Effective Dose of PRP for Knee Osteoarthritis: Key Findings from a Peer-Reviewed Study

Osteoarthritis (OA) is a prevalent condition, leading to significant pain and disability globally. With about 10% of the world’s population affected, finding effective treatments is crucial. Platelet-rich plasma (PRP) therapy has emerged as a promising regenerative solution. This blog summarizes key findings from a peer-reviewed study published in Scientific Reports, highlighting the critical dose of PRP for long-term efficacy in treating knee OA.

The study aimed to optimize the dose and concentration of PRP for knee OA, evaluating its clinical efficacy compared to hyaluronic acid (HA). A total of 150 patients with moderate knee OA were randomized to receive either PRP (10 billion platelets) or HA, with follow-up over one year.

Study Overview

The study, titled “Platelet-Rich Plasma (PRP) in Osteoarthritis (OA) Knee: Correct Dose Critical for Long-Term Clinical Efficacy,” was published in Scientific Reports in February 2021. Himanshu Bansal and colleagues conducted research to optimize the dose and concentration of therapeutic PRP for knee OA and evaluate its structural and physiological efficacy using a new manual preparation method.

Objectives

  • To determine the ideal PRP dosage and concentration for treating knee OA.
  • To compare the clinical efficacy of PRP against Hyaluronic Acid (HA), a commonly used treatment for OA.
  • To evaluate the structural and physiological improvements in patients treated with PRP.

Study Design

The study was a randomized controlled trial involving 150 patients with knee OA. Participants were divided into 75 patient groups of PRP (10 billion platelets) and HA (4 ml). The participants were followed for one year to assess the long-term effects of the treatments.

Patient Demographics

  • Age range: 52-74 years
  • Mean age: PRP group – 64.4 years, HA group – 65.8 years
  • Gender distribution: Majority male in both groups
  • Baseline clinical characteristics were comparable between the groups

Key Findings

The study provided several significant insights into the efficacy of PRP for knee OA:

Optimal PRP Dose

The researchers found that an absolute count of 10 billion platelets in 8 ml of PRP was crucial for sustained therapeutic effects. This amount of platelets is only possible with large blood draws (of approximately 50 ml or more of blood) and high platelet recovery rates.

WOMAC and IKDC Scores

WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores, which measure pain, stiffness, and physical function, showed significant improvement in the PRP group compared to the HA group.

Pain-Free Walking Distance

Patients in the PRP group exhibited a notable increase in the pain-free walking distance (6-minute walking test) compared to those in the HA group, indicating enhanced mobility and reduced pain.

Reduction in Inflammatory Cytokines

The study observed a significant decline in the levels of inflammatory cytokines IL-6 and TNF-α in the PRP group compared to the HA group at one month, correlating with reduced inflammation and pain relief.

Comparison with Hyaluronic Acid

The PRP group consistently outperformed the HA group in all measured outcomes. While the HA group showed initial improvements, these effects diminished over time, with scores returning to baseline levels or worse by the end of the study. In contrast, the PRP group maintained significant improvements throughout the one-year follow-up period.

Methodology

The study employed a novel, filtration-based manual method to prepare PRP, ensuring high platelet yield and consistency.

PRP Preparation Method

  • Blood Sample Collection: 60 ml of blood mixed with 10% ACD solution.
  • Centrifugation Steps: The platelet-rich plasma is separated by initial centrifugation at 600×g for 10 minutes and a second centrifugation at 4000×g for 15 minutes.
  • Filtration: The plasma was passed through a one-micron filter to trap platelets, which were then flushed back and combined with the initial PRP.
  • Leukocyte Removal: The mixture was passed through a white blood cell filter to ensure a leukocyte-free PRP.

Treatment Protocol

  • Injection: 8 ml of PRP or 4 ml of HA was injected into the knee joint through a supralateral approach.
  • Follow-Up: Patients were assessed at 1, 3, 6, and 12 months using WOMAC, IKDC scores, and the 6-minute walking distance test.
  • Structural Assessment: Joint space width (JSW) and cartilage thickness were evaluated using X-ray and MRI at baseline and after one year.

