An experimental new treatment that uses a patient’s own blood platelets to ease knee arthritis has been found to be effective and safe, potentially offering a natural alternative to cortisone shots and other current therapies.
The treatment — known as PRP, short for platelet-rich plasma — involves injecting the liquid component of a patient’s own blood into the knee to deliver a high concentration of growth factors to arthritic cartilage that can enhance healing.
A study, by researchers from the Hospital for Special Surgery in New York City, has shown that PRP greatly improves pain and function in patients with knee osteoarthritis. It also found that the treatment appeared to delay the progression of the disease in up to 73 percent of patients.
"This is a very positive study," said Brian Halpern, M.D., chief of the Primary Care Sports Medicine Service at the hospital, who led the study, published online in the Clinical Journal of Sports Medicine.
"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."
Current treatments for osteoarthritis involve 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.
But a small number of doctors who are testing PRP in patients have found it holds great promise.
For the new study, researchers enrolled 15 patients with early osteoarthritis, gave each an injection of PRP, and then monitored them for one year, evaluating overall knee pain, stiffness, function, and the ability to perform various activities of daily living. Physicians also evaluated the knee cartilage with magnetic resonance imaging (MRI).
The results showed PRP helped ease the patients’ knee pain and stiffness, while improving function. Using a standardized pain measurement scale, researchers found patients’ pain levels were reduced by more than 56 percent at six months and nearly 59 percent at one year. They also showed improvements in knee function and, for a large majority of patients, there was no additional cartilage loss after PRP treatment.
"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."
Osteoarthritis, which causes pain and joint stiffness, affects more than 27 million Americans and is a leading cause of disability. According to the Centers for Disease Control and Prevention, osteoarthritis affects 14 percent of adults aged 25 and older and nearly a third of those older than 65.