Key points

  • Platelet-rich plasma (PRP) is an experimental treatment that may reduce pain from osteoarthritis.
  • It uses ingredients from your own blood to treat damaged tissues.
  • Early trials have shown promising results, but experts do not currently recommend its use.
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Injections of platelet-rich plasma (PRP) are a novel treatment for managing pain related to osteoarthritis (OA) of the knee. Researchers are still investigating this option.

Some PRP preparations have approval from the Food and Drug Administration (FDA), but approval does not yet cover the use of PRP in OA of the knee. Nevertheless, some clinics may offer it “off-label”.

Current guidelines from the American College of Rheumatology and the Arthritis Foundation (ACR/AF) strongly recommend avoiding this treatment because it has not yet been fully developed and standardized. This means you cannot be sure of what your dose contains.

With further research, however, it could become a useful treatment option. Read on to learn more about PRP and other options for treating OA.

The platelets in your blood contain growth factors. Scientists believe that injecting PRP growth factors from your own blood into an injured area will help tissues repair themselves by causing new cells to form.

In this way, PRP could help reverse existing tissue damage.

Evidence about using PRP to treat knee OA has not yet confirmed that it is a safe and effective option, and studies have produced conflicting results.

While many studies support its use, many others say PRP has no effect, according to a 2019 review.

A 2017 review looked at 14 randomized controlled trials with a total of 1,423 participants. Results suggested that PRP may help manage pain associated with knee OA.

The authors noted the following at 3-, 6-, and 12-month follow-ups:

Pain levels: Compared with placebos, PRP injections significantly reduced pain scores at each follow-up appointment.

Physical function: Compared with controls, PRP significantly improved physical function at these follow ups.

Adverse effects: Some people experienced adverse effects, but these were no more significant than those produced by other types of injection.

While the results appear promising, 10 of the 14 studies reviewed had a high risk of bias, and four had a moderate risk of bias.

More studies are needed to determine whether PRP could offer a suitable option to manage pain from OA of the knee.

PRP is an experimental therapy, and experts do not currently recommend its use. If you are considering PRP injections, start by asking your doctor for their advice.

Since PRP injections are experimental, there is limited evidence about how safe and effective they are. In addition, your insurance policy may not cover them.

Work closely with your doctor before starting any experimental treatments, and ensure that any provider is fully qualified to offer this treatment.

First, your doctor will draw a small amount of blood from your arm.

Then, they’ll put the blood sample into a centrifuge to separate the components and obtain a concentrated suspension of platelets in plasma. At this point, variations in procedure may lead to different concentrations of the various components.

Next, the doctor will numb your knee and inject the PRP into the joint space in the knee. They may use ultrasound to guide the injection.

After resting a while, you will be able to go home. You should arrange for someone to drive you home, as there may be pain and stiffness after the injection.

After the procedure, your doctor may advise you to:

  • ice your knee for 20 minutes every two to three hours for the first three days
  • take Tylenol to help manage discomfort
  • avoid NSAIDs, like ibuprofen, since they may block the effect of PRP
  • get plenty of rest and avoid activities that put weight on your knee

You may need to use crutches or a walking frame for a few days to keep the weight off of your knee.

Follow your physician’s advice about follow-up appointments.

PRP uses your own blood, so experts say it is likely to be safe.

However, an injection into the knee joint can entail some risks, including:

  • local infection
  • pain at the site of injection
  • nerve damage, most likely at the site of injection

The 2017 review mentioned above found that some people experienced:

  • pain and stiffness
  • a rapid heartbeat
  • fainting and dizziness
  • nausea and upset stomach
  • sweating
  • headache

However, the researchers noted that these were non-specific and no more significant than the side effects of other injections.

Moreover, the cost of this type of treatment can be high, and insurers may not cover it. Find out how much it is likely to cost before you go ahead.

Bear in mind also that there may be unforeseen adverse effects, due to the experimental nature of the treatment.

There are various ways to manage OA-related pain and other symptoms. Weight management and exercise are key long-term strategies, but other options can provide more immediate relief.

Decrease OA pain

  • Apply ice and heat to the knee.
  • Take over-the-counter NSAIDS, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).
  • Use prescription pain relief if your doctor recommends it.
  • Consider using medical devices such as a cane, a walker, or a brace.
  • Apply ointments that contain NSAIDs or capsaicin.
  • Ask your doctor about corticosteroid injections.
  • Consider surgery if severe symptoms affect your mobility and quality of life.
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Learn more about the treatment options for OA.

PRP injections use your own blood to stimulate growth in injured tissues. There is some evidence that this treatment may help manage pain associated with OA of the knee, but not enough to confirm that it works.

Experts do not currently recommend PRP injections for OA of the knee, due to the lack of standardization at the preparation stage.

If you are considering PRP, be sure to discuss it first with your doctor and follow their advice. Remember that it is an experimental treatment that clinics can only provide off-label.

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