Jun 7, 2020

Recommendations for Intra-Articular Injections of Platelet-Rich Plasma for the Management of Knee OA

By Eric Ramos

CHICAGO -- June 7, 2020 -- Recommendations on the use of intra-articular injections of platelet-rich plasma for knee osteoarthritis (OA) were presented at the 2020 Virtual Meeting of the European League Against Rheumatism (EULAR) by an international multidisciplinary task force group.

“There has been much debate regarding the use of intra-articular injections of platelet-rich plasma as symptomatic treatment for knee osteoarthritis,” said Florent Eymard, MD, AP-HP Henri Mondor Hospital, Créteil, France.

Dr. Eymard and colleagues, on behalf of the Groupe de Réflexion sur les Injections de PRP (GRIP), came together to develop the practice recommendations in order to provide a basis for standardisation of clinical practices and future research protocols.

A total of 15 physicians (10 rheumatologists, 4 specialists in rehabilitation and sport medicine and, 1 interventional radiologist) from different countries gave their expertise. All experts voted their agreement or not for each recommendation using a score between 1 (totally inappropriate) and 9 (totally appropriate). Depending on the median value and extreme scores, recommendations were judged as appropriate, inappropriate, or uncertain due to indecision or absence of consensus.

The main recommendations are as follows:
• Intra-articular injections of platelet-rich plasma constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis (median score, 8; appropriate).
• Intra-articular injections of platelet-rich plasma may be useful in severe knee osteoarthritis (median score, 7; appropriate).
• Intra-articular injections of platelet-rich plasma in knee osteoarthritis should be proposed as second-line therapy after failure of non-pharmacological and pharmacological (oral and topic) symptomatic treatment (median score, 9; appropriate).
• Intra-articular injections of platelet-rich plasma should not be performed in osteoarthritis flare-up with significant effusion (median score, 7; appropriate).
• Intra-articular platelet-rich plasma treatment may include 1 to 3 consecutive injections (median score, 9; appropriate).
• Leukocyte-poor platelet-rich plasma should be preferred for knee OA treatment (median score, 8; appropriate).
• Platelet-rich plasma injections should be performed under ultrasound or fluoroscopic guidance (median score, 8; uncertain).
• Platelet-rich plasma should not be mixed with injectable anesthetic or corticosteroid (median score, 9; appropriate).

[Presentation title: Consensus Statement on Intra-Articular Injections of Platelet-Rich Plasma for the Management of Knee Osteoarthritis. Abstract AB0862]

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