Responders to Platelet-Rich Plasma in Osteoarthritis: A Technical Analysis

Abstract EN

Purpose.

To evaluate the similarities and differences between the variety of platelet-rich plasma (PRP) formulations, preparation, and uses to try to determine the best responses for the treatment of knee osteoarthritis.

Materials and Methods.

A comparison of the outcomes of randomized controlled trials (RCTs) included in the 3 most recent and high-quality meta-analyses to classify the different studies in 2 groups (bad responders group (BRG) and very good responders group (VGRG)).

Results and Discussion.

From the 19 RCTs analyzed, 7 trials were included in the VGRG and 4 in the BRG.

In VGRG, 1 or 2 injections were performed in 4/7 trials, time between injections was 2 to 3 weeks in 4/5 studies with many injections, volume injected varied from 2.5 to 8 mL, and single spinning technique was used in 5/7 studies.

PRP classification was Mishra 4B and PAWP2Bβ in 5/7 studies.

The use of PRP with leukocytes is only found in the BRG.

Conclusion.

There is a lack of standardization in PRP preparation technique for knee osteoarthritis.

However it appears that the use of a single spinning technique, a platelet concentration lower than 5 times the baseline, and avoidance of leukocytes should be preferred.