Platelet Rich Plasma (PRP): A Potentially Promising Treatment for Knee Arthritis
For the last many years I have added Platelet-rich Plasma (PRP) injections as a added treatment for arthritic conditions. Platelet rich plasma is a simple and non invasive treatment that can potentially be used to relieve symptoms associated with knee arthritis. I find that treatment of knee arthritis in general can be very difficult. It is especially difficult in patients who have early arthritis and who are young. These are difficult cases because the arthritis is not severe enough to warrant a Total Knee Replacement Surgery but significant enough to cause pain that affects lifestyle. A cookie cutter approach for everyone with arthritic knee pain does not always work
What is Knee Arthritis?
Knee arthritis involves the inflammation, degeneration of the joint surface, damage to the meniscus, bowing of the leg, swelling in the bone and pathological changes in the joint fluid of the knee joint. Common symptoms include pain, swelling, and stiffness starts with difficulty in sitting crossleg. Often, knee arthritis can interfere with daily activities such as walking, using indian toilet and climbing stairs. Arthritis knee pain can also occur simply from sitting in one position for a long time specially in low chair like movie theatre. When severe, symptoms may prevent patients from working and doing the activities which bring them happiness
Treatment depends on a multitude of factors including the amount pain, exact location, presence of deformity such as bowing, presence of bone edema, presence stiffness, presence of loose fragments floating in the joint, age, and other medical problems. Typical treatments for knee arthritis includes lifestyle modifications, physical therapy, steroid injections, Hyaluronate injections, bracing, weight loss, anti-inflammatories and medication. Effective treatment needs to be patient specific
Platelet Rich Plasma Treatment for Knee Arthritis
Recent literature suggest that PRP can be effective for patients with knee arthritis pain. Platelet rich plasma has become an option for the treatment of specific injuries especially soft tissue injuries such as tennis elbow and plantar fasciitis. Over the last few years PRP has also been used to treat various other injuries and pathologies including rotator cuff tears and knee arthritis. Recently PRP has been used as an other treatment for arthritis of the knee. The good news about PRP is that when done properly no harm is done and a advantage may be experienced. Overall it’s a low risk procedure.
How is PRP injected?
The procedure is very simple. Platelet Rich Plasma is produced from the patient’s own blood. A sample of the patient’s blood is first taken, filtered and then platelets are concentrated. Platelets are known to produce a high concentration of essential growth factors which theoretically initiate a natural healing process. The process is relatively painless. The hope is that the growth factors will repair the degenerative cartilage, reduce inflammation and reduce pain.
Clinical Research on PRP for Knee Arthritis
A recent study by the Hospital for Special Surgery found PRP not only to improved the pain, stiffness and function of the knee in 73% of patients, but also reverse degeneration of the knee joint. Platelet Rich Plasma treatment has also been linked to tissue repair. Researchers have proposed that PRP treatment may stimulate the healing of tissues that have a limited ability to heal on their own. Furthermore, PRP has been used as an alternative treatment of professional sports injuries, which has contributed to the public’s greater enthusiasm for PRP treatment. Although these results seem promising, most scientific studies conducted on PRP and knee arthritis have been no been solid or totally convincing. Thus, although PRP treatment may be effective in some cases, more research utilizing strict scientific methods should be done before PRP is used as a standard form of alternative treatment for knee arthritis.
I do not inject all patents with platelet rich plasma. I use it in circumstances where I think the chance of it helping is high. My goal is to first understand what is the cause of pain. It is not always straightforward. Platelet rich plasma is not my first recommendation. Once I do recommend PRP I will do 2 to 3 injections. Its rare for patients to experience magical results after one injection. In addition there are usually concurrent recommendations such as stretching, bracing and other non operative treatments like physiotherapy being done.