Efficacy of platelet-rich plasma and plasma for symptomatic treatment of knee osteoarthritis: a double-blinded placebo-controlled randomized clinical trial

• Published in: BMC musculoskeletal disorders Vol. 22; no. 1; p. 822
• Main Authors: Dório, Murillo, Pereira, Rosa Maria Rodrigues, Luz, Alexandre Galeno Branco, Deveza, Leticia Alle, de Oliveira, Ricardo Manoel, Fuller, Ricardo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24-09-2021; BioMed Central; BMC
• Subjects: Adverse events; Aged; Arthritis; Blood platelets; Care and treatment; Clinical trials; Disease; Double-Blind Method; Drugs; Female; Growth factors; Hospitals; Humans; Hyaluronic Acid; Injections, Intra-Articular; Knee; Knee osteoarthritis; Knee pain; Laboratories; Male; Musculoskeletal diseases; Osteoarthritis; Osteoarthritis, Knee - diagnostic imaging; Osteoarthritis, Knee - therapy; Pain; Pharmacists; Placebos; Plasma; Platelet-Rich Plasma; Platelet-rich plasma therapy; Platelets; PRP; Rheumatology; Testing; Treatment Outcome; Ultrasonic imaging; Brazil; Plasma; Knee osteoarthritis; Platelet-rich plasma; PRP
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-021-04706-7

Platelet-rich plasma (PRP) has a still conflicting efficacy for knee osteoarthritis (KOA) and might be a minimally invasive and safe treatment alternative. The potential benefit of only plasma (non-enriched) has never been investigated. Our aim was to evaluate the efficacy of intra-articular platelet-rich plasma (PRP) and plasma to improve pain and function in participants with KOA over 24 weeks.
Randomized, double-blind, placebo-controlled trial with 3 groups (n = 62): PRP (n = 20), plasma (n = 21) and saline (n = 21). Two ultrasound-guided knee injections were performed with a 2-week interval. The primary outcome was visual analog scale 0-10 cm (VAS) for overall pain at week 24, with intermediate assessments at weeks 6 and 12. Main secondary outcomes were: KOOS, OMERACT-OARSI criteria and TUGT.
At baseline, 92% of participants were female, with a mean age of 65 years, mean BMI of 28.0 Kg/m
and mean VAS pain of 6.2 cm. Change in pain from baseline at week 24 were -2.9 (SD 2.5), -2.4 (SD 2.5) and -3.5 cm (SD 3.3) for PRP, plasma and saline, respectively (p intergroup = 0.499). There were no differences between the three groups at weeks 6 and 12. Similarly, there were no differences between groups regarding secondary outcomes. The PRP group showed higher frequency of adverse events (65% versus 24% and 33% for plasma and saline, respectively, p = 0.02), mostly mild transitory increase in pain.
PRP and plasma were not superior to placebo for pain and function improvement in KOA over 24 weeks. The PRP group had a higher frequency of mild transitory increase in pain.
ClinicalTrials.gov, NCT03138317 , 03/05/2017.