PRP injections with high platelet concentrations may improve outcomes for knee OA
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Key takeaways:
- Platelet-rich plasma injections with high platelet counts may yield superior outcomes for patients with osteoarthritis.
- High platelet concentration was defined as more than 1,200,000 platelets per L of PRP.
Published results showed platelet concentration may impact clinical outcomes for patients who receive platelet-rich plasma injections for knee osteoarthritis, as injections with higher platelet counts were associated with superior outcomes.
Angelo Boffa, MD, and colleagues from the Rizzoli Orthopedic Institute in Bologna, Italy, performed a cohort study of 253 patients (mean age, 54.8 years) who were treated with intra-articular PRP injections for knee OA, defined by Kellgren Lawrence grades 1, 2 or 3.
According to the study, all patients received three weekly intra-articular knee injections of 5 mL of autologous PRP. Overall, 40 patients received injections with low platelet concentration, defined as fewer than 800,000 platelets per L of PRP; 153 patients received injections with medium platelet concentration, defined as between 800,000 and 1,200,000 platelets per L of PRP; and 60 patients received injections with high platelet concentration, defined as more than 1,200,000 platelets per L of PRP.
Outcome measures included IKDC and KOOS scores at 2-month, 6-month and 1-year follow-ups.
Boffa and colleagues found the three cohorts had an overall statistically significant improvement in clinical scores from baseline to all follow-ups. However, they found a positive correlation between platelet concentration and clinical outcomes.
Patients in the high-platelet cohort had significantly better improvements in KOOS pain scores, KOOS subscales and IKDC subjective scores compared with patients in the low-platelet cohort. In addition, patients in the medium-platelet cohort had significantly better improvements in KOOS symptom scores at 2 months compared with patients in the low-platelet cohort.
Overall, six patients (15%) in the low-platelet cohort, five patients (3.3%) in the medium-platelet cohort and two patients (3.3%) in the high-platelet cohort were deemed to have failed treatment. However, Boffa and colleagues noted no significant differences in complication rates found between the three cohorts.
“The results of this study shed new light on the PRP field and could explain some controversial literature findings on the potential of this orthobiologic approach for patients with knee OA,” Boffa and colleagues wrote in the study.
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