Date of Award

5-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Daryl Sieg

Abstract

Osteoarthritis (OA) of the knee is one of the most common joint disorders in the United States with rising prevalence due to obesity and an aging population. Regarding non-surgical approaches to management, there has been growing interest in the use of intra-articular injections (IAI) of Platelet Rich Plasma (PRP). However, there has been a lack of strong evidence to support its use in clinical practice guidelines. In this literature review, two search methods were utilized in an effort to, first, inform clinicians about PRP and, second, to shed light on recent clinical control trials regarding the safety and efficacy of IAI of PRP for symptomatic OA of the knee. A comprehensive review of eighteen clinical control trials studies was performed. The primary scope of this review focuses on outcomes related to adverse events and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for analysis. Other outcomes were also analyzed to evaluate for trends in efficacy. In conclusion, PRP seems to be beneficial for short-term (<6 >months) management, especially in younger patients with mild-moderate osteoarthritis. Also, multiple and cyclical injections as well as PRP preparations with concentrated growth factors may be advantageous. The use of CaCl2 in the preparation of PRP appears to have adverse effects. In the mist of overwhelming bias and inconsistencies in study designs and wide variability in PRP preparation, current literature may not provide strong evidence to influence changes to future national guideline recommendations. Note: This paper does not review non-autologous uses of platelet-rich plasma or platelet-rich plasma co-administered with mesenchymal or multipotent stem cells as those from placenta, adipose tissue, or those derived from any other sources.

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