Using Platelet-Rich Plasma in Younger Individuals With OA
OA is the most common type of arthritis, and the older an individual is, the severe its effects will be. Osteoarthritis (OA) is a chronic musculoskeletal condition that mainly affects the knee and/or hip joints, characterized by focal areas of loss of articular cartilage in synovial joints. Osteoarthritis is associated with considerable pain, disability, and decreased quality of life, especially in older adults. With a rapidly projected increase because of an aging population and increased risk factors, it has become an important public health problem worldwide.
Most treatments of OA aim to alleviate symptoms and improve functionality. However, the long-term use of oral drug therapies is associated with undesirable effects. In contrast, biomechanical interventions such as knee braces, knee sleeves, foot orthoses, and biomechanical training programs tend to offer short-term benefits. In fact, an ideal treatment should target the processes of tissue degeneration and inflammation, which are characteristic of the condition; alternatively, the use of hyaluronic acid (HA) has not demonstrated that it can slow down the progression of OA.
Platelet-rich plasma (PRP) recently came under the spotlight due to its high regenerative potential and promising preliminary clinical results in several conditions. The use of platelet-rich plasma (PRP), the autologous blood centrifuged to produce a higher concentration of platelets than baseline, has gained attention in recent years. The growth factors released by PRP promote cell recruitment, proliferation, and angiogenesis, leading to decreased expression of inflammatory enzymes and decreased critical regulators of the inflammatory process. Therefore, PRP injections have the objective to stimulate cartilage repair and may delay the need for joint replacement surgery.11 The objective of this study was to compare PRP, bone marrow aspirate concentrate (BMAC), and adipose-derived MSC in the treatment of OA of the knee using functional scores.
Current literature supports the use of PRP in early OA, preferably in younger individuals. As concluded in recent reviews, most studies of PRP are case studies or preclinical investigations, with only a few clinical trials in the case of OA. Moreover, there are several protocols for the production of PRP and no consensus in methods and concentration.
It was shown that using PRP in younger individuals had good safety and the directional trends in patient-reported outcomes warrant more research; these injection therapies could provide effective, safe, and inexpensive treatments to symptomatic OA of the knee.
Estrada, E., Décima, J.L., Rodríguez, M., Di Tomaso, M. and Roberti, J., 2020. Patient-Reported Outcomes After Platelet-Rich Plasma, Bone Marrow Aspirate, and Adipose-Derived Mesenchymal Stem Cell Injections for Symptomatic Knee Osteoarthritis. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, 13, p.1179544120931086.
Cho, H., Kim, H., Kim, Y.G. and Kim, K., 2019. Recent Clinical Trials in Adipose-derived Stem Cell Mediated Osteoarthritis Treatment. Biotechnology and Bioprocess Engineering, 24(6), pp.839-853.
Kenihan, L., McTier, L. and Phillips, N.M., 2020. Patients' expectations and experiences of stem cell therapy for the treatment of knee osteoarthritis. Health Expectations, 23(5), pp.1300-1309.