Is PRP for arthritis a good idea?
Osteoarthritis of the knee is one of the most debilitating conditions affecting adult athletes and active people. When looking at all body parts, the CDC estimates that 22.7 million U.S. adults have activity limitations attributable to arthritis.
When the cartilage lining on the ends of the bones breaks down, orthopedic surgeons have little ability to make that cartilage new again. We mainly use treatments that aim to improve pain and swelling, although they don’t reverse the arthritis changes.
Treatments for knee arthritis
Conventional treatments for knee arthritis include anti-inflammatory medications, braces, weight-loss, activity modification, physical therapy and injections. Cortisone injections, or injections of a corticosteroid into the knee, offer quick relief of pain and swelling. Concern has grown over the long-term effects of multiple cortisone injections on the articular cartilage. Injections of hyaluronic acid, called viscosupplementation, have been shown to have variable results. These series of injections, often known by patients as “rooster” injections for the origin of the hyaluronic acid in the product, help some patients while failing to provide much relief for others.
Use of platelet-rich plasma
In recent years, some orthopedic surgeons have tried platelet rich plasma (PRP) for osteoarthritis of the knee. PRP involves the physician drawing a small amount of blood and spinning it in a centrifuge to remove the red blood cells and white blood cells. He then rejects that plasma filled with platelets and their growth factors.
PRP for arthritis
This procedure has been used for years for muscle, tendon and ligament injuries, but can PRP help with knee arthritis? A new study published in the American Journal of Sports Medicine aims to answer that question.
Patrick A. Smith, M.D. performed a randomized controlled trial involving 30 patients with osteoarthritis of the knee. Half of the patients received a type of PRP called autologous conditioned plasma, and half received placebo injections. Each patient received an injection of either ACP or placebo each week for three weeks. Dr. Smith then analyzed the WOMAC scores of the patients, which demonstrated their outcomes based on pain, joint stiffness and physical function.
Did PRP help patients with knee arthritis?
One week after the first injection, and at every post-injection visit during the 12-month follow-up period, patients who received the PRP injections had better WOMAC scores than did patients who received placebos. One year after treatment, PRP improved WOMAC scores 78% compared to baseline. The scores of patients who received placebo injections only improved 7%. No patient who received PRP had a complication or adverse reaction.
Also listen to these discussions from The Dr. David Geier Show:
Episode 38: Is it safe to exercise with hip and knee arthritis?
Episode 129: What treatments are available for athletic people with knee arthritis?
Episode 207: Does arthroscopic surgery help patients with knee arthritis?
Take home message about PRP for arthritis
Is PRP the answer for a patient fighting knee pain and swelling due to osteoarthritis? This study suggests that it can at least be an option. Like cortisone or hyaluronic acid injections, PRP is not likely to reverse underlying arthritis damage. If it relieved some pain and swelling, it might improve the quality of life for some patients. Insurance companies usually don’t pay for PRP treatments, so it can be important to discuss using PRP for knee arthritis with your doctor or orthopedic surgeon.
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Smith PA. Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial. Am J Sports Med. 2016 Feb 1.