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Injection of Platelet-Rich Plasma in Patients with Primary and Secondary Knee Osteoarthritis: A Pilot Study

Sampson, Steven DO; Reed, Marty MD; Silvers, Holly MPT; Meng, Michael DC; Mandelbaum, Bert MD

American Journal of Physical Medicine & Rehabilitation: December 2010 - Volume 89 - Issue 12 - p 961-969
doi: 10.1097/PHM.0b013e3181fc7edf
Original Research Article: Osteoarthritis

Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B: Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: A pilot study.

Objective: To evaluate the clinical effects of intraarticular platelet-rich plasma (PRP) injections in a small group of patients with primary and secondary osteoarthritis. Most of the current treatments for osteoarthritis are palliative and attack the symptoms rather than influencing the biochemical environment of the joint. Autologous platelet-rich plasma has emerged as a treatment option for tendinopathies and chronic wounds. In addition to release of growth factors, platelet-rich plasma also promotes concentrated anti-inflammatory signals including interleukin-1ra, which has been a focus of emerging treatments for osteoarthritis.

Design: In this single-center, uncontrolled, prospective preliminary study, 14 patients with primary and secondary knee osteoarthritis who met the study criteria received three platelet-rich plasma injections in the affected knee at ∼4-wk intervals. Outcome measures included the Brittberg-Peterson Visual Pain (Visual Analog Scale [VAS]), Activities, and Expectations score and the Knee Injury and Osteoarthritis Outcome Scores at preinjection visit at 2-, 5-, 11-, 18-, and 52-wk follow-up visits. Musculoskeletal ultrasound was used to measure cartilage thickness.

Results: There were no adverse events reported. The study demonstrated significant and almost linear improvements in Knee Injury and Osteoarthritis Outcome Scores, including pain and symptom relief. Brittberg-Peterson VAS showed many improvements including reduced pain after knee movement and at rest. Cartilage assessment was limited because of the small sample size. The majority of the patients expressed a favorable outcome at 12 mos after treatment.

Conclusions: The positive trends and safety profile demonstrated could potentially be used to inspire a larger, blinded, and randomized clinical trial to determine whether platelet-rich plasma is safe and effective for the treatment of knee osteoarthritis.

Affiliations: From The Orthobiologic Institute (TOBI) (SS), Los Angeles, California; Department of Orthopedics (MR), Kaiser Permanente, Sacramento, California; San Diego Arthritis (MM), San Diego, California; and Santa Monica Orthopaedic and Sports Medicine Group (HS, BM), Santa Monica, California.

Correspondence: All correspondence and requests for reprints should be addressed to Steven Sampson, DO, The Orthobiologic Institute (TOBI), 10780 Santa Monica Boulevard, Suite 440, Los Angeles, CA 90025.

Disclosures: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2010 Lippincott Williams & Wilkins, Inc.