Platelet rich Plasma (PRP) has been used for well over 10 years for treatment of symptoms of osteoarthritis (OA), particularly for knees. The use of PRP for OA knees has remained somewhat controversial, with sub standard evidence and a lack of uniform treatment protocols and PRP preparations/kits. PRP is essentially a preparation of concentrated platelets from a patients’ own blood (autologous) to harness the healing/anti-inflammatory properties found in platelets.
March 2016 seems to have seen a renewed focus on PRP use in osteoarthritis, with 3 separate international groups releasing systematic reviews or meta-analyses on the topic, all supporting the use of PRP for treatment of symptoms of OA in knees.
Systematic reviews/meta-analyses are review articles usually published by groups of experts in a field after a review of available published evidence, with a strict set of guidelines and hurdles for research articles to be included and further guidelines on the way evidence is interpreted. The following 3 papers were all released recently in March 2016:
- “Efficacy of Platelet Rich Plasma injection in osteoarthritis of the knee: An updated systematic review and meta-analysis” by M.Moen et al (presented as a poster presentation at the recent 2016 OARSI congress).
#OARSI stands for Osteoarthritis Research Society International
- “Efficacy of intraarticular platelet rich plasma injections in knee osteoarthritis: A systematic review” by Meheux et al published in Arthroscopy Journal.
- “Efficacy of platelet rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A systematic review and meta-analysis” by Sadabad HN et al in Electron Physician Journal.
#hyaluronic acid are commonly used gel like joint injections which in Australia are branded as either Synvisc or Durolane
It was interesting to note that all 3 international groups independently concluded that PRP had a better and longer lasting effect compared to comparative treatments such as hyaluronic acid or corticosteroid injections. In addition to the above, the following randomized control trial was also published in the American Journal of Sports Medicine supporting the use of PRP in hip osteoarthritis (over hyaluronic acid or combination PRP/hyaluronic acid)
- “Ultrasound guided injection of PRP and hyaluronic acid, separately and in combination for hip osteoarthritis: A randomized controlled trial” Dallari D et al
In most studies, the benefits of PRP when used for osteoarthritis will last on average between 9-12 months and in some patients up to 2 years. Whilst there are symptom relieving benefits, there has really been NO evidence to suggest cartilage repair or regeneration from PRP therapy.
For patients wishing to learn more about platelet rich plasma and use in osteoarthritis please speak to your GP, and/or get a referral to one of our Sport and Exercise Physicians. You can also refer to the website, www.prpinjection.com.au
Unfortunately, the Medicare rebate previously available for patients having PRP treatments was removed by the Federal government in January 2015, meaning that patients now bear all the out of pocket costs.