Who Is a Candidate for Platelet-Rich Plasma Therapy?

Scientists are still exploring which arthritis patients should be eligible for PRP injections. While no definitive conclusions can be made, research suggests that PRP injections are appropriate for younger patients in the early stages of the disease.¹Kon E, Filardo G, Matteo BD, Marcacci M. PRP For the Treatment of Cartilage Pathology. Open Orthop J. 2013 May 3;7:120-8. doi: 10.2174/1874325001307010120. Print 2013. PubMed PMID: 23730375; PubMed Central PMCID: PMC3664439.^,2Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG, Nguyen J. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clin J Sport Med. 2013 May;23(3):238-9. doi: 10.1097/JSM.0b013e31827c3846. PubMed PMID: 23238250.^,3Jang SJ, Kim JD, Cha SS. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. Eur J Orthop Surg Traumatol. 2013 Jul;23(5):573-80. doi: 10.1007/s00590-012-1037-5. Epub 2012 Jul 7. PubMed PMID: 23412170.

See Stem Cell Therapy for Arthritis

These patients may have already tried treatments such as rest and physical therapy but are not yet thinking about joint replacements or other surgeries.

Suggested Indications for PRP Injections for Osteoarthritis

While there is no universally adopted list of criteria describing who is eligible for PRP injections, professional organizations such as the American Academy of Orthopaedic Surgeons and the International Cellular Medicine Society have suggested guidelines, many of which are included below:

• Osteoarthritis pain affects daily activities
• Other more conservative treatments have failed or been eliminated:
  • Physical therapy to strengthen joint muscles has not helped
  • The patient is sensitive to anti-inflammatory medications (NSAIDs) such as ibuprofen, or find NSAIDs do not provide adequate pain relief
  • Joint aspirations are not appropriate or do not provide adequate pain relief
  • Steroid injections have not worked, or the patient wants to avoid steroid injections

Platelet-rich plasma injections are not typically recommended for the most severe cases of osteoarthritis.

Contraindications for Platelet-Rich Plasma Therapy

Platelet-rich plasma injections may not be appropriate for osteoarthritis patients who:

• Have a medical condition that could worsen or spread with injections, such as an active infection, a metastatic disease, or certain skin diseases
• Have certain blood and bleeding disorders
• Are undergoing anticoagulation therapy (and cannot temporarily suspend treatment)
• Are anemic
• Are pregnant

See Is Stem Cell Therapy for Arthritis Safe and Effective?

Additionally, patients who have an allergy to cow products should tell their doctor. These patients could experience an allergic reaction if the platelet-rich plasma is combined with an additive called bovine thrombin, which is derived from cows.