Protective Nature of Platelet-Rich Plasma Against Chondrocyte Death When Combined With Corticosteroids or Local Anesthetics

Abstract

Background: The use of corticosteroids and local anesthetics to treat osteoarthritis has established benefits, including relief of pain and increased range of motion, but may also have the potential to lead to tissue atrophy or degeneration, specifically on chondrocytes. There is growing evidence that platelet-rich plasma (PRP) has anti-inflammatory characteristics that can limit the cytotoxic effects of corticosteroids and local anesthetics. Hypothesis/Purpose: The purpose of this study was to determine the effects of PRP in chondrocyte cultures when combined with corticosteroids or local anesthetics. The hypothesis of this study was that PRP would (1) dampen the negative effects on chondrocyte viability and (2) improve chondrocyte proliferation seen with corticosteroid or local anesthetic treatment alone. Study Design: Controlled laboratory study. Methods: Peripheral blood was obtained from 8 healthy participants, followed by centrifugation to obtain PRP. Human chondrocytes were treated with PRP alone or in combination with corticosteroids or local anesthetics. Saline (concentration of 0.9%) served as the control. Luminescence and radioactive thymidine assays were performed to examine chondrocyte viability and proliferation, respectively. Cell exposures of 0, 5, 10, and 30 minutes were used for viability and 120 hours for proliferation. Results: The presence of PRP significantly limited the negative effect on chondrocyte viability at tested time points for the examined corticosteroids and local anesthetics (P < .05). PRP in addition to corticosteroids and local anesthetics significantly improved chondrocyte proliferation (P < .05). Conclusion: The addition of PRP can significantly reduce the cytotoxic effects of corticosteroids and/or local anesthetics applied to chondrocytes. PRP can improve the proliferation of chondrocytes compared with corticosteroids or local anesthetics alone. Clinical Relevance: With the use of corticosteroids and local anesthetics for temporary symptomatic relief and improvement of function to treat the chronic progressive nature of osteoarthritis, long-term negative effects of these agents can be limited with the parallel use of PRP.