According to the American Academy of Orthopedic Surgeons, “PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.”
To use PRP as a treatment, platelets from the patient’s own blood are separated from the other blood cells. The platelets undergo centrifugation and filtration to increase their concentration, and the platelets are then mixed with the plasma again.
Evidence Suggests Compounded PRP Could Be Beneficial
In reviewing the results of my PRP data base, we observed reduced pain in the knee at one year. Assessment included using the Visual Analog Scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC), respectively as well as the Knee Society Score.
After one month, the PRP group had significantly reduced VAS scores and WOMAC pain sub-scores. At six months, VAS scores remained low in the PRP group, and all WOMAC parameters were significantly lower compared to the placebo group. We did not measure Cartilage thickness.
A study, published in the Journal of Orthopaedic Research, evaluated whether cartilage thickness played a role in outcomes for knee OA patients undergoing PRP therapy. This trial included 59 patients who underwent PRP with a low-leukocyte autologous conditioned plasma (ACP) system. Patients underwent MRI prior to treatment; researchers collected patients’ Whole-Organ MRI Score (WORMS), which determined knee OA level based on 14 parameters: integrity of the cartilage, affection of the bone marrow, subcortical cysts, bone attrition, osteophytes, integrity of the menisci and ligaments, presence of synovitis, loose bodies, and periarticular cysts.
“The findings of the current study suggest that positive effects of intraarticular injections of PRP might improve quality of life and reduce the pain of patients suffering from osteoarthritis of the knee joint independent from the level of cartilage damage.”
The largest Orthobiologic meeting of the year is taking place this Thursday, Friday and Saturday in McCormick Place. I will be serving as faculty and in preparing for discussions and debate; I reviewed our outcomes using proprietary Platelet Rich Plasma compounded interventions. I believe the take home message to be that joint restoration, the absence of pain and improved function is not dependent on cartilage regeneration that might be seen on an MRI.
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