Musculoskeletal Care of the Mature Patient
In an attempt to evaluate the clinical effects of harvesting platelets from the blood, concentrating them and injecting the concentrate, platelet-rich plasma (PRP), in to the knee joint of patients with primary and secondary osteoarthritis, a single-center, uncontrolled, prospective preliminary study was undertaken. The scientific theory behind the study was based on the fact that most of the current treatments for osteoarthritis are palliative and attack symptoms rather than influence the biochemical environment of the joint. Autologous platelet-rich plasma not only releases growth factors, it promotes concentrated anti-inflammatory signals including interleukin-1ra, the latter being a focus of emerging treatments for osteoarthritis.
In the study, 14 patients with primary or secondary knee osteoarthritis who met the study criteria received three platelet-rich plasma injections in the affected knee at 4-week intervals. Outcome measures included the Visual Analog Scale, Activities and Expectations score and Knee Injury and Osteoarthritis Outcome Score at two, five, 11,18, and 52-week follow-up visits.
The Study, first and foremost, did not result in any adverse or harmful events. What was observed were significant and almost linear improvements in all the scores measured. One could conclude that platelet-rich plasma is safe and potentially could postpone or eliminate a patient’s need for a total knee replacement. At present, there are few options for patients with mild to moderate arthritis to alter disease progression. While both arthritis and joint pain become more common with age, they’re by no means inevitable. There is a long list of modifiable risk factors-obesity, injury and overuse, infections, and on-the-job squatting and kneeling. The current practice is relief at the pharmacy. The study described was done at the Orthohealing Center in Los Angeles and used a non-surgical healing treatment being applied in many fields, including plastic surgery, cardiothoracic surgery, and dentistry. In orthopedics, PRP has been used for tendinopathies and soft tissue injury. Platelet-Rich Plasma injections are potentially very cost effective by reducing the need for pharmaceutical and surgical management while targeting the biochemical process of osteoarthritis. The next step is testing highly concentrated platelet rich plasma and that should be available in my office starting next week.