Email: info@BSBortho.com
Osteoarthritis is the most common form of degenerative joint disease and is the breakdown of joint cartilage resulting in pain, stiffness, and the loss of function. There are no curative medications and is a progressive disease, meaning that over time the cartilage will continue to wear down.
X-ray diagnostic imaging is most commonly utilized to assess the progression of osteoarthritis. Osteoarthritis is defined clinically as having marginal osteophytes, worsening joint space narrowing as well as subchondral sclerosis and cyst formation. Another way to evaluate the joint closer is utilization of an MRI. This allows the physician to evaluate surrounding structures as well including the articular cartilage, ligaments, synovium and joint capsules to gather a better, more comprehensive, evaluation of the joint.
Another, more cost friendly alternative to evaluation and diagnosis of osteoarthritis is ultrasound. This allows for evaluation of inflammation and structural abnormalities without exposure to radiation or contrast administration. Ultrasound is able to show real-time imaging detecting osteophytes, joint space narrowing and signs of synovial inflammation implicating the presence of hand osteoarthritis.
Conservative treatment typically focuses on symptoms including non-steroidal anti-inflammatory drugs, topical capsaicin, heat, and steroid injections. In large joints, joint replacements are common. However, surgical interventions for small foot and hand osteoarthritis remain meager and joint fusion comes at the expense of function.
In joints and osteoarthritis, PRP acts predominately by anti-inflammatory cascades to reduce pain. The data suggests that PRP may be superior to other intra-articular injections in improving pain and function in small joint osteoarthritis (Evans et al, 2020).
Platelet-rich plasma (PRP) uses a patient’s own blood, which is separated into different cellular layers. The final PRP preparation is a concentration of platelets and growth factors. There are many different protocols for preparing PRP, but studies show that to be effective the PRP has to concentrate platelets to greater than 5 times normal blood.
Evans A, Ibrahim M, Pope R, Mwangi J, Botros M, Johnson SP, Al Kassis S. Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma. J Orthop. 2020 Jan 28;18:226-236. doi: 10.1016/j.jor.2020.01.037. PMID: 32071509; PMCID: PMC7015825.
Hayashi, D., Roemer, F. W., & Guermazi, A. (2016). Imaging for osteoarthritis. Annals of physical and rehabilitation medicine, 59(3), 161–169. https://doi.org/10.1016/j.rehab.2015.12.003