, G., Kon, E., Buda, R., Timoncini, A., Di Martino, A., Cenacchi, A., Fornasari, P. M., and Marcacci, M. (2011). Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surgery, Sports Traumatology, and Arthroscopy, 19(4), 528–535.

• Kon, E., Mandelbaum, B., Buda, R., Filardo, G., Delcogliano, M., Timoncini, A., Fornasari, P. M., Marcacci, M., and Zaffagnini, S. (2011). Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 27(11), 1490–1501.