The Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis
Osteoarthritis is wear and tear of the joint that occurs over time. It is a condition that causes worsening pain and complications over time. Osteoarthritis can impair a person’s quality of life, cause pain and limit him/her in the activities that they can do. Sports medicine doctors can help reduce or treat osteoarthritis with medications, physical therapy, and also with operations such as knee replacements. Platelet-rich plasma (PRP) has been used to help treat or reduce pain from osteoarthritis. The effectiveness of PRP is still being studied; studies performed to date have shown conflicting results.
A review of the results of the many studies evaluating the efficacy of PRP for the treatment of painful knee arthritis was performed. The data from the different studies were combined and examined. Multiple databases, including Medline, Embase, Cochrane Central Register of Controlled Trials, Pubmed, and www.clinicaltrials.gov were searched to locate prospective studies and clinical trials that have evaluated the effectiveness of PRP.
Six studies were included in this review. Among these six studies, a total of 577 patients were included, with 264 patients (45.8%) in the treatment group (those that received PRP) and 313 patients who did not. The average age of patients receiving PRP was 56.1 years old (51.5% of them were male) compared with 57.1 years (49.5% male patients) who did not receive PRP. Combining the data from the multiple studies showed that patients who used PRP for osteoarthritis had significant improvement (reduction of symptoms) compared to those that did not use it (average difference, using the Western Ontario and McMaster Universities Arthritis Index scale was -18.0, 95% confidence interval (-28.8 to -8.3), p < 0.001). There was also a significant improvement noted with use of PRP when the International Knee Documentation Committee score was used (average difference, 7.9, 95% confidence interval, 3.7 to 12.1, p < 0.001). Adverse events such as pain, stiffness, syncope, dizziness, headache, nausea, gastritis, sweating, fast heart rate and pain and swelling at the injection site occurred more commonly in patients treated with PRP (8.4% v. 3.8%, p=0.002).
In conclusion, intra-articular PRP injections may aid in the treatment of adult patients who have mild to moderate knee osteoarthritis at approximately 6 months. There seems to be an increased incidence of adverse events amongst patients treated with PRP.
If you are faced with knee arthritis or hip arthritis, contact our orthopedic specialists at Orthopedic Surgery San Diego to undergo an evaluation.