Source: Giuseppe et al report findings on platelet-rich plasma intra-articular knee injections verses viscossupplementation for the treatment of knee arthritis in a randomized controlled trial recently published in the American Journal of Sports Medicine.
Over the course of our life, nearly half of us will face some degree of knee arthritis. To ensure many active years to come, new minimally invasive treatments for early stage osteoarthritis (OA) have been proposed.
Two of these treatments include Platelet-Rich Plasma (PRP) procedures and Viscosupplementation.
Platelet-Rich Plasma (PRP)
The use of PRP procedures has grown in many realms of medicine. Its use is believed effective in a range of areas, including wound healing and the treatment of tennis elbow, Achilles tendonitis, ligament and muscle damage, fractures, joint degeneration and more. PRP has become a popular treatment for patients who continue to suffer from pain and/or swelling despite trying other nonsurgical, conservative treatments.
Known best for their role in clotting blood, platelets also contain growth factors (proteins) integral to healing. PRP is plasma, which contains more platelets than what is generally found in blood. It is prepared by taking the patient’s own blood and separating the platelets from other blood cells using a special device and one or two-step centrifugation process. PRP is then injected into the arthritic knee.
Another popular treatment for arthritis of the knee is viscosupplementation, a gel-like fluid known as hyaluronic acid, which is a naturally occurring substance found in the synovial fluid surrounding healthy joints. Injected into the arthritic knee, it is expected to mimic and support this naturally occurring fluid serving as a lubricant that allows the bones to again glide smoothly over one another – reducing pain and facilitating knee movement.
Both PRP and viscosupplementation procedures are recommended after other nonsurgical, conservative treatments for arthritis of the knee no longer prove effective in reducing pain and improving function. Both are reported to reduce inflammation associated with osteoarthritis, reduce pain and facilitate knee movement.
To date, though, there is relatively little scientific data showing that one is better than the other. Therefore researchers have focused efforts in this area. One such newly published study examined 192 patients, who showed evidence of early stage osteoarthritis of the knee and experienced chronic knee pain and/or swelling for at least four months (1). The patients received three weekly intra-articular injections of either PRP or HA (viscosupplementation) and were assessed at two, six and 12 months following the treatment.
The results of the study conducted by Giuseppe et al. showed that while both treatments proved to be effective in improving knee function and reducing symptoms, the comparative analysis of the two showed “no significant intergroup difference at any follow-up evaluation in any of the clinical scores adopted.”
The investigators of this study concluded that PRP offers no superior clinical improvement to HA and should not be preferred to viscosupplementation as injection treatment for OA patients and those affected by knee cartilage degeneration (1).
- Giuseppe F, Berardo DM, Alessandro DM, et al. Platelet-Rich Plasma Intra-articular Knee Injections Show No Superiority Versus Viscosupplementation. A Randomized Controlled Trial. Published online before print May 7, 2015, doi: 10.1177/0363546515582027 Am J Sports Med July 2015 vol. 43 no. 7 1575-1582