Key result
Intra-articular PRP linked to reduced pain and inflammatory cytokines in knee osteoarthritis.
Why the study?
Platelet-rich plasma may reduce pain associated with osteoarthritis, prompting the study to assess its therapeutic effects across various severities of knee osteoarthritis.
Does intra-articular injection of platelet-rich plasma reduce pain and inflammatory cytokines in patients with knee osteoarthritis?
Observational (n=90)
No
Does intra-articular injection of platelet-rich plasma reduce pain and inflammatory cytokines in patients with knee osteoarthritis?
Intra-articular PRP injections significantly reduce pain and synovial inflammatory cytokines in patients with knee osteoarthritis, particularly in mild to moderate cases.
PRP was associated with reduced pain and cytokines in knee OA; hypothesis-generating and should not change practice pending RCTs.
Background: Osteoarthritis (OA) is a multifactorial disease that commonly affects the knee. Tumor necrosis factor-α (TNF-α) is able to regulate inflammation in OA. Macrophage migration inhibitory factor (MIF) may be involved in the pathophysiology of arthritis. Platelet-rich plasma (PRP) may reduce pain associated with OA. The current study aimed to assess the possible therapeutic effects of PRP in patients with knee OA of various severities. Methods: A prospective study was performed on 90 patients were included and categorized into mild (30 cases, moderate (30 cases) and severe (30 cases) knee OA. Three intra-articular (I.A) injections of PRP, 2 weeks a part, were received. Pain score and MRI Osteoarthritis Knee Score (MOAKS) were assessed. Serial synovial fluid cytokines assays in the form of Tumor necrosis factor-α (TNF-α) and Macrophage migration inhibitory factor (MIF), were performed using commercially available ELISA assay kits. The assays were performed pre-injection (S1), two weeks from the 1st I.A injection and two weeks from the 2nd I.A injection (S3) for all included patients. Results: The mean values of pain score and synovial TNF-α and MIF levels were significantly higher levels (S1, pre-injection) among severe OA when compared with both mild and moderate cases, p˂0.05 for all. There were significantly lower pain score and synovial TNF-α and MIF levels at S3 in mild, moderate and severe knee OA when compared with S1 values, p˂0.05 for all. There was significant improvement in synovitis in both mild and moderate cases (p˂0.05 for both). Conclusion: I.A injection of PRP significantly reduces the synovial fluid TNF-α and MIF levels with great therapeutic effects on both synovitis via reducing inflammatory cytokines, and bone marrow lesions mainly for mild knee OA and to a lesser extent for moderate cases.
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Hassan et al. (2020) conducted an observational in Knee osteoarthritis (n=90). Platelet-rich plasma (PRP) vs. Pre-injection baseline was evaluated on Pain score (VAS) and synovial fluid cytokine levels at 2 weeks after the second injection. Intra-articular injection of platelet-rich plasma significantly reduced pain scores and synovial fluid inflammatory cytokines (TNF-α and MIF) across patients with mild, moderate, and severe knee osteoarthritis.
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