Background: Increased physical activities and prolonged life expectancies, coupled with biomechanical, metabolic, and biological changes of articular cartilage, have led to a significant rise in osteoarthritis. Unfortunately, cartilage lesions are difficult to treat because of their inherit limit of adequate blood and nerve supplies, which decreases healing potential. There are numerous, non-invasive treatment approaches with emphasis on pain management, improvement in function, and hindering the disease progress. But most of them are of short-term success with significant side effects, and do not address the biological pathology. New experimental studies have targeted the biomechanical process of OA with the focus on promoting cartilage repair or replacement. Can platelet rich-plasma (PRP) be an effective alternative option in the treatment of knee OA?
Method: An extensive search of the literature using Medline, CINAHL, Web of Science, and Google Scholar was conducted with the help of the following keywords: platelet-rich plasma, cartilage, injections, and osteoarthritis. For the purpose of performing a systematic review, articles that identified the effects of PRP injections on OA were selected and assessed via the GRADE system.
Results: Three articles were selected which directly addressed the question and met the inclusion and exclusion criteria. One prospective cohort study of 150 participants showed statistically significant improvements in pain, function and patient satisfaction with PRP treatment after 2 and 6 month follow up when compared to hyaluronic acid (HA) injections. Another cohort study of 120 individuals displayed safe and effective outcomes in pain reduction and recovery of function over HA treatments. However, major changes were only noticeable during the first 3 months. A retrospective study observed success rate of 33.3% by week 5 in the PRP group versus 10% in the control group.
Conclusion: All of the studies suggest that PRP injections are a good alternative in the treatment of OA. This procedure showed a higher degree of efficacy in pain reduction, improved function, and patient satisfaction compared to current options. No complications were identified. However, more research is needed, with emphasis on blinded randomized control trials, to further confirm current findings, determine precise mechanism of action, its disease-modifying properties, and possible long-term relief.
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