Both doctors and their patients are more willing than ever before to consider platelet-rich plasma (PRP) injections to treat osteoarthritis in the knee. Yet as beneficial as the therapy is for many patients, it does not work for everyone. Researchers want to know why. A recent study conducted by the National Center for Biotechnical Information is being welcomed by PRP therapy proponents because it offers a bit more clarity.
If there is one thing we know about PRP therapy for osteoarthritis it is the fact that there are few standards among clinicians. Clinicians differ in their approach to dosage and treatment length. Some clinicians inject the serum in roughly the same location for all patients, others use imaging techniques to locate the best site for injection.
Apex Biologix, a company that supplies doctors with centrifuges and PRP kits, says that clinicians even prepare their serums in different ways. With so many ways of doing things, we would expect the results of PRP injections to vary greatly in patients. They do. That is what makes this most recent research so important.
7 Things for Clinicians to Consider
The researchers behind this latest study looked at numerous factors they believe could influence the efficacy of PRP injections for osteoarthritis of the knee. Their research produced some surprising findings. In light of what they found, there are 7 things for clinicians to consider:
1. PRP Serum Constituents
The constituents of PRP serum can vary depending how the serum is produced. Research seems to indicate that leucocyte-poor platelet-rich plasma (L-PRP) is the best option for osteoarthritis. An L-PRP serum appears to increase the production of cells that generate cartilage.
2. PRP Dosage
One of the least uniform aspects of PRP therapy is dosage. Some doctors prefer higher doses over a shorter treatment period while other doctors believe in the opposite approach. The research indicates that the latter approach is probably better. Smaller doses given over a longer period seem to achieve better results.
3. Obtaining and Processing PRP
It is fairly common for doctors to extract blood and create a single dose for every injection. The research has found that it is possible to draw more blood and create multiple doses that can be frozen for later use without inhibiting the efficacy of future injections.
4. General Condition of Patients
PRP therapy is like any other medical procedure in that results vary based on the general condition of patients. Researchers have shown that younger patients with a lower body mass index respond more positively to PRP injections.
5. Injection Sites
Injecting PRP serum directly into the knee joint may not be the best way to promote healing. Rather, the research suggests that injecting into bone marrow could prove more efficacious. The mechanism behind this is not clear at this time.
6. Combining Treatments
The research has confirmed something a few clinicians have suspected for a long time: PRP therapy is more effective as an osteoarthritis treatment when it is combined with other treatments. The research specifically mentions combining PRP with hyaluronic acid, gelatin, and chitosan. Although researchers did not cite physical therapy, there are clinicians who swear by it as a companion treatment.
7. Photoactivated PRP
Finally, the research suggests that photoactivated PRP serum may offer better results than non-activated serum. Clinicians can photoactive PRP using a fast and simple procedure involving light exposure.
It is clear that PRP therapy is being taken seriously by researchers. As the evidence mounts, it is becoming more and more apparent that osteoarthritis can be treated with minimally invasive knee injections.