Featured Research

from universities, journals, and other organizations

Platelet-rich plasma (prp) treatment shows potential for knee osteoarthritis

Date:
February 12, 2013
Source:
Hospital for Special Surgery
Summary:
A new study has shown that platelet-rich plasma (PRP) holds great promise for treating patients with knee osteoarthritis. The treatment improved pain and function, and in up to 73% of patients, appeared to delay the progression of osteoarthritis.

A study by researchers from Hospital for Special Surgery has shown that platelet-rich plasma (PRP) holds great promise for treating patients with knee osteoarthritis. The treatment improved pain and function, and in up to 73% of patients, appeared to delay the progression of osteoarthritis, which is a progressive disease. The study appears online, ahead of print, in the Clinical Journal of Sports Medicine.

Related Articles


"This is a very positive study," said Brian Halpern, M.D., chief of the Primary Care Sports Medicine Service at Hospital for Special Surgery, New York City, and lead author of the study.

Several treatments for osteoarthritis exist, including exercise, weight control, bracing, nonsteroidal anti-inflammatories, Tylenol, cortisone shots and viscosupplementation, a procedure that involves injecting a gel-like substance into the knee to supplement the natural lubricant in the joint. A new treatment that is being studied by a small number of doctors is PRP injections. PRP, which is produced from a patient's own blood, delivers a high concentration of growth factors to arthritic cartilage that can potentially enhance healing.

"You take a person's blood, you spin it down, you concentrate the platelets, and you inject a person's knee with their own platelets in a concentrated form," said Dr. Halpern. "This then activates growth factors and stem cells to help repair the tissue, if possible, calm osteoarthritic symptoms and decrease inflammation."

In the new study, researchers at Hospital for Special Surgery enrolled patients with early osteoarthritis, gave them each an injection of PRP (6-mL), and then monitored them for one year. Fifteen patients underwent clinical assessments at baseline, one week, and one, three, six, and 12 months. At these time points, clinicians used validated tools to assess overall knee pain, stiffness and function, as well as a patient's ability to perform various activities of daily living. At baseline and then one year after the PRP injection, physicians also evaluated the knee cartilage with magnetic resonance imaging (MRI), something that has not previously been done by researchers in other PRP studies. The radiologists reading the MRIs did not know whether the examination was performed before or after the PRP treatment.

"The problem with a lot of the PRP studies is that most people have just used subjective outcome instruments, such as pain and function scores," said Hollis Potter, M.D., chief of the Division of Magnetic Resonance Imaging at Hospital for Special Surgery, another author of the study. "But even when patients are blinded, they know there has been some treatment, so there is often some bias interjected into those types of studies. When you add MRI assessment, it shows you the status of the disease at that time, regardless of whether the patient is symptomatic or asymptomatic or they have good or poor function in the knee. You find out what the cartilage actually looks like. We can noninvasively assess the matrix or the building blocks of cartilage."

While previous studies have shown that patients with osteoarthritis can lose roughly five percent of knee cartilage per year, the HSS investigators found that a large majority of patients in their study had no further cartilage loss. "The knee can be divided into three compartments, the medial compartment, the lateral compartment and the patellofemoral compartment," said Dr. Halpern. "If we look at these compartments individually, which we did, in at least 73% of these cases, there was no progression of arthritis per compartment at one year. That is very significant, because longitudinal studies suggest a four to six percent progression of arthritis at one year."

Treatment with PRP was also useful in improving pain, stiffness and function. The investigators found that pain, measured by a standard test called the Western Ontario and McMaster Universities Arthritis Index, significantly improved with a reduction of 41.7% at six months and 55.9% at one year. On a pain scale commonly used by clinicians called the Visual Analog Scale, pain was reduced by 56.2% at six months and 58.9% at one year. Functional scores improved by 24.3% at one year. Activity of Daily Living Scores also showed a significant increase at both six months (46.8%) and one year (55.7%).

"We are entering into an era of biologic treatment, which is incredibly ideal, where you can use your own cells to try to help repair your other cells, rather than using a substance that is artificial," Dr. Halpern said. "The downside is next to zero and the upside is huge." Dr. Halpern pointed out, however, that the study is a small case series and PRP needs to be pitted against a traditionally treated group in a randomized, controlled trial.

Osteoarthritis, which causes pain and joint stiffness, impacts over 27 million Americans and is a leading cause of disability. According to statistics from the Centers for Disease Control and Prevention, overall osteoarthritis affects 13.9% of adults aged 25 and older and 33.6% of those older than 65. The disease is characterized by degeneration of cartilage and its underlying bone within a joint as well as bony overgrowth. Disease onset is gradual and usually begins after the age of 40.

Other HSS investigators involved in the study include Salma Chaudhury, M.D., Ph.D, Scott Rodeo, M.D., Catherine Hayter, MBBS, Eric Bogner, M.D., and Joseph Nguyen, MPH.


Story Source:

The above story is based on materials provided by Hospital for Special Surgery. Note: Materials may be edited for content and length.


Journal Reference:

  1. Brian Halpern, Salma Chaudhury, Scott A. Rodeo, Catherine Hayter, Eric Bogner, Hollis G. Potter, Joseph Nguyen. Clinical and MRI Outcomes After Platelet-Rich Plasma Treatment for Knee Osteoarthritis. Clinical Journal of Sport Medicine, 2012; 1 DOI: 10.1097/JSM.0b013e31827c3846

Cite This Page:

Hospital for Special Surgery. "Platelet-rich plasma (prp) treatment shows potential for knee osteoarthritis." ScienceDaily. ScienceDaily, 12 February 2013. <www.sciencedaily.com/releases/2013/02/130212171957.htm>.
Hospital for Special Surgery. (2013, February 12). Platelet-rich plasma (prp) treatment shows potential for knee osteoarthritis. ScienceDaily. Retrieved April 1, 2015 from www.sciencedaily.com/releases/2013/02/130212171957.htm
Hospital for Special Surgery. "Platelet-rich plasma (prp) treatment shows potential for knee osteoarthritis." ScienceDaily. www.sciencedaily.com/releases/2013/02/130212171957.htm (accessed April 1, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, April 1, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) — Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com
Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins