Medical science has been searching for a reliable osteoarthritis (OA) treatment for as long as I can remember. And why not? Osteoarthritis is the most common form of arthritis in the world. It will impact just about everybody, to one degree or another, over the course of a lifetime.
There may be hope for some in platelet rich plasma (PRP) therapy, a therapy that has been subject to considerable debate. Yet a recent study out of Italy might help to quell some of the disagreement. The study shows that “PRP injections with high platelet concentrations may improve outcomes for knee OA.”
More About Osteoarthritis
Osteoarthritis is a degenerative condition that tends to come with age. The reasoning is simple: over decades, the cartilage that cushions joints slowly wears away. In addition, it is more difficult for the body to replace lost cartilage as it grows older. When the cartilage is gone, the two bones of a joint grind against one another. The result is pain that can be debilitating in the worst cases.
There is no cure for OA. Patients either need to make do with therapy designed to relieve pain or have the affected joints surgically replaced. Unfortunately, neither form of treatment is guaranteed to work. Many patients only find minimal relief with pain medications. As for those undergoing joint replacement surgery, a fair number continued to report pain afterward.
PRP as an OA Treatment
PRP therapy is an alternative treatment that some say can relieve OA pain as effectively as more traditional treatments. What does the Italian study say? Let us take a look.
Researchers from the Rizzoli Orthopedic Institute in Bologna conducted a cohort study among 253 patients whose knee OA was treated with PRP injections. Each of the patients received three injections weekly consisting of 5 mL of autologous PRP. The patients were divided into three groups:
- Low Platelet – Received injections with fewer than 800k platelets/liter.
- Medium Platelet – Received injections of 800k-1.2m platelets/liter.
- High Platelet – Received injections of 1.2m+ platelets/liter.
Patient volumes were 40, 153, and 60, respectively. Patients were assessed for pain at intervals of 2, 6, and 12 months. When all was said and done, all three patient groups demonstrated statistically significant improvement. In addition, the improvement correlated with the volume of platelets received. In other words, the high platelet group reported the most pain relief.
Mechanisms Not Fully Understood
Although researchers concluded that PRP injections did provide pain relief to the majority of OA patients, they did not delve into potential mechanisms. That is not surprising. Here in the U.S., a small number of regenerative medicine practitioners swear by PRP therapy even though science is not clear about how it works.
PRP is on the regenerative medicine menu at Texas-based Lone Star Pain Medicine in Weatherford. Lone Star doctors explain that one line of thinking lies in the concentrated growth factors found in PRP. It is possible that the growth factors encourage the body to naturally take action against lost cartilage by encouraging new tissue growth. Such thinking has never been proved; it is just a hypothesis.
Irrespective of how it works, evidence in support of PRP as a pain-relieving treatment for OA is growing. And as the data mounts, it’s getting harder for mainstream medical science to deny reality. To me, there is a lesson here.
It’s time to stop writing off regenerative medicine as quackery or a mere money-making scheme. Studies are showing otherwise. Now is the time to fully dive in and start working on effective regenerative treatments.
