Updated: Jan 5, 2021
Platelet-rich plasma (PRP) uses platelets from your own body to help reduce pain and improve function in mild osteoarthritis of the knee. There are numerous randomized control studies showing that PRP can be a therapeutic option for patients with this type of knee pain. In patients reporting an 8 out of 10 on the pain scale, PRP treatment can reduce the pain levels by more than half. Patients typically see PRP effects in 4-6 weeks and benefits can last at least a year.
Critical components of successful PRP
But not all PRP is not created equal. First, the correct proportion of plasma components is critical in patient outcomes. It is important to measure the volume of platelets in the patient sample as well as the proportion and type of white blood cells (we don't want to see neutrophils). Secondly, PRP has better long-term patient outcomes if administered under ultrasound guidance. Studies have shown that ultrasound-guided PRP injections prevented patients from requiring knee replacements several years later. Additionally, the patient's knee anatomy, including bone alignment, should be examined to determine if the patient is a good candidate for the procedure. Patients in advanced stages of osteoarthritis may not benefit from PRP.
Preparing for the procedure
Adequate preparation by patients is simple but crucial. In order to get the best platelets, it is important not to use ibuprofen (2 weeks prior and 2 weeks post procedure), eat a healthy diet and implement a rehabilitation program. This is all a part of the integrated medicine approach - to combine cellular treatment and physical rehabilitation to achieve the best possible outcomes for the patient.
What patients can expect during the appointment
At the first appointment, a patient history is taken, a physical examination is performed and images (x-rays) are reviewed. Good PRP candidates should have already been treated through therapy and bracing. During the follow-up appointment, the patient's blood is taken. Platelets are then extracted while the patient waits, which takes ~20 mins using centrifugation. Next, a local anesthetic is administered and the platelets are injected into the knee under ultrasound guidance. After the procedure, the patient should rest for a few days. During this time, some minimal pain is normal. A therapy protocol with a physical therapist helps the patient's progressive return to normal activities over the next few weeks.
Patients should expect to see knee pain improvement within a few weeks following the PRP procedure and lasting a year or longer.