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With each movement, you are reminded of the pain from osteoarthritis.  The medications and therapy have not eased the pain.  Your doctor recommended PRP.  What is osteoarthritis?  What is PRP?  What three joints benefit from PRP for Osteoarthritis?  Let’s dig in.

 

What Is Osteoarthritis?

To discuss PRP for Osteoarthritis we need to define Osteoarthritis. Arthritis is a general term for painful conditions that involve one or more body joints such as the knee and hip.  Most types of arthritis involve pain, swelling, and stiffness.  There are more than 100 types of arthritis.  Osteoarthritis is the most common form of arthritis affecting more than 30 million adults in the united states (1).  It involves the breakdown of the protective cartilage.  In 2013 osteoarthritis was the second most expensive condition treated in US hospitals accounting for more than $165 billion in hospital costs (2).  Other types of arthritis include rheumatoid arthritis, juvenile arthritis, and gout.

 

What Is PRP?

PRP stands for Platelet-Rich Plasma.  Platelets are blood cells that prevent bleeding.  They contain important growth factors that aid in healing.  Plasma is the light yellow liquid portion of our blood.  So PRP is simply a concentration of a patient’s own platelets that are suspended in plasma and are used to accelerate healing.  PRP is NOT stem cell therapy.  Regrettably, blood contains few circulating stem cells.   Rich sources of stem cells are bone marrow and fat.

PRP is rich in growth factors.  There are many different types of growth factors with different properties. VEGF is a very important one as it can increase the blood flow to an area.  Blood flow brings important nutrients to damaged tissue and can stimulate repair and healing.  Regrettably, tendons, ligaments, and most parts of the spine have a poor blood supply.  This makes injuries difficult to heal.  PRP for Osteoarthritis can facilitate repair and healing by increasing the amount of blood flow.

To learn more about PRP please click on the video below.

 

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3 Joints that Benefit from PRP for Osteoarthritis

 

Knee Osteoarthritis

Knee osteoarthritis is typically the result of wear and tear and progressive loss of the protective cartilage.  Approximately 13% of women and 10% of men aged 60 years and older have symptomatic knee osteoarthritis (3). Risk factors for knee osteoarthritis include old age, female gender, obesity, knee injuries, muscle weakness, and ligament laxity (4).  Is PRP effective in the treatment of knee osteoarthritis?  ABSOLUTELY!!  To date, there are 27 randomized control studies on PRP injections in the treatment of knee osteoarthritis.  A previous blog discussed PRP for Osteoarthritis of the Knee at length.  Key Points:

  • PRP is superior to steroids in reducing pain and increasing function (5, 6)
  • PRP is superior to exercise alone (7)
  • PRP was superior to lubricant knee injections (8)
  • PRP can delay the need for knee replacement (9)

 

Hand Osteoarthritis

Hand arthritis is common affecting women more than men.  The pain, loss of movement, and loss of strength can be disabling.  Steroids are often recommended but should be avoided as they are toxic to cartilage.   PRP is more effective than steroids in reducing pain and increasing function (10).

 

Hip Osteoarthritis

Hip osteoarthritis is common with a prevalence of 19.6% in patients 50 years old and over. It is associated with pain, restricted level of activity, diminished mobility, and increased risk for falls.  Lubricant injections called hyaluronic acid (HA) are often recommended when other conservative treatment options fail. These are similar to the lubricant injections used in the knees.

PRP is more effective than hyaluronic acid in reducing pain and increasing function (11).

 

Experts in PRP for Osteoarthritis

At the Centeno-Schultz Clinic, we are experts in the treatment of osteoarthritic conditions.  Treatment options include PRP and bone marrow-derived stem cell injections.  The Centeno-Schultz Clinic was the first clinic in the world to inject stem cells in the lumbar spine.  We have published extensively in the field of regenerative orthopedics providing patients an alternative to the risks and complications associated with traditional orthopedic surgery. We have also published our results which are available by clicking here.

 

In Conclusion

Osteoarthritis can be debilitating.  It is the most common form of arthritis and involves the inflammation of one or more joints, swelling, pain, and stiffness.  When severe it can limit one’s mobility and ability to function.  PRP stands for Platelet Rich Plasma.  It is a concentration of a patient’s own platelets that are suspended in plasma.  PRP is rich in growth factors that can stimulate repair and healing.  PRP for osteoarthritis is effective for patients with ongoing knee, hand, and hip pain and limitations due to osteoarthritis.  Using your own platelets allows patients to avoid the risks of steroids and the complications associated with orthopedic surgery.

 

 

Osteoarthritis can rob you of freedom and dignity.  It starts out mild and progresses.  Act now while the issues are small and treatable.  If your doctor tells you that PRP is pixie dust and not supported by evidence please tell him that it is time to attend to his homework.  27 randomized controlled studies exist on the use of PRP in orthopedic conditions.  Contact us today to schedule a telemedicine appointment and learn about your candidacy so that you can live pain-free without dependence on narcotics or NSAID’s.

References

1.Cisternas MG, Murphy L, Sacks JJ, Solomon DH, Pasta DJ, Helmick CG. Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken). 2016 May;68(5):574-80. doi: 10.1002/acr.22721. PMID: 26315529; PMCID: PMC4769961.

2.Cisternas MG, Murphy L, Sacks JJ, Solomon DH, Pasta DJ, Helmick CG. Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken). 2016 May;68(5):574-80. doi: 10.1002/acr.22721. PMID: 26315529; PMCID: PMC4769961.

3.Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011;2(2):205-212.

4.Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010 Aug;26(3):355-69. doi: 10.1016/j.cger.2010.03.001. Erratum in: Clin Geriatr Med. 2013 May;29(2):ix. PMID: 20699159; PMCID: PMC2920533.

5.Forogh B, Mianehsaz E, Shoaee S, Ahadi T, Raissi GR, Sajadi S. Effect of single injection of platelet-rich plasma in comparison with corticosteroid on knee osteoarthritis: a double-blind randomized clinical trial. J Sports Med Phys Fitness. 2016 Jul-Aug;56(7-8):901-8. Epub 2015 Jul 14. PMID: 26173792.

6.Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2016 Mar;32(3):495-505. doi: 10.1016/j.arthro.2015.08.005. Epub 2015 Oct 1. PMID: 26432430.

7. Rayegani SM, Raeissadat SA, Taheri MS, Babaee M, Bahrami MH, Eliaspour D, Ghorbani E. Does intra articular platelet rich plasma injection improve function, pain and quality of life in patients with osteoarthritis of the knee? A randomized clinical trial. Orthop Rev (Pavia). 2014 Sep 18;6(3):5405. doi: 10.4081/or.2014.5405. PMID: 25317308; PMCID: PMC4195987.

8. Huang, Y., Liu, X., Xu, X. et al. Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis. Orthopäde 48, 239–247 (2019). https://doi.org/10.1007/s00132-018-03659-5

9. Sánchez M, Jorquera C, Sánchez P, Beitia M, García-Cano B, Guadilla J, Delgado D. Platelet-rich plasma injections delay the need for knee arthroplasty: a retrospective study and survival analysis. Int Orthop. 2020 Jul 3. doi: 10.1007/s00264-020-04669-9. Epub ahead of print. PMID: 32621139.

10. Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial. Cartilage. 2018 Oct 20:1947603518805230. doi: 10.1177/1947603518805230. Epub ahead of print. PMID: 30343590.

11.Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. Am J Sports Med. 2016 Mar;44(3):664-71. doi: 10.1177/0363546515620383. Epub 2016 Jan 21. PMID: 26797697.