Knee osteoarthritis (OA) is a debilitating condition affecting millions worldwide, leading to pain, stiffness, and reduced mobility. While traditional treatments such as corticosteroid and hyaluronic acid injections are widely recognized, a lesser-known yet promising option—platelet-rich plasma (PRP) therapy—remains significantly underutilized.

A recent study by Klein et al. highlights this gap in patient awareness and how often physician discuss PRP injections for knee arthritis treatment. The findings are concerning:

• While 93.5% of patients had been offered corticosteroid injections and 37% had been offered HA.
  
• Only 6.5% had been offered PRP, and a mere 10.9% had even heard of it.

Why Is PRP Overlooked?

Despite growing evidence supporting PRP’s efficacy in reducing pain and improving function in knee arthritis, several factors contribute to its lack of mainstream adoption:

1. Limited Physician Awareness and Recommendation
   Many healthcare providers primarily offer corticosteroid or hyaluronic acid injections, as these are well-established in treatment guidelines.
   

2. Guideline Hesitation
   Organizations like the American Academy of Orthopaedic Surgeons and the American College of Rheumatology have not endorse PRP.

   

3. Insurance Coverage Barriers
   Unlike corticosteroid and hyaluronic acid, which are often covered by insurance, PRP is typically an out-of-pocket expense for patients and not covered by insurance.
   

The Case for PRP

• Recent studies indicate that PRP may be superior to both corticosteroid and hyaluronic acid for long-term symptom relief in knee arthritis [Donovan et al, 2022; Belk et al, 2023].
• While corticosteroid offers short-term benefits, it may contribute to cartilage degradation over time.
  
• PRP, on the other hand, contains growth factors that may help stimulate cartilage repair and reduce inflammation [Xie et al, 2014; Liang et al, 2022].

The Need for Greater Awareness about PRP and Knee Osteoarthritis

The study by Klein et al. underscores the urgent need for better patient education and physician training on PRP as a viable treatment option in knee osteoarthritis. Given its potential to improve pain and function, PRP should be part of the conversation when discussing knee arthritis management.

Moving Forward

• Patients should ask their healthcare providers about PRP as an alternative to steroids or hyaluronic acid injections.
• More clinical research and standardized protocols are needed to improve PRP’s credibility in treatment guidelines.
• Insurance companies should consider covering PRP, given its potential to delay costly surgeries like knee replacements.

By addressing these barriers, PRP could become a more accessible and effective option for knee arthritis patients, ultimately improving quality of life for patients with knee osteoarthritis.

Has your orthopedic surgeon discussed PRP as an option before a total knee replacement? To learn more about PRP for knee osteoarthritis:

(781) 591-7855

info@BSBortho.com

20 Walnut St

Suite 14

Wellesley MA 02481

References:

• Belk JW, Lim JJ, Keeter C, McCulloch PC, Houck DA, McCarty EC, Frank RM, Kraeutler MJ. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis. Arthroscopy. 2023 Jul;39(7):1714-1734.
  
• Donovan RL, Edwards TA, Judge A, Blom AW, Kunutsor SK, Whitehouse MR. Effects of recurrent intra-articular corticosteroid injections for osteoarthritis at 3 months and beyond: a systematic review and meta-analysis in comparison to other injectables. Osteoarthritis Cartilage. 2022 Dec;30(12):1658-1669.
• Klein J, Soni C, Ayotte B, Castro-Nunez C, Feketeova E. Are patients with knee osteoarthritis aware that platelet-rich plasma is a treatment option? Medicine (Baltimore). 2024 Jan 19;103(3):e36712.
  
• Liang Y, Li J, Wang Y, He J, Chen L, Chu J, Wu H. Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review. Cartilage. 2022 Jul-Sep;13(3):19476035221118419.
• Xie X, Zhang C, Tuan RS. Biology of platelet-rich plasma and its clinical application in cartilage repair. Arthritis Res Ther. 2014 Feb 25;16(1):204.