Assessment Metrics

  • WOMAC: Measures pain, stiffness, and physical function.
  • IKDC: Evaluates knee function and symptoms.
  • 6-Minute Walking Distance: Assesses mobility and pain-free walking capacity.

Statistical Analysis of Clinical Outcomes

WOMAC Scores:

  • The PRP group showed a significant improvement in WOMAC scores across all categories (pain, stiffness, and physical function) compared to the HA group. This improvement was sustained throughout the one-year follow-up period.
  • The HA group exhibited initial improvement at one month, but these effects diminished over time, with scores returning to baseline or worse by the end of the study.

IKDC Scores:

  • The PRP group experienced a significant increase in IKDC scores, indicating improved knee function and reduced symptoms.
  • After the initial improvement at one month, the HA group showed a decline in IKDC scores, eventually falling below baseline levels.

Pain-Free Walking Distance:

  • Patients in the PRP group showed a significant increase in the pain-free walking distance (6MWD) test compared to those in the HA group. This indicates enhanced mobility and reduced pain over the one-year period.
  • The HA group did not maintain these improvements, decreasing walking distances over time.

Practical Implications

Significance for Clinicians and Patients:

  • The study provides robust evidence supporting the use of PRP with a standardized dose of 10 billion platelets in 8 ml for treating knee OA. This can help clinicians make informed decisions about PRP therapy and optimize treatment protocols for better patient outcomes.

Potential for PRP as a Standard Treatment:

  • PRP therapy shows promise as a standard treatment for knee OA, offering a long-term solution with sustained clinical benefits. Its ability to reduce pain and improve function over a prolonged period makes it a valuable alternative to traditional treatments.

Cost-Effectiveness and Accessibility:

  • The filtration-based manual method of PRP preparation used in the study ensures a high platelet yield, making PRP therapy more cost-effective and accessible. This is particularly important for patients in developing countries where resources may be limited.

Recap of the Study’s Findings and Their Importance

The study “Platelet-Rich Plasma (PRP) in Osteoarthritis (OA) Knee: Correct Dose Critical for Long Term Clinical Efficacy” highlighted the significant benefits of PRP therapy for knee OA when administered at an optimal dose of 10 billion platelets in 8 ml. The key findings included:

  • Sustained improvement in WOMAC and IKDC scores, indicating reduced pain, stiffness, and enhanced physical function.
  • Significant increase in pain-free walking distance, showcasing better mobility.
  • Reduction in inflammatory cytokines (IL-6 and TNF-α), correlating with decreased inflammation and pain relief.
  • Better maintenance of joint space width and cartilage thickness compared to the HA group.

These results underscore the potential of PRP as a long-term, effective treatment for knee OA, offering a promising alternative to conventional therapies.

 

If you or someone you know is suffering from knee osteoarthritis, consider consulting with your healthcare provider about the potential benefits of PRP therapy. With its promising results and minimal invasiveness, PRP could be the solution to managing your OA symptoms effectively.

Explore the best PRP equipment at PRP Labs, where we provide advanced preparation equipment to ensure optimal platelet yield and therapeutic efficacy. Visit our website, PRP Labs, for more information.

References

Bansal H, Leon J, Pont JL, Wilson DA, Bansal A, Agarwal D, Preoteasa I. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Sci Rep. 2021 Feb 17;11(1):3971. doi: 10.1038/s41598-021-83025-2. Erratum in: Sci Rep. 2021 Sep 14;11(1):18612. doi: 10.1038/s41598-021-98365-2. PMID: 33597586; PMCID: PMC7889864. Link to Study

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Daniel Zengel

Daniel Zengel, an executive with over 10 years of experience in the pharmaceutical and medical device space, is dedicated to delivering industry-leading, cost-effective products to US-based medical providers. Specializing in regenerative medicine, Daniel focuses on sales, training, and marketing support to help clinics across the country successfully implement platelet-rich plasma (PRP) therapy.

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