Knee Osteoarthritis
Regenerative medical researchers in Barcelona, Spain are investigating new treatments, such as PRP, for osteoarthritis (OA) that address the underlying disease pathology rather than simply treat symptoms. The goal is to improve quality of life and physical function in persons with osteoarthritis. There currently is no curative approach for the millions of people with OA. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is commonly prescribed but many people, especially the elderly, have a high risk of side effects with NSAIDs.
Recently autologous plasma rich in growth factors (PRGF), commonly called PRP or Platelet Rich Plasma in the US, rich in proteins, has been considered a promising regenerative approach to stimulate chondrocytes to produce more cartilage (Cartilage is destroyed in OA). PRGF has a high concentration of growth factors. These factors act specifically on the tissue to repair and heal and have been shown to stimulate chondrocytes in the fibrous knee cartilage.
The aim of this study was to evaluate the effect of PRGF injected into knee joints on pain, quality of life, and daily ability to function in persons with OA. The study was designed as a non-randomized, prospective study over a six month period. The intervention consisted of three PRGF injections into knees of persons with OA. Twenty ccs of blood were drawn from subjects which were processed in a centrifuge and the layer of concentrated platelets was removed. Platelets were activated with calcium chloride. Three injections were given over a two week period. The average age of subjects was 48 years and their arthritis symptoms ranged from mild to severe. At the six months follow up patients reported significantly less pain and stiffness and increased functional ability. None of the subjects reported side effects. This study did not have a control group, so results must be interpreted cautiously, however, the significant positive results are promising.
The researchers attribute the positive results to stimulation of chondrocytes by PRGH to produce proteoglycans (joint proteins that provide structure and lubrication) and collagen. Platelets are known to release growth factors that stimulate wound healing. Previous laboratory studies have shown that PRGF stimulates the body’s stem cells to differentiate into chondrocytes. Additionally, PRGF continually releases a wide range of growth factors and proteins needed for healing in a way that mimics the body’s natural healing process and restores elasticity to the joint. There is even evidence of full thickness cartilage injuries healing. PRGF has been shown to be more effective in reducing pain and longer lasting than hyaluronan injections. There is also evidence that PRFG reduces inflammation. The safety profile in studies is good and it is an appropriate alternative treatment for OA.
Wang-Saegusa A, Cugat R, Ares O, et al. (2011). Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Archives of Orthopaedic and Trauma Surgery, 131: 311-317. DOI: 10.1007/s00402-010-1167-3 ·