Osteoarthritis is a chronic, degenerative disease of the cartilage that covers the ends of the bones.  As the cartilage deteriorates the bones rub together causing joint pain, swelling and stiffness, bone spurs and altered gait. Eventually impaired joint movement and joint deformity negatively impact a patient’s quality of life.

OA is the most common kind of arthritis, also called ‘wear and tear’ arthritis. OA can affect any joint, but knee OA is the most common type. OA is the most common reason for total hip and total knee replacement.

There is no cure.  Nonsurgical treatments focus on relieving pain and stiffness and slowing progression of the disease to avoid the need for joint replacement. Nonsurgical treatments include corticosteroid injections, physical therapy and non-narcotic pain medications.  Joint replacement surgery is the last resort. However, up to one third of joint replacement patients continue to suffer chronic pain after surgery.

Platelet – rich plasma therapy for OA can be an adjunct to conservative treatment or when conservative treatment fails and before surgery. Recent studies have shown that PRP therapy is beneficial for knee and hip arthritis. PRP modulates the degenerative process and is beneficial in the nonsurgical management of OA. 

Knee OA

Knee OA is estimated to affect 10% of men and 13% of women over the age of 60 in the U.S., causing pain and disability. Treatment of knee OA is difficult due to the fact that knee cartilage has no blood supply which results in low regenerative capacity and limited healing potential.

Studies consistently report that PRP therapy is effective to improve function and quality of life and reduce pain in patients with mild to moderate OA of the knee.

PRP injections are more effective at treating knee OA for pain relief and improved function when compared to Hyaluronic Acid, cortisone and other injections.

Meniscus tears in the knee joint predispose a patient to OA. The meniscus is made of cartilage. Surgery to remove part of the damaged meniscus has been shown to lead to the onset of OA, and arthritic changes in the knee joint damage the meniscus. Meniscus tears treated with PRP injections provide a higher healing rate and better functional outcome.

Clinical evidence supports the benefit of PRP treatments for knee and hip OA. It is proven to reduce pain and improve function and provides results that are superior to alternatives.

Joint injections of PRP for patients with hip OA are well tolerated and improve clinical outcomes, delivering significant long-term pain reduction and improved function. PRP therapy for thumb joint arthritis is a reasonable therapeutic option for people in the early stage of thumb OA.

What is Platelet Rich Plasma?

Blood is primarily plasma, the liquid that contains red blood cells, white blood cells and platelets. Platelets are best known for their blood clotting ability, but platelets are a natural reservoir of hundreds of biologically active proteins called growth factors that play a key role in wound healing and tissue repair. When there is an injury or inflammation, platelets flood the area to stop bleeding, and heal damaged tissues.

PRP is a solution made by concentrating platelets, and growth factors to increase potency.  Increased concentrations of platelets and growth factors boost the body’s repair mechanisms and shorten recovery. PRP harnesses the power of your body’s natural healing abilities to promote healing, and regenerate tissues that help you recover quickly.

How is PRP made?

A small amount of your blood is collected and prepared to separate the platelets from the other blood components. The concentrated platelets and growth factors are combined with the remaining blood and local anesthetic, for your comfort.

The PRP Procedure

The PRP solution is injected in to the injured area, often under ultrasound guidance. The activated growth factors stimulate the release of repair cells to accelerate the healing process and provide symptom relief.

Side effects are minimal and may include pain at the site of injection that can last for a few hours or days and swelling that resolves within a few days.  After treatment a patient will be advised to rest and avoid exercise for a time.

Generally, it can take up to a month to experience pain relief which will improve over the course of 3-6 months after treatment. However, the recovery period is determined by the type and severity of injury.

PRP therapy offers pain relief without the risks of surgery, anesthesia, and a long recovery. In some cases, PRP therapy is an alternative to surgery; and in some cases, it is used during surgery.

PRP therapy stimulates and accelerates tissue repair and healing, without invasive procedures and the associated risks.  PRP therapy may significantly improve your function and quality of life, so you can get back to the life you love.

Is PRP therapy safe?

PRP therapy is very safe. It is not a drug. Because it is made from your own blood and injected into the site of your injury or degeneration, there is no risk of adverse reaction, or disease transmission.

How does PRP work?

PRP injections soak injured cells in the concentrated plasma and the numerous growth factors to enhance one or more phases of bone and soft tissue healing. PRP also enhances proliferation of stem cells and fibroblasts to boost healing and regeneration of damaged tissues. Studies show that the increased concentration of growth factors catalyze the body’s repair mechanisms and shorten recovery time.

Benefits of PRP Therapy

PRP therapy reduces inflammation, relieves pain, promotes repair, increases collagen production for firmer and more resilient cartilage, enhances blood flow to deliver nutrients that support healing, and recruits and supports stem cells to regenerate tissues. PRP restores normal healing mechanisms and accelerates repair of damaged tissues.

The result is improved pain relief without the risks of cortisone injections, surgery, anesthesia, and a long recovery. Most patients can resume their work and activities immediately after treatment. In some cases, PRP therapy is an alternative to surgery.

Side effects are minimal and may include pain at the site of injection that usually lasts for a few hours and swelling that resolves within a few days.

Is PRP right for me?

When conservative methods fail to relieve pain and restore function, PRP therapy can help you heal with minimal scarring and halt tissue degeneration. It is a fast, painless procedure that takes just a few hours from start to finish.

Our physicians are specially trained in the procedures and preparation of PRP. Physicians Rehabilitation has locations in Fort Myers, Lady Lake, Naples, Port Charlotte and Sun City Center Florida for convenient, high-quality specialized sports-medicine and orthopedic services. Contact us to learn about how PRP therapy can benefit you.

---

References

• Wasserman A, Matthewson G, MacDonald P. Platelet-Rich Plasma and the Knee-Applications in Orthopedic Surgery. Curr Rev Musculoskelet Med. 2018;11(4):607–615. doi:10.1007/s12178-018-9521-0
• Lubkowska A, Dolegowska B, Banfi G. Growth factor content in PRP and their applicability in medicine.
• J Biol Regul Homeost Agents. 2012 Apr-Jun;26(2 Suppl 1):3S-22S.
• Kennedy MI, Whitney K, Evans T, LaPrade RF. Platelet-Rich Plasma and Cartilage Repair. Curr Rev Musculoskelet Med. 2018;11(4):573–582. doi:10.1007/s12178-018-9516-x
• Di Y, Han C, Zhao L, Ren Y. Is local platelet-rich plasma injection clinically superior to hyaluronic acid for treatment of knee osteoarthritis? A systematic review of randomized controlled trials. Arthritis Res Ther. 2018;20(1):128. Published 2018 Jun 19. doi:10.1186/s13075-018-1621-0
• Dai WL, Zhou AG, Zhang H, Zhang J. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2017 Mar;33(3):659-670.e1. doi: 10.1016/j.arthro.2016.09.024. Epub 2016 Dec 22.
• Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2017;12(1):16. Published 2017 Jan 23. doi:10.1186/s13018-017-0521-3
• Kaminski R, Kulinski K, Kozar-Kaminska K, et al. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma. Biomed Res Int. 2018;2018:9315815. Published 2018 Mar 11. doi:10.1155/2018/9315815
• Laver L, Marom N, Dnyanesh L, Mei-Dan O, Espregueira-Mendes J, Gobbi A. PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies. Cartilage. 2016;8(4):341–364. doi:10.1177/1947603516670709
• Dallari D^, Stagni C, Et Al. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study.
• Am J Sports Med. 2016 Mar;44(3):664-71. doi: 10.1177/0363546515620383. Epub 2016 Jan 21.
• Loibl M, Lang S, Dendl LM, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909. doi:10.1155/2016/9262909