Platelet-Rich Plasma Therapy for Osteoarthritis: A Review of Patient-Reported Outcomes
Supervisors / Principle Investigators:
Teresa De Freitas
MD Class of 2021
Osteoarthritis (OA) is a degenerative condition of joint cartilage leading to pain, inflammation, and loss of joint function. It affects over 37% of adults in Canada and incidence increases with age, with nearly 45% of Canadians over 65 suffering from OA. Currently, no therapies can reverse this degeneration and thus it is a chronic and worsening condition. Joint replacement surgery is the only definitive treatment. While limited evidence exists, intra-articular platelet-rich-plasma (PRP) injections for OA have demonstrated positive results. The Glen Sather Sports Medicine Clinic at the University of Alberta has performed PRP injections since 2010. Via retrospective chart review (Jan 2010–Aug 2017), we aimed to assess PRP efficacy for OA-affected joints by examining longitudinal patient-reported visual-analogue-scale (VAS) Likert scores (0-10) under the domains of Pain, Limitation, and Activity before and after PRP. Ninety-eight records were identified and stratified by affected joint (i.e. knee, shoulder, hip, other (e.g. ankle, hand)); only patients who completed both pre- and post-VAS questionnaires were included in the analysis. Data were analyzed using descriptive statistics, t-tests, and repeated measures analyses where applicable. OA PRP patients (60.52±11.55 years) presented most commonly for knee OA (59%). Overall, VAS pain, limitation, and activity scores improved following PRP in all examined joints. However, not all score reductions were statistically significant. Significant improvements were found after first PRP injection for knee OA limitation and activity (p=0.0023; p=0.0016; n=21), shoulder OA activity (p=0.0091; n=17), and “other” OA pain, limitation, and activity (p=0.0022; p=0.00091; p=0.017; n=7). Patients who received a second PRP injection for knee OA reported significant improvement in pain, limitation, and activity (p=0.039, p=0.014, p=0.012; n=7). Our analyses are limited by various factors, such as incomplete health record charting, small sample, varied patient follow-up, and inconsistent VAS completion. A controlled, prospective study is recommended to further evaluate these results.