Platelet Rich Plasma (PRP) Injections

What is PRP?

Knee osteoarthritis (OA) is a common degenerative joint disease that causes pain, stiffness, and reduced mobility. Platelet-rich plasma (PRP) is an innovative treatment option that has gained popularity in recent years. PRP (platelet-rich plasma) therapy has shown promise in promoting the healing and regeneration of damaged tissues, including cartilage, in various joint conditions such as osteoarthritis. However, it is important to note that while PRP may help reduce inflammation, alleviate pain, and potentially slow down cartilage degeneration, it is not proven to cause full cartilage regrowth. 

PRP Preparation Process

PRP is created from a patient's own blood. The process involves collecting a small amount of blood, which is then placed in a centrifuge to separate its components. This centrifugation process isolates platelets, which are cells rich in growth factors that promote tissue healing and regeneration. The platelet-rich portion of the blood is then recombined with a small amount of plasma to create PRP, which is injected directly into the affected knee joint. 

Ideal Candidates for PRP Treatment

Patients with mild to moderate knee OA may benefit most from PRP treatment, as it can help alleviate pain, reduce inflammation, and promote tissue healing. PRP may not be as effective for patients with severe OA or those who have significant joint instability or deformity.

Evidence Supporting PRP Treatment

Several studies and clinical trials have demonstrated the effectiveness of PRP in treating knee OA. For example, a 2018 meta-analysis published in the American Journal of Sports Medicine found that PRP injections were more effective than hyaluronic acid (HA) injections and placebo in reducing pain and improving function in patients with knee OA. Another study published in the Journal of Bone and Joint Surgery in 2020 showed that PRP was more effective than corticosteroid injections in reducing pain and improving function in patients with knee OA over a one-year follow-up period. A significant amount of research is currently underway to assess the efficacy of PRP injections. However, the existing literature is limited by the use of diverse PRP preparation methods and dosing regimens, which affects the quality of the studies.

Potential Side Effects and Risks

PRP treatment has a relatively low risk of complications due to the use of the patient's own blood. However, some potential side effects and risks may include:

1. Pain or discomfort at the injection site

2. Infection, though rare, as with any injection

3. Allergic reaction to the local anesthetic, if used during the procedure

4. No guarantee of effectiveness, as individual responses to PRP treatment may vary 

Cost-Effectiveness and Patient Outcomes

PRP treatment can be more expensive than other non-surgical options, such as pain medication and corticosteroid injections. However, PRP may provide longer-lasting pain relief and functional improvement, potentially reducing the need for more invasive treatments, such as joint replacement surgery. It is essential to consider the potential benefits and costs of PRP treatment compared to alternative options when making a decision about your treatment plan.

Long-Term Effects and Sustainability of PRP Treatment

While some studies have shown promising results with PRP treatment for knee OA, the long-term effects and sustainability of PRP treatment are still being researched. PRP may provide temporary pain relief and functional improvement, but it is not a cure for knee OA. PRP may help to delay the progression of the disease and the need for more invasive treatments, but further research is needed to determine the full extent of its long-term benefits. 

Success Rates, Duration of PRP Injection Effects, and Treatment Frequency

Success rates for PRP treatment vary, but many patients experience significant pain relief and improved function after receiving PRP injections. The duration of the effects of PRP injections can range from several months to over a year, depending on the individual patient and the severity of their knee OA. Some patients may require additional PRP injections to maintain the benefits, while others may only need one or two treatments.

The optimal frequency of treatments relies on the patient's response to PRP injections and the severity of their condition. Multiple studies have established that receiving three PRP injections, spaced two weeks apart, may offer enhanced benefits for knee osteoarthritis compared to a single injection. Mr Pai will carefully assess your circumstances to determine the most suitable treatment schedule for your needs.

Controversies and Differing Opinions Surrounding PRP for Knee OA

Several controversies and differing opinions surround the use of PRP for knee OA. Some healthcare professionals argue that more research is needed to establish standardised PRP preparation methods and treatment protocols. Additionally, there is debate regarding the optimal concentration of platelets in PRP and the best method for administering the injections.

Another point of contention is the cost of PRP treatment, as it is often not covered by insurance and can be expensive compared to other treatment options. Some critics argue that the high cost of PRP is not justified, given the lack of long-term studies and inconsistent results across existing research.

Despite these controversies, many patients have reported positive outcomes with PRP treatment for knee OA. As research continues, more evidence is expected to emerge to support the use of PRP in treating knee OA and potentially guide the development of standardised treatment protocols. 

PRP for knee osteoarthritis at Sandringham Orthopaedic Specialists

Mr Pai provides intra-articular PRP injections for the knee in his practice at Sandringham Orthopaedic Specialists. An initial consultation with Mr Pai is required to determine if PRP is recommended for your situation. If PRP is deemed suitable, a separate appointment will be scheduled to administer the injection. Mr Pai uses the Arthrex ACP Max system for knee osteoarthritis. This can concentrate platelets at 10-12 times the concentration in the bloodstream.

Regrettably, Medicare rebates do not cover PRP injections. Much of the expense is attributed to the consumable items required for the procedure.