title: Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study.
abstract: OBJECTIVE
  To evaluate the clinical effects of intraarticular platelet-rich plasma (PRP) injections in a small group of patients with primary and secondary osteoarthritis. Most of the current treatments for osteoarthritis are palliative and attack the symptoms rather than influencing the biochemical environment of the joint. Autologous platelet-rich plasma has emerged as a treatment option for tendinopathies and chronic wounds. In addition to release of growth factors, platelet-rich plasma also promotes concentrated anti-inflammatory signals including interleukin-1ra, which has been a focus of emerging treatments for osteoarthritis.
  
  
  METHODS
  In this single-center, uncontrolled, prospective preliminary study, 14 patients with primary and secondary knee osteoarthritis who met the study criteria received three platelet-rich plasma injections in the affected knee at ∼4-wk intervals. Outcome measures included the Brittberg-Peterson Visual Pain (Visual Analog Scale [VAS]), Activities, and Expectations score and the Knee Injury and Osteoarthritis Outcome Scores at preinjection visit at 2-, 5-, 11-, 18-, and 52-wk follow-up visits. Musculoskeletal ultrasound was used to measure cartilage thickness.
  
  
  RESULTS
  There were no adverse events reported. The study demonstrated significant and almost linear improvements in Knee Injury and Osteoarthritis Outcome Scores, including pain and symptom relief. Brittberg-Peterson VAS showed many improvements including reduced pain after knee movement and at rest. Cartilage assessment was limited because of the small sample size. The majority of the patients expressed a favorable outcome at 12 mos after treatment.
  
  
  CONCLUSIONS
  The positive trends and safety profile demonstrated could potentially be used to inspire a larger, blinded, and randomized clinical trial to determine whether platelet-rich plasma is safe and effective for the treatment of knee osteoarthritis.
authors.affiliation: The Orthobiologic Institute, Los Angeles, California 90025, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Sampson
authors.forename: Marty
authors.initials: M
authors.lastname: Reed
authors.forename: Holly
authors.initials: H
authors.lastname: Silvers
authors.forename: Michael
authors.initials: M
authors.lastname: Meng
authors.forename: Bert
authors.initials: B
authors.lastname: Mandelbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002358:Cartilage, Articular / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000628:therapy*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010865:Pilot Projects; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult