The use of platelet-rich plasma in osteoarthritis - the current state of knowledge
DOI:
https://doi.org/10.12775/JEHS.2023.44.01.002Keywords
osteoarthritis, intra-articular therapies, platelet-rich plasmaAbstract
Introduction and objective: Osteoarthritis (OA) is a chronic condition characterized by progressive damage to the joint cartilage and bone. Platelet-rich plasma (PRP) has gained increasing interest as a potential therapeutic approach for relieving symptoms and improving joint function. The aim of this article is to present the current knowledge regarding the PRP preparation method, mechanisms of action, and treatment outcomes in OA based on scientific literature and recent research.
Materials and methods: A review of scientific literature available on Google Scholar, PubMed, and Via Medica journal database was conducted using relevant keywords.
State of knowledge: Platelet-rich plasma is obtained from the patient's own blood using differential centrifugation method, resulting in a concentration of platelets (PLT) that is 300-700% higher compared to the baseline. PLTs release various biologically active substances, including growth factors, which stimulate tissue repair and regeneration processes. Numerous studies have shown that PRP administration in patients with osteoarthritis of the knee and hip joints leads to pain reduction and improved joint function. The therapeutic effect yields long-lasting results, lasting up to 12 months after the completion of the treatment.
Conclusions: The use of platelet-rich plasma (PRP) in the treatment of osteoarthritis presents a promising alternative to conventional therapies. However, further research is needed to confirm the effectiveness of PRP on a larger sample size and assess the long-term effects of this therapy. Knowledge regarding dosage, treatment protocols, and the duration of therapy remains limited.
References
Romanowski W., Zdanowska A., Romanowski M. Choroba zwyrodnieniowa stawów-aktualne standardy leczenia. [Osteoarthritis-current treatment standards]. Forum Reumatol 2016;2(2):52-57. Polish.
Abramoff B, Caldera FE. Osteoarthritis: Pathology, Diagnosis, and Treatment Options. Med Clin North Am. 2020 Mar;104(2):293-311. https://doi.org/10.1016/j.mcna.2019.10.007
Ebell MH. Osteoarthritis: Rapid Evidence Review. Am Fam Physician. 2018 Apr 15;97(8):523-526.
Nowaczyk A, Szwedowski D, Dallo I, Nowaczyk J. Overview of First-Line and Second-Line Pharmacotherapies for Osteoarthritis with Special Focus on Intra-Articular Treatment. Int J Mol Sci. 2022 Jan 29;23(3):1566. https://doi.org/10.3390/ijms23031566
Kon E, Filardo G, Matteo BD, Marcacci M. PRP For the Treatment of Cartilage Pathology. Open Orthop J. 2013; 7: 120–128. https://doi.org/10.2174/1874325001307010120
Marx RE, Carlson ER, Eichstaedt RM, et al. Platelet-rich plasma - Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Jun;85(6):638-46. https://doi.org/10.1016/s1079-2104(98)90029-4
Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. J Cutan Aesthet Surg. 2014 Oct-Dec;7(4):189-97. https://doi.org/10.4103/0974-2077.150734
Andia I, Sanchez M, Maffulli N. Joint pathology and platelet-rich plasma therapies. Expert Opin Biol Ther. 2012 Jan;12(1):7-22. https://doi.org/10.1517/14712598.2012.632765
Marwah M, Godse K, Patil S, Nadkarni N. Is There Sufficient Research Data to Use Platelet-Rich Plasma in Dermatology? Int J Trichology. 2014 Jan-Mar; 6(1): 35–36. https://doi.org/10.4103/0974-7753.136763
Prządka P, Kiełbowicz Z, Skrzypczak P. Autogenne osocze bogatopłytkowe
– rodzaje, sposoby aktywacji i zastosowanie. [Autologous platelet-rich plasma
- Types, methods of activation and application]. Med. Weter. 2016, 72 (7), 403-407. https://doi.org/10.21521/mw.5539. Polish.
Wasterlain A, Braun HJ, Dragoo JL. Contents and Formulations of Platelet-Rich Plasma. Oper Tech Orthop. 2012. 22(1):33–42.
Dovlatova N. Current status and future prospects for platelet function testing in the diagnosis of inherited bleeding disorders. Br J Haematol. 2015 Jul;170(2):150-61. https://doi.org/10.1111/bjh.13405
Lee JW, Kwon H, Kim TK, Cho YK, Choi KY, Chung HY, Cho BC, Yang JD, Shin JH. Platelet-Rich Plasma: Quantitative Assessment of Growth Factor Levels and Comparative Analysis of Activated and Inactivated Groups. Arch Plast Surg. 2013 Sep; 40(5): 530–535. https://doi.org/10.5999/aps.2013.40.5.530
Akhundov K, Pietramaggiori G, Waselle I, Darwiche S, Guerid S, Scaletta C, Hirt-Burri N, Applegate LA, Raffoul WV. Development of a cost-effective method for platelet-rich plasma (PRP) preparation for topical wound healing. Ann Burns Fire Disasters. 2012 Dec 31; 25(4): 207–213.
Zhang N, Wu YP, Qian SJ, Teng C, Chen S, Li H. Research Progress in the Mechanism of Effect of PRP in Bone Deficiency Healing. ScientificWorldJournal. 2013; 2013:134582. https://doi.org/10.1155/2013/134582
Gołos A, Treliński J. Kliniczne zastosowanie osocza bogatopłytkowego. [Clinical application of platelet-rich plasma]. Hematology in Clinical Practice. 2014 Vol 5, No 3. Polish.
Burnouf T, Goubran HA, Chen TM, Ou KL, El-Ekiaby M, Radosevic M. Blood-derived biomaterials and platelet growth factors in regenerative medicine. Blood Rev. 2013 Mar;27(2):77-89. https://doi.org/10.1016/j.blre.2013.02.001
Ghai B, Gupta V, Jain A, Goel N, Chouhan D, Kumar Batra YK. Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study. Braz J Anesthesiol. 2019 Sep-Oct;69(5):439-447. https://doi.org/10.1016/j.bjan.2019.06.003
Lin KY, Yang CC , Hsu CJ, Yeh ML, Renn JH. Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial. Arthroscopy. 2019 Jan;35(1):106-117. https://doi.org/10.1016/j.arthro.2018.06.035
Elik H, Doğu B, Yılmaz F, Begoğlu FA, Kuran B. The efficiency of platelet-rich plasma treatment in patients with knee osteoarthritis. J Back Musculoskelet Rehabil. 2020;33(1):127-138. https://doi.org/10.3233/BMR-181374
Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. 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. https://doi.org/10.1177/0363546515620383
Battaglia M, Guaraldi F, Vannini F, Rossi G, Timoncini A, Buda R, Giannini S. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics. 2013 Dec;36(12):e1501-8. https://doi.org/10.3928/01477447-20131120-13
Di Sante L, Villani C, Santilli V, Valeo M, Bologna E, Imparato L, Paoloni M, Iagnocco A. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis. Med Ultrason. 2016 Dec 5;18(4):463-468. https://doi.org/10.11152/mu-874
Chou SH, Shih CL. Efficacy of different platelet-rich plasma injections in the treatment of mild-moderate knee osteoarthritis: A systematic review and meta-analysis. Int J Clin Pract. 2021 Jun;75(6):e14068. https://doi.org/10.1111/ijcp.14068
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Copyright (c) 2023 Anna Pawlak, Anna Jaremek, Joanna Kępa, Norbert Kandefer, Michał Wyszkowski, Aleksandra Grabarczyk, Sylwia Grad, Małgorzata Gregorek, Paweł Gregorek
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