Today’s Research Article
Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis
The RESTORE Randomized Clinical Trial
Kim L. Bennell, PhD; Kade L. Paterson, PhD; Ben R. Metcalf, BSc; Vicky Duong, DPT; Jillian Eyles, PhD; Jessica Kasza, PhD; Yuanyuan Wang, PhD; Flavia Cicuttini, PhD; Rachelle Buchbinder, PhD; Andrew Forbes, PhD; Anthony Harris, MSc; Shirley P. Yu, MPH; David Connell, MMed; James Linklater, MBBS; Bing Hui Wang, PhD; Win Min Oo, PhD; David J. Hunter, PhD
Read the full article here.
Summary:
This randomized clinical trial (RESTORE) aimed to evaluate the effectiveness of platelet-rich plasma (PRP) injections compared to a placebo (saline) in patients with mild to moderate knee osteoarthritis (OA). Over a 12-month period, the study measured changes in pain levels and knee joint structure, specifically the medial tibial cartilage volume. The trial included 288 participants aged 50 and older who received either PRP or saline injections.
The results showed that both groups experienced reductions in pain, but there was no significant difference between the PRP and placebo groups. Similarly, the change in cartilage volume was minimal and comparable in both groups. Secondary outcomes related to function and quality of life also showed no significant differences. This suggests that PRP may not provide meaningful clinical benefits for managing knee OA, contrary to what is commonly believed.
Review:
This trial used a very low dose PRP, some would classify it as not actually PRP, as the platelet dose may have not even reached the elevation over normal platelet dose in whole blood. With this understanding, the conclusions are that very low dose PRP does not help with pain, does not improve structural benefit, but may give temporary relief.
Best Practices should be to make sure you are offering your patients adequate dosing. Please see the graphic below:
