Do Platelet-Rich Plasma Injections for Knee Osteoarthritis Work?

Abbas Shahid; Asad Malik; Ali Bukhari; Adil Shaikh; Jill Rutherford; Bilal Barkatali

doi:10.7759/cureus.34533

Do Platelet-Rich Plasma Injections for Knee Osteoarthritis Work?

Cureus. 2023 Feb 2;15(2):e34533. doi: 10.7759/cureus.34533. eCollection 2023 Feb.

Authors

Abbas Shahid¹, Asad Malik², Ali Bukhari³, Adil Shaikh⁴, Jill Rutherford¹, Bilal Barkatali¹

Affiliations

¹ Trauma & Orthopedics, Salford Royal NHS Foundation Trust, Manchester, GBR.
² Emergency Medicine, Warrington and Halton Hospitals NHS Trust, Manchester, GBR.
³ Emergency Medicine, University Hospitals of North Midlands NHS Trust, Manchester, GBR.
⁴ Vascular Surgery, Northern Care Alliance NHS Group, Manchester, GBR.

Abstract

Background: Recent evidence suggests a benefit in platelet-rich plasma injections (PRP) for the knee in the management of mild to moderate osteoarthritis (OA). There is a reported reduction in pain, stiffness, and improved function. However, there is very little level-one literature available that supports this practice and conclusively proves a benefit gained throughout the course. Three main randomized control trials (RCTs) conducted in North America are often referenced and cited to prove their efficacy. This study aimed to look at the outcomes of patients having undergone this treatment to determine if there was any benefit.

Aims: This study aimed to determine if PRP injections administered in patients with knee OA over a six to eight-week time period demonstrated any benefit.

Methods: The Western Ontario and McMaster Universities arthritis index (WOMAC) tool was used before each of the three PRP injections over the six to eight-week period, and six weeks after the final injection in 31 patients. Each injection was given spaced two to three weeks apart. The outcomes observed were pain, stiffness, and physical function, and the total WOMAC score was calculated.

Results: The third injection showed a reduction in total WOMAC score, pain, stiffness, and physical function by 16.36%, 16.37%, 5.12%, and 18.03%, respectively. However, all scores returned close to baseline at the sixth-week follow-up post treatment.

Conclusion: Results showed a trend of reduction in the WOMAC score. However, they are overall indicative of a placebo effect from the injections. Further studies are needed to explore whether the grade of OA and patients' weight have a significant impact on the results.

Keywords: chronic pain management; knee oa; knee osteo-arthritis; knee osteoarthritis/koa; orthopaedics surgery; platelet-rich plasma therapy for joints; platelet-rich plasma/prp.