A novel medical procedure used by Kobe Bryant, Dwight Howard and Peyton Manning to speed their recovery from stubborn injuries is also effective at treating osteoarthritis.
A new study found that platelet-rich plasma (PRP) therapy relieved pain and improved function in up to 73 percent of patients with knee osteoarthritis. Researchers say PRP also appeared to delay the progression of osteoarthritis.
“This is a very positive study,” said Brian Halpern, MD, chief of the Primary Care Sports Medicine Service at the Hospital for Special Surgery, New York City, and lead author of the study published online in the Clinical Journal of Sports Medicine.
“We are entering into an era of biologic treatment, which is incredibly ideal, where you can use your own cells to try to help repair your other cells, rather than using a substance that is artificial,” says Halpern. “The downside is next to zero and the upside is huge.”
Over 27 million Americans have osteoarthritis, which is characterized by degeneration of the cartilage in joints, causing pain and stiffness. It’s usually treated with pain relievers, anti-inflammatory medicines and cortisone shots.
PRP injections are being studied as a new form of treatment by a small number of doctors. The procedure involves withdrawing blood from the patient and then spinning it to produce a high concentration of platelet cells. The plasma is then injected back into the patient’s joint, speeding up the healing process.
“You take a person’s blood, you spin it down, you concentrate the platelets, and you inject a person’s knee with their own platelets in a concentrated form,” said Halpern. “This then activates growth factors and stem cells to help repair the tissue, if possible, calm osteoarthritic symptoms and decrease inflammation.”
In the study, researchers at Hospital for Special Surgery enrolled 15 patients with early osteoarthritis, gave them each a single injection of PRP and then monitored them for a year. The patients were evaluated with magnetic resonance imaging (MRI) both before and after the study.
Radiologists reading the MRIs did not know whether they were performed before or after the PRP treatment.
“The problem with a lot of the PRP studies is that most people have just used subjective outcome instruments, such as pain and function scores,” said Hollis Potter, MD, chief of the Division of Magnetic Resonance Imaging at Hospital for Special Surgery, and a co-author of the study.
“Even when patients are blinded, they know there has been some treatment, so there is often some bias interjected into those types of studies. When you add MRI assessment, it shows you the status of the disease at that time, regardless of whether the patient is symptomatic or asymptomatic or they have good or poor function in the knee. You find out what the cartilage actually looks like.”
Previous studies have shown that patients with osteoarthritis can lose about five percent of their knee cartilage each year. In the Hospital for Special Surgery study, researchers say a large majority of patients had no further cartilage loss.
Treatment with PRP also improved pain, stiffness and function. Researchers said pain levels dropped an average of 42% after six months and 56% after one year.
A recent study in Italy found that PRP was also effective in treating pain and cartilage tears in the knee.
Harvesting and processing a patient’s blood cells to treat injuries is growing in popularity with professional athletes. Kobe Bryant, Peyton Manning, Alex Rodriguez and Vijay Singh have traveled to Europe for a more refined version of PRP therapy known as Regenokine treatment. In that procedure, the blood is heated before it is spun to increase the concentration of anti-inflammatory and pain inhibiting proteins. Patients are also genetically screened to personalize their treatment, but because the gene test is not approved by the Food and Drug Administration it is not available in the U.S.