There is currently a range of ways in which platelet rich plasma can be made. One way is to extract out the platelets with care taken to also reduce the concentration of leukocytes or white blood cells.  Leukocytes or white blood cells are responsible for inflammation.  This study indicates leukocyte poor platelet rich plasma injections resulted in a better quality of life and less pain after 24 weeks than taking acetaminophen.

The Research

Arch Orthop Trauma Surg. 2016 Dec;136(12):1723-1732. Epub 2016 Aug 9.

Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis.

Simental-Mendía M¹, Vílchez-Cavazos JF², Peña-Martínez VM², Said-Fernández S¹, Lara-Arias J², Martínez-Rodríguez HG³.

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Abstract

INTRODUCTION:

Knee osteoarthritis (OA) is a degenerative and progressive articular cartilage disease. Infiltration of autologous platelet-rich plasma (PRP) has been proposed as a therapeutic alternative due to the content of biologically active cytokines in PRP. We aimed to compare the clinical response of acetaminophen and intra-articular leukocyte-poor PRP (LP-PRP) in early knee OA.

MATERIALS AND METHODS:

A total of 65 patients with clinically and radiographically documented knee OA (grade 1-2) were analyzed. Patients were randomized into two groups: 32 were treated with acetaminophen (500 mg/8 h) over 6 weeks, and 33 received three intra-articular injections of autologous LP-PRP (once every 2 weeks). All patients were evaluated by the Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities (WOMAC) score, and the SF-12 health survey at baseline and 6, 12, and 24 weeks of follow-up. All LP-PRP preparations were analyzed for the platelet, leukocyte, IL-1ra, and TGF-β concentrations.

RESULTS:

The decrease in the VAS pain level in the LP-PRP group was greater than that in the acetaminophen group (p < 0.05). Patients treated with LP-PRP showed a sustained improvement in knee function at week 24 (p < 0.01). The SF-12 results only indicated an improvement in quality-of-life in the LP-PRP group at 6, 12, and 24 weeks of follow-up (p < 0.01). Both IL-1ra and TGF-β were detected in the LP-PRP samples (313.8 ± 231.6 and 21,183.8 ± 8556.3 pg/mL, respectively).

CONCLUSIONS:

Treatment with LP-PRP injections resulted in a significantly better clinical outcome than did treatment with acetaminophen, with sustained lower EVA and WOMAC scores and improvement in quality-of-life (higher SF-12 score). Therapy with LP-PRP may positively modify the inflammatory joint environment by counteracting IL-1β action.

KEYWORDS:

Acetaminophen; Intra-articular infiltration; Leukocyte-poor platelet-rich plasma; Osteoarthritis