The effects of repeated intra-articular PRP injections on clinical outcomes of early osteoarthritis of the knee.

Abstract

To assess the outcome of intra-articular platelet-rich plasma (PRP) injections into the knee in patients with early stages of osteoarthritis (OA) and to determine whether cyclical dosing would affect the end result. This is a prospective, randomized study in which 93 patients (119 knees) were followed up for a minimum of 2years. Fifty knees were randomly selected prior to the first injection, to receive a second cycle at the completion of 1year. A cycle consisted of three injections, each given at a monthly interval. The outcome was assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS), Tegner and Marx scoring systems, recorded prior to the first injection and then at 12, 18 and 24months. There was a significant improvement in all scores over time compared to the pre-treatment value (p<0.001). At 12months, both groups showed similar and significant improvement. At 18months, except for KOOS (Symptoms) and Tegner score, all other parameters showed a significant difference between the two groups in favour of the patients who had received the second cycle (p<0.001). At 2years, the scores declined in both groups but remained above the pre-treatment value with no significant difference between the groups despite the patients with two cycles showing higher mean values for all the scores. Intra-articular PRP injections into the knee for symptomatic early stages of OA are a valid treatment option. There is a significant reduction in pain and improvement in function after 12months, which can be further improved at 18months by annual repetition of the treatment. Although the beneficial effects are ill sustained at 2years, the results are encouraging when compared to the pre-treatment function. II.