Objective:

To compare the effectiveness of two intra-articular platelet-rich plasma (PRP) injections with a single corticosteroid injection and oral nonsteroidal anti-inflammatory drug (NSAID) therapy in patients with advanced knee osteoarthritis awaiting knee replacement.

Approach:

Key Findings:

• PRP group showed significant reductions in pain scores from about 6 at baseline to about 3 at 3 months (p < 0.001) and about 4 at 6 months (p < 0.01).
• WOMAC total scores improved significantly in the PRP group from 49 at baseline to 28 at 3 months (p < 0.001) and 33 at 6 months (p < 0.01).
• Rescue opioid use was lower in the PRP group at 3 months compared to both comparator groups (p < 0.05).
• Biomarker analysis indicated lower levels of several inflammatory markers in the PRP group compared to corticosteroid and NSAID groups (p < 0.05).

Interpretation:

The findings suggest that PRP may provide better pain relief and functional improvement compared to corticosteroid injections and NSAID therapy in patients with advanced knee osteoarthritis.

Limitations:

• No placebo or sham-injection group was included, limiting the ability to assess the efficacy of PRP against an inert control.
• The study design and open-label conditions may introduce bias.
• The small sample size and short follow-up period limit generalizability.

Conclusion:

Further research with larger, longer-duration randomized trials is needed to confirm these findings and address the limitations of the current study.

Sources:

• Journal of Orthopaedic Surgery and Research
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