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J Knee Surg 2017; 30(07): 627-633
DOI: 10.1055/s-0037-1603795
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Review

Nicolas S. Piuzzi
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
2   Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
3   Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
,
Morad Chughtai
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Anton Khlopas
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Steven F. Harwin
4   Adult Reconstruction Service, Mount Sinai West, New York, New York
,
Anthony Miniaci
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Michael A. Mont
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
George F. Muschler
1   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
3   Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

07 February 2017

08 May 2017

Publication Date:
23 June 2017 (online)

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Abstract

Platelet-rich plasma (PRP) consists of a volume of plasma with a platelet concentration above whole blood baseline values. Based on the group of bioactive molecules that platelets release when activated and the regenerative and healing potential they have, the use of PRP has followed a rapid development and application in orthopedics, with applications that frequently outpaces the basic science and clinical evidence supporting its use. Currently, significant heterogeneity and discrepancies exist between the different types of available PRP formulations. Because of this, although there is a vast literature on PRP, the published results are often contradictory, making it challenging to obtain definitive conclusions. Therefore, the purpose of this review article is to provide an overview of PRP with a focus on (1) preparation protocols; (2) nomenclature and classifications; (3) biological effects; and (4) clinical evidence of its role in the treatment of knee osteoarthritis. On the basis of the current evidence, although PRP injections reduced pain and improved function more efficiently when compared with controls, these findings need to be interpreted with caution due to the limited level of evidence and high risk of bias. There is a need for a standardized scientific approach for analyzing PRP formulations composition, beginning with standardization of PRP preparation protocols, and detailed characterization of the final product (e.g., platelets and leukocytes content, volume, growth factors profile). Good quality and sizeable double-blinded randomized trials will be required to establish whether or not PRP injections are effective and should be included as a standard of care for the management of patients with knee osteoarthritis.

Keywords

osteoarthritis - knee - platelet-rich plasma - intra-articular injections - PRP
 

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