PRP Injections for Osteoarthritis: Key Questions Answered

I have osteoarthritis of the knee and would like to inquire about the injection of high-concentration platelet-rich plasma (PRP)?

Dr.
Tsai: Hello, I have osteoarthritis of the knee.
The doctor has taken X-rays and said it is mild to moderate.
I have undergone three courses of hyaluronic acid injections with no significant effect.
I would like to ask about the injection of high-concentration platelet-rich plasma (PRP): 1.
I have read the educational materials, which state that after PRP injection, one should avoid vigorous exercise for two weeks.
Does this refer to the injected joint? 2.
It mentions avoiding corticosteroids or steroidal anti-inflammatory medications for three weeks after PRP injection.
Does this include cold medications as well? 3.
After PRP injection, how long will it take to determine if it is effective? Thank you for your response.

Lao Chen, 50~59 year old female. Ask Date: 2016/08/19

Dr. Cai Shanglin reply Orthopedics

1.
Yes.
2.
Avoid taking anti-inflammatory medications, including steroids and non-steroidal anti-inflammatory drugs (NSAIDs).
It is unclear whether cold medications contain the above, as each physician may prescribe differently.
3.
Generally, there will not be an immediate effect; the action takes time and varies from person to person.
It is recommended to combine with weight loss and appropriate exercise for more noticeable results.

Reply Date: 2016/08/19

More Info

Platelet-Rich Plasma (PRP) therapy has gained popularity as a treatment for osteoarthritis, particularly in the knee joint. This regenerative medicine approach utilizes the patient's own blood components to promote healing and reduce inflammation. However, there are several important considerations and questions that arise regarding its application, especially for individuals with specific medical histories, such as a history of cancer or chronic viral infections like hepatitis B.

1. Post-Injection Activity Restrictions: After receiving a PRP injection, it is generally advised to avoid vigorous activities for at least two weeks. This recommendation specifically pertains to the joint that has been injected. The rationale behind this guideline is to allow the injected PRP to settle and exert its effects without being disrupted by excessive movement or stress on the joint. Engaging in high-impact activities too soon could potentially negate the benefits of the treatment and lead to further injury.

2. Medication Restrictions: Following a PRP injection, patients are typically advised to refrain from taking corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) for about three weeks. This is crucial because these medications can interfere with the healing process that PRP aims to promote. As for over-the-counter medications like cold medicine, it is essential to check the ingredients. Some cold medications may contain NSAIDs or other anti-inflammatory components, so it is advisable to consult with your physician regarding any specific medications you are considering.

3. Timeline for Effectiveness: The timeline for noticing the effects of PRP therapy can vary significantly among individuals. Generally, patients may start to feel improvements within a few weeks, but it can take up to three months to fully assess the effectiveness of the treatment. Factors such as the severity of osteoarthritis, the individual's overall health, and adherence to post-injection care can all influence the outcome.

4. Considerations for Patients with a History of Cancer: For patients with a history of cancer, such as yourself, it is crucial to approach PRP therapy with caution. While PRP is localized and not a systemic treatment, the concern lies in the potential for any procedure that involves injections to stimulate cellular activity, which could theoretically influence tumor growth. However, many orthopedic specialists believe that PRP can be safely administered in patients with a history of cancer, particularly if they have been cancer-free for an extended period and are under regular medical supervision. It is essential to have a thorough discussion with your healthcare provider about your specific situation, including your cancer history and any ongoing monitoring for hepatitis B.

5. Alternative Treatments: If PRP therapy is not deemed suitable