Is Platelet-Rich Plasma (PRP) a safe and effective treatment for osteoarthritis of the knee?
The answer to this question depends on your age, health status, and other factors. However, there are some things that everyone needs to know before they decide whether PRP is right or wrong for them.
What is PRP?
Platelets are white blood cells which help fight infections and other diseases. They are present in all body tissues including joints. When these white blood cells become damaged, they release substances called cytokines into the bloodstream. These cytokines cause inflammation and pain. Some of these cytokines include interleukin-1beta (IL-1β), tumor necrosis factor alpha (TNFα), interferon γ (IFNγ), IL-6, and others.
In order to prevent further damage from the cytokine, the body produces new platelets. This process is known as autologous platelet production. There are two types of platelets: monocytes and macrophages.
Monocytes are white blood cells found in large numbers in the blood stream; they help control infection and other diseases. Cytokines released by platelets can cause destruction of cartilage in the body. However, as we age, the amount of cytokines decreases and some cytokines such as TNFα and IL-1β are known to cause inflammation which in turn stops the disease. The process of controlling and regulating cytokines is important for the health of the body at all ages.
What is PRP treatment normally used for?
Platelet-rich Plasma is used to treat and prevent various medical conditions and is normally injected back into the body. It can be injected into the body as a liquid (20 to 40 cc), or it can be injected into muscles as a fine powder.
The immune system of the body normally deals with foreign objects such as bacteria, viruses, and other pathogens. If these bacteria and viruses enter the body, they can cause inflammation which leads to pain and discomfort. But these foreign objects are not always bacteria or viruses.
Some of them are the white blood cells. It is important to keep the right amount of white blood cells in the body. The immune system will always produce more white blood cells when it needs them and remove them when they are no longer needed. Sometimes however, this process can go wrong and too many white blood cells are produced. In these cases, the body may benefit from a treatment with platelets.
These platelets have growth factors (proteins), which help prevent or treat low-grade inflammation.
What are the other names for PRP?
Autologous conditioned plasma
Stem cell therapy using platelet-rich plasma
Platelet-rich plasma therapy is a type of treatment which uses the blood from your body to treat or prevent diseases and conditions such as osteoarthritis, rheumatoid arthritis, tendonitis, cartilage damage, and more.
What is the typical PRP treatment procedure?
First, you will be asked to fill out a health questionnaire which will ask questions related to your medical history and your current condition. Your blood sample will be drawn and you may have to wait for about an hour before proceeding to the next step.
After drawing your blood, the lab technicians will spin it in a centrifuge at high speed. The purpose of this is to separate the various elements in your blood.
The liquid part (plasma) which contains the platelets will be drained from the tube and placed in a special container. The lab technician will then add a specific amount of normal saline solution to your platelets. The amount of liquid added is very critical since too much or too little will make the entire procedure useless.
The platelet and liquid mixture is then placed in a machine which uses sound waves to create small bubbles in the mixture. Now, here is where things get interesting!
The small bubbles which are created in the mixture have an important role to play. These microbubbles will make your blood more viscous or “thicker”. This increased viscosity prevents the growth of white blood cells and other foreign bodies in your body.
In other words, your body is less likely to reject the mixture since it is similar in nature to your own blood.
The next step involves placing this mixture in a syringe and injecting it into your body. Normally, PRP is injected directly into the area in which you are suffering from pain. For instance, if you have pain in your knee, then that is where the injection will be made.
The entire process takes about 15 to 20 minutes and there is minimal discomfort.
Once the PRP is injected, you will have to wait for its effects to manifest. You may experience some mild bruising or swelling at the injection site. In some cases, patients have reported feeling immediate relief from their pain.
What types of medical conditions can be treated with PRP?
PRP is used to treat a host of medical conditions. Some of the most common uses are listed below:
The use of platelet-rich plasma is an excellent treatment option for osteoarthritis which is also referred to as “wear and tear” arthritis. It is caused by the degeneration of cartilage in the joints which leads to painful symptoms. In most cases, patients experience a reduction in joint function and minor changes in their bone structure.
Although there is no known cure for osteoarthritis, PRP injections have been proven to provide relief from pain as well as boosting the healing process. In fact, some doctors suggest that the effects of this therapy last longer than conventional treatment options such as painkillers or even hyaluronic acid (HA) injections.
Chronic Ankle Pain
Ankle sprains are a common cause of pain in the ankles. In most cases, the ligaments in the joint are injured due to trauma or excessive stress. This can occur when a person lands awkwardly while running or jumping.
The injection of platelet-rich plasma into the ankle can help treat chronic ankle pain caused by these sports injuries or even just day-to-day wear and tear. The therapy also stimulates the growth of collagen and regenerative tissue.
Chronic Shin Splints
Shin splints is a condition that involves pain and inflammation in the muscles of the shin. This is most commonly seen in people who are on their feet all day such as nurses or those in the military.
This type of injury is almost always caused by excessive stress being put on the muscles and tendons of the lower legs. This can sometimes be caused by the patient having flat feet or wearing improper shoes.
Patients who suffer from shin splints experience pain when running, walking or jumping. The pain tends to manifest itself in the inner part of the leg and becomes worse over time. Although rest and over-the-counter pain medication can provide temporary relief, it does not address the cause of the injury.
Sources & references used in this article:
Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid by T Spaková, J Rosocha, M Lacko… – American Journal of …, 2012 – journals.lww.com
Knee osteoarthritis injection choices: platelet-rich plasma (PRP) versus hyaluronic acid (a one-year randomized clinical trial) by SA Raeissadat, SM Rayegani… – Clinical Medicine …, 2015 – journals.sagepub.com
Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis by SJ Jang, JD Kim, SS Cha – European Journal of Orthopaedic Surgery & …, 2013 – Springer
Allogeneic platelet-rich plasma: at the dawn of an off-the-shelf therapy? by E Anitua, R Prado, G Orive – Trends in biotechnology, 2017 – Elsevier
Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip by M Sánchez, J Guadilla, N Fiz, I Andia – Rheumatology, 2012 – academic.oup.com
Intra-articular injections of expanded mesenchymal stem cells with and without addition of platelet-rich plasma are safe and effective for knee osteoarthritis by R Bastos, M Mathias, R Andrade, R Bastos… – Knee Surgery, Sports …, 2018 – Springer