Like almost all medical treatments, there are potential advantages as well as potential drawbacks and uncertainties to using PRP injections to treat osteoarthritis.

Advantages of Platelet-Rich Plasma (PRP) Therapy

There are several reasons why osteoarthritis patients might consider platelet-rich plasma injections:

  • Platelet-rich plasma is autologous, meaning it comes from the patient’s body, so it is natural and the injections carry few risks.
  • Other treatments for mild to moderate osteoarthritis can be unreliable or vary from person to person, and some have side effects or drawbacks:
    • Physical therapy and/or weight loss can often improve but not always eliminate symptoms.
    • Cortisone injections are proven to reduce osteoarthritis pain, but repeated injections can weaken ligaments and tendons over time, and may have a detrimental effect on healthy cartilage.26,27
    • Anti-inflammatory medications (NSAIDS) such as aspirin and ibuprofen can reduce pain, but long-term use can aggravate stomach problems, blood pressure and heart problems.
    • Minor surgeries to treat osteoarthritis, such as arthroscopic debridement, have mixed results, and may be no better than placebo.28,29
    • Joint replacement surgeries are major surgeries that require long-term rehabilitation, and should be reserved for more debilitating cases of arthritis
  • While more data are needed, research so far seems to be promising.
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Because osteoarthritis has no surefire treatment and there are few risks associated with platelet-rich plasma injections, some doctors believe PRP therapy is worth trying.

See Stem Cell Therapy for Arthritis

Patients should keep in mind that PRP is not a cure-all, and it may be best used in combination with nonsurgical treatments and lifestyle changes, such as physical therapy, weight loss, bracing, and NSAIDs.

Uncertainties Regarding Platelet-Rich Plasma Therapy

Knee Injection
Knee injection. Click to enlarge

Though laboratory studies have shown platelet-rich plasma encourages cell regeneration, scientists do not completely understand how or why this happens. Experts still have many questions regarding platelet-rich plasma treatment:

  • Indications, i.e. when should this treatment be used? If it is an effective treatment for osteoarthritis, should it be used in the early stages of osteoarthritis or only when all other options are exhausted?
  • What are the optimal concentrations of platelets and white blood cells?
  • How much platelet-rich plasma should be injected?
  • Do certain additives, such as thrombin, make the PRP more effective?
  • When and with what frequency should injections be given? Is one injection enough?
  • What is the best rehabilitation protocol to use after PRP injection?
  • Several clinical trials are underway and will help add to the body of knowledge regarding platelet-rich plasma. Until more is known, doctors must answer these questions based on the research data that are available, personal experience, and doctor-patient communication.

    References

    1. Dragoo JL, Danial CM, Braun HJ, Pouliot MA, Kim HJ. The chondrotoxicity of single-dose corticosteroids.
    2. Piper SL, Kramer JD, Kim HT, Feeley BT. Effects of local anesthetics on articular cartilage.
    3. Kirkley A, Birmingham TB, Litchfield RB, Giffin JR, Willits KR, Wong CJ, Feagan BG, Donner A, Griffin SH, D'Ascanio LM, Pope JE, Fowler PJ. A randomized trial of arthroscopic surgery for osteoarthritis of the knee.

    Complete Listing of References

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