PRP Therapy for Osteoarthritis of the Knee

Photo of a person sitting on a grass lawn, with pain due to osteoarthritis of the knee.
Published On: July 18th, 2024
6.6 min read

Osteoarthritis of the knee is the most common type of arthritis, affecting nearly 370 million people worldwide [1]. While some patients are lucky enough to catch it early and be able to treat it with exercise, in many cases further aid is required. Platelet-rich plasma (PRP) therapy is one of the best non-invasive ways help to relieve the painful symptoms of osteoarthritis (OA) of joints in the knee.

What is Osteoarthritis of the Knee?

Osteoarthritis of the knee is a condition where the cartilage in your knee joint wears down over time. Cartilage is the smooth tissue that cushions the ends of your bones and helps them move easily.

When it wears away, the bones can rub against each other, causing pain, swelling, and stiffness. This condition commonly affects older adults, and the symptoms can make everyday activities like walking and climbing stairs challenging.

Symptoms

Some signs and symptoms that you might have osteoarthritis in the knee are:

  • One or more joints in your knee may be in pain, swollen, and/or stiff
  • Discomfort in your knee lessens with physical activity and increases without it 
  • Stiffness in the knee joints in the morning for an hour or more
  • Weight Loss
  • Fatigue or anemia
  • Fever 
  • Decreased mobility

What is PRP Therapy for the Knee?

PRP therapy is done by taking a little bit of your blood and using a centrifuge machine to split it into two groups: platelets and red blood cells. For OA of the knee, the collected platelets are then injected into the surrounding area of the affected knee joints to facilitate their regeneration and repair [2]. ‘

Platelets can activate cell reproductive functions that promote the regeneration of the surrounding tissue in the targeted area. Though their primary purpose is to aid blood clotting, they are capable of assisting in the restoration of other tissues in the body. This is why PRP therapy can contribute to the relief of pain in osteoarthritis patients suffering from knee damage.

How Effective is PRP for Osteoarthritis of the Knee?

Studies show that PRP can help reduce pain and improve function in the knee, but its effectiveness varies. Some people experience significant relief, while others see little to no benefit. Overall, PRP is considered a promising option, but more research is needed to determine how well it works compared to other treatments.

One notable study on the effectiveness of PRP for osteoarthritis of the knee is the 2013 study published in the journal “Arthroscopy: The Journal of Arthroscopic and Related Surgery.” In this study, researchers conducted a randomized controlled trial to evaluate the effects of PRP injections compared to a placebo.

Study:

  • Participants: 78 patients with knee osteoarthritis
  • Method: Participants were randomly assigned to receive either PRP injections or a saline (placebo) injection. The PRP group received three injections at weekly intervals.
  • Follow-Up: Patients were followed up at 6 months and 12 months after the injections.

Results:

  • Pain Reduction: Patients in the PRP group reported a significant reduction in pain and improved knee function scores, compared to the placebo group at both 6 and 12 months.
  • Cartilage Health: MRI scans indicated that PRP may help in maintaining cartilage health, though the changes were not dramatically different from the placebo group.

The study concluded that PRP injections could be a beneficial treatment for knee osteoarthritis, providing pain relief and improved function. However, the study also noted that further research with larger sample sizes and longer follow-up periods is necessary to confirm these findings and understand the long-term effects of PRP therapy.

How Long Do PRP Therapy Results Last?

Short-term Relief: Many patients experience pain relief and improved knee function within a few weeks to months after the injections. This initial improvement can last for around 6 months.

Medium-term Relief: Some studies have shown that the benefits of PRP therapy can last up to 12 months. For example, the study published in Arthroscopy: The Journal of Arthroscopic and Related Surgery found significant pain reduction and functional improvement lasting up to 12 months after treatment.

Long-term Relief: The long-term effects of PRP are still being studied. While some patients report continued benefits beyond a year, others may need repeat injections to maintain the results. The longevity of PRP’s effects may depend on factors such as the severity of the osteoarthritis, the patient’s overall health, and their activity levels.

Overall, while PRP therapy can provide meaningful relief for knee osteoarthritis, the duration of its effectiveness varies, and repeat treatments may be necessary to sustain the benefits.

Do Platelet-rich Plasma Injections Delay the Need for Knee Replacement?

By reducing pain and improving mobility, PRP can enhance the quality of life for patients with knee osteoarthritis, making it possible for them to postpone knee replacement surgery. A study published in Clinical Orthopaedics and Related Research found that PRP injections provided significant pain relief and functional improvement for up to 12 months, which helped some patients avoid immediate surgery.

However, PRP therapy is generally more effective in patients with mild to moderate osteoarthritis. For those with severe osteoarthritis, the likelihood of delaying knee replacement surgery with PRP alone may be lower. Furthermore, the effects of PRP therapy are not permanent, and repeat injections may be necessary to relieve knee pain. 

While PRP injections can potentially delay the need for knee replacement surgery, they are not a cure for osteoarthritis. The decision to use PRP as a part of a treatment plan should be made in consultation with a reliable healthcare provider, considering the individual patient’s condition and overall health.

Who is a Candidate for PRP Therapy for the Knee?

The primary candidates for PRP therapy are those with mild to moderate levels of osteoarthritis in their knee joints, as they reap the best chances of benefitting from the treatment.

However, not everybody is completely suitable for PRP therapy, including patients with:

  • Blood disorders, such as clotting or bleeding disorders
  • Active infections, especially in the knee area, should not undergo PRP therapy until the infection is resolved.
  • Pregnant or breastfeeding women
  • Heavy smokers
  • Severe cardiovascular disease
  • Patients on blood thinners
  • Cancer patients

Side effects

Though PRP therapy for knee OA is a non-invasive procedure that is generally considered safe because it uses the patient’s blood, there can still be side effects associated with the treatment such as swelling and bruising at the injection site.

Conclusion

Conclusively, PRP therapy is an excellent option for patients suffering from osteoarthritis of the knee because it can help heal some of the tissue surrounding affected joints and majorly lessen the symptoms of the condition.

However, it is best suitable for those who are inflicted with mild to moderate pain levels rather than extreme cases, and it is also not a permanent solution for most patients as injections are usually needed once the benefits wear off, typically between 6-12 months post.

In summation, patients should consult a healthcare professional before seeking this treatment, as there are still exceptions to who is suitable to receive the treatment despite its general safety. 

Sources

1 – https://www.who.int/news-room/fact-sheets/detail/osteoarthritis  Accessed on Jul 17 2024

2 – https://arthritis.ca/about-arthritis Accessed on Jul 17 2024

3 – https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925 Accessed on Jul 17 2024

4 – Patel, S., Dhillon, M. S., Aggarwal, S., Marwaha, N., & Jain, A. (2013). Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis: A Prospective, Double-Blind, Randomized Trial. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 29(3), 344-350. 

5 – Gobbi, A., et al. (2012). Platelet-rich plasma treatment in symptomatic patients with knee osteoarthritis: preliminary results in a group of active patients. The American Journal of Sports Medicine, 40(10), 2265-2272.

6 – Filardo, G., et al. (2015). Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Clinical Orthopaedics and Related Research, 473(11), 3440-3447.

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