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PRP for Arthritis: A Comprehensive Guide to Treatment and Benefits

Updated: May 2

Arthritis, a prevalent condition, significantly influences the daily lives of those affected. In the search for effective treatments, platelet-rich plasma (PRP) therapy has emerged as a contemporary intervention garnering interest within the field of arthritis management. PRP therapy has been explored in various medical fields and can be used off-label for various orthopaedic conditions, including arthritis, based on the rationale of its potential to promote tissue healing and reduce inflammation.


While PRP therapy for arthritis is not yet FDA-approved, new research has made it a worth while avenue to explore for health care practitioners -depending on the patient's circumstances -and a potentially viable avenue in treating the condition when presented with the full scope of clinical studies currently available. This informational piece aims to provide healthcare professionals with a detailed overview of PRP therapy, focusing on its mechanism of action, potential therapeutic benefits, and current position within the spectrum of arthritis treatment modalities.


Understanding Arthritis


Arthritis, characterized by joint pain, is a term that encompasses a broad spectrum of over a hundred musculoskeletal disorders, impacting a significant portion of the population. This condition is not only associated with physical symptoms and pain but also affects individuals' daily lives and psychological well-being.


prp for arthritis - Selphyl Ortho

Classification and Types of Arthritis


Among the various forms of arthritis, osteoarthritis is commonly observed as a result of the progressive degeneration of joint integrity, often due to aging or past injuries. In contrast, rheumatoid arthritis is an autoimmune condition wherein the immune system aberrantly targets the synovial lining of joints, leading to inflammation and discomfort. Other notable forms include gout, characterized by the deposition of urate crystals within joints, and psoriatic arthritis, which combines joint inflammation with psoriasis. [1] [2]


Symptomatology and Impact on Patients


The hallmark symptoms of arthritis encompass pain, edema, stiffness, and a decline in joint mobility. The intensity of these symptoms can vary, presenting as either persistent or episodic in nature. Beyond the physical manifestations, arthritis significantly impairs functional capacity, restricting the performance of routine activities. Moreover, the chronic pain associated with arthritis is frequently correlated with psychological distress, manifesting as anxiety and depression, thereby underscoring the multifaceted impact of the condition.


Therapeutic Approaches and Limitations


The management strategy for arthritis is multifaceted, incorporating pharmacological interventions such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). These pharmacological treatments are complemented by non-pharmacological measures, including physical therapy and lifestyle modifications aimed at optimizing physical activity and managing weight.


Given the chronic nature of arthritis and the current absence of curative therapy, the primary objective of treatment is symptom management and the preservation of joint function. However, the extended use of certain medications, notably NSAIDs and corticosteroids, is associated with potential adverse effects, necessitating judicious use and monitoring by healthcare professionals. [3]


The Rise of PRP Therapy


Originally introduced in the realm of maxillofacial surgery during the 1970s, the utility of PRP therapy has since diversified, finding relevance in orthopedics, dermatology, sports medicine, and beyond. The mechanism by which PRP therapy operates involves the injection of a concentration of platelets into the arthritic joint. These platelets release growth factors that contribute to the reduction of the joint inflammation and the promotion of tissue healing within the joint. Such biological actions have been shown to potentially improve joint functionality and alleviate pain, addressing arthritis at a foundational level.


prp for arthritis - Selphyl Ortho

Beyond its application in arthritis management, PRP therapy has been adopted in various other medical areas. Its efficacy in treating sports-related injuries, for example, has facilitated quicker recovery times for athletes. In the field of dermatology, PRP treatment has been leveraged for aesthetic enhancements, including anti-aging treatments and interventions for hair loss. Additionally, its role in supporting post-surgical recovery and wound healing underscores the versatility of PRP therapy as a treatment option across different clinical settings. [4] [5] [6]


PRP for Arthritis vs. Traditional Therapies


In the domain of arthritis management, healthcare professionals are presented with a spectrum of treatment modalities, each characterized by distinct advantages and clinical considerations. Among these, conventional therapies such as corticosteroid injections, hyaluronic acid injections, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been staples in providing symptomatic relief.


Corticosteroid injections, while effective in reducing inflammation and pain, may see diminished benefits with repeated administration and carry potential risks, including joint damage and elevated blood sugar levels. Hyaluronic acid injections, intended to lubricate joints and improve mobility, offer variable efficacy and may induce site-specific reactions such as pain and swelling. NSAIDs, widely utilized for their pain-relieving and anti-inflammatory properties, pose risks of gastrointestinal, cardiovascular, and renal adverse effects with long-term use. [7] [8]


Platelet-rich plasma (PRP) therapy emerges as an innovative approach within this landscape, distinguished from other treatments by its targeted delivery directly into the affected joint, thereby addressing the root cause of symptoms. This method capitalizes on the body’s inherent healing mechanisms by using autologous platelets, significantly reducing the likelihood of allergic reactions or rejection associated with exogenous substances. Furthermore, PRP therapy is associated with a reduced risk of systemic side effects compared to systemic treatments, such as oral medications, which can impact the body more broadly. [9]


However, the implementation of PRP therapy in clinical practice necessitates careful consideration of its variable effectiveness among patients. This variability can be attributed to individual patient factors, including the underlying pathology and overall health status, as well as the specific techniques used for PRP preparation. The concentration and preparation methods of platelets may differ across practices, contributing to inconsistencies in treatment outcomes.


PRP Injections for Arthritis: What to Expect


Extraction Process


The initial step in PRP therapy involves the extraction of a blood sample from the patient, akin to a standard blood draw procedure. This blood sample is then transferred to a PRP tube designed for PRP processing and placed in a centrifuge. The centrifugation process separates platelets from other blood components by spinning the tube at high velocities. Subsequently, the concentrated platelet-rich plasma is carefully extracted for therapeutic use.


Administration


The prepared PRP injection is administered directly into the affected joint area, with the procedure often being assisted by ultrasound imaging to ensure precision. To alleviate discomfort, local anesthesia is typically applied to the injection site prior to PRP administration.


Post Treatment


Post-treatment expectations should be managed carefully, as immediate results are uncommon with PRP therapy. Patients generally observe noticeable improvements several weeks following the procedure as the body gradually responds to the introduced growth factors and commences the tissue repair process within the joint.


The efficacy and duration of PRP therapy's benefits are subject to individual variability. Factors influencing the longevity of symptom relief include the severity of the arthritis condition, the patient's general health status, and adherence to recommended lifestyle modifications. While many patients report sustained relief for several months, the specific duration of the effect can differ based on the aforementioned variables.


prp for arthritis - Selphyl Ortho

FAQ


For healthcare professionals exploring PRP therapy as a potential treatment for patients with arthritis, understanding the nuances, costs, procedure frequency, recovery expectations, and potential side effects is crucial. This information aids in providing comprehensive patient care and setting realistic expectations.


What's the cost of platelet rich plasma injections for arthritis, and is it covered by insurance?


The financial aspect of PRP therapy varies widely, with treatments ranging from several hundred to thousands of dollars per session. The coverage of PRP therapy by insurance companies is limited, as it is often classified as an investigational procedure. Healthcare providers should advise patients to consult their insurance plans and policies and consider the out-of-pocket expenses associated with PRP therapy.


Is the platelet rich plasma treatment a one-time solution for arthritis, or does it require multiple sessions?


PRP therapy typically requires more than a single session to achieve optimal outcomes. The frequency and total number of sessions necessary are contingent upon the individual's arthritis severity and their response to the initial treatment. Healthcare providers will assess patient-specific factors to develop a tailored treatment plan, offering estimates on the expected number of sessions after evaluating the patient's condition.


What's the typical recovery time after undergoing PRP therapy for arthritis?


One of the advantages of PRP therapy is the relatively brief recovery period, which allows most individuals to promptly return to their daily routines. Despite this, healthcare providers may recommend a temporary hiatus from vigorous physical activities to ensure the treatment site heals adequately. This precaution helps minimize potential complications and maximizes the therapy's efficacy.


Are there any notable side effects or risks associated with PRP therapy?


While PRP therapy is generally associated with a favorable safety profile, especially given the autologous nature of the treatment, there are inherent risks as with any invasive procedure. Potential complications from treatment may include infection, nerve damage, or discomfort at the site of injection.


Potential Limitations and Risks


While PRP therapy is gaining attention as a potential treatment for arthritis, it is crucial for healthcare providers to carefully evaluate the current limitations and associated risks of this emerging therapeutic modality. A thorough understanding of these important factors is vital for guiding patients through informed decision-making processes regarding PRP therapy for arthritis.


1. Limited Clinical Evidence


The field of PRP therapy for arthritis, while promising, is characterized by a relative paucity of extensive, long-term clinical studies. The effectiveness of PRP therapy in treating arthritis, its potential side effects, and the criteria for identifying optimal candidates for this treatment are still under active investigation. The variability in treatment outcomes, influenced by patient-specific factors such as age, overall health status, and the nature of the arthritic condition, necessitates a cautious approach. Healthcare providers must stay informed about emerging research and transparently communicate the evolving understanding of PRP therapy's efficacy and safety to patients.


2. FDA Approval


The equipment used for preparing PRP and conducting the various injection therapy procedures has been cleared by the U.S. Food and Drug Administration (FDA); however, the application of PRP therapy specifically for arthritis treatment is not formally approved and remains investigational. Given that PRP is derived from the patient’s own blood, it is not regulated as a drug, allowing medical professionals discretion in its use based on clinical judgment and patient need, despite the absence of explicit FDA approval for arthritis indications. [10]


In this context, when contemplating the use of PRP therapy for arthritis, it is essential for practitioners to carefully consider the encouraging facets of PRP research alongside its present status as an investigational treatment for arthritis.


3. Potential for Adverse Reactions


Despite PRP therapy's utilization of autologous blood components, which typically reduces the risk of allergic reactions or rejection, there is still a potential for adverse reactions. These can include localized pain or discomfort at the injection site, the risk of infection, and other procedural complications. It is essential for healthcare providers to fully discuss these potential risks with patients in order to provide a comprehensive overview of the safety profile of PRP.


SELPHYL® Disclaimer


Instructions for the use of SELPHYL® can be found here and here.


SELPHYL® has not been approved by the FDA for subcutaneous, submucous, or intradermal injections in aesthetic medicine, and the safety and effectiveness of SELPHYL® for these conditions have not been established.


SELPHYL® is designed to be used for the safe and rapid preparation of autologous platelet-rich plasma (PRP) from a small sample of peripheral blood at the patient's point of care. The PRP is mixed with autograft and/or allograft bone prior to application to a boney defect to improve handling characteristics.


As of the time of writing, SELPHYL® has no known serious, life-threatening, or fatal risks apart from the adverse reactions described above.


SELPHYL® Limitations, Restrictions, Cautions, and Warnings


  • Prescription only.

  • Do not use the kit if the sterile packaging is damaged or compromised.

  • Follow universal safety precautions for blood collection and sharps disposal.

  • During blood draw, failure to align and properly seat tubes in the tube holder can result in a loss of vacuum and a loss of blood draw.

  • During PRP transfer, failure to align and securely seat tubes simultaneously in assembled blood transfer device tube holders can result in a loss of vacuum and the failure of PRP to transfer to the red-top PRFM tube.

  • Do not initiate the transfer of PRP into the red-top PRFM tube until the physician is ready to complete the procedure.

  • Do not reuse.


SELPHYL® Contraindications


These are not in FDA-required labeling and are part of SELPHYL®’s clinical evaluation for EU CE requirements.

  • Direct connection to a patient’s vascular system of circulating blood volume.

  • Other health conditions and diseases may also contraindicate the use of autologous PRP, including but not limited to low platelet count, sepsis, localized infection in the treatment area, anemia, malignancy with hematologic or bony involvement, and anticoagulation therapy.


Takeaway


PRP therapy represents an evolving therapeutic strategy in the management of arthritis, characterized by its utilization of autologous biological components to promote the body's intrinsic reparative processes. This modality provides a focused intervention aimed at mitigating joint dysfunction and reducing pain itself, distinguishing itself with the potential for sustained symptom alleviation and a reduced incidence of systemic side effects relative to conventional pharmacological approaches.


For healthcare professionals navigating the application of PRP therapy in arthritis treatment, it is imperative to balance the promising aspects clinical outcomes of this therapy with a comprehensive evaluation of its practical considerations. Engaging patients in informed discussions regarding the potential benefits, costs, and treatment expectations is essential to fostering informed decision-making and optimizing therapeutic outcomes within the context of arthritis management.


About the Author


Dr. Ali is a medical journalist and copywriter employed by SELPHYL® for the writing of this article.


References


  1. Sen R, Hurley JA. Osteoarthritis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 20, 2023.

  2. Chauhan K, Jandu JS, Brent LH, Al-Dhahir MA. Rheumatoid Arthritis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 25, 2023.

  3. Senthelal S, Li J, Ardeshirzadeh S, Thomas MA. Arthritis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 20, 2023.

  4. Selphyl. About PRFM. Selphyl. Published June 1, 2023. https://www.selphyl.com/about-prfm

  5. White C, Brahs A, Dorton D, Witfill K. Platelet-Rich Plasma: A Comprehensive Review of Emerging Applications in Medical and Aesthetic Dermatology. J Clin Aesthet Dermatol. 2021;14(11):44-57.

  6. Bava ED, Barber FA. Platelet-rich plasma products in sports medicine. Phys Sportsmed. 2011;39(3):94-99.

  7. Kwong CA, Woodmass JM, Gusnowski EM, et al. Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection: A Double-Blind Randomized Controlled Trial. Arthroscopy. 2021;37(2):510-517.

  8. Park YB, Kim JH, Ha CW, Lee DH. Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid. Am J Sports Med. 2021;49(2):487-496.

  9. Milants C, Bruyère O, Kaux JF. Responders to Platelet-Rich Plasma in Osteoarthritis: A Technical Analysis. Biomed Res Int. 2017;2017:7538604.

  10. Johns Hopkins Medicine. Platelet-Rich Plasma (PRP) Injections. Accessed February 21, 2024. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/plateletrich-plasma-prp-treatment 

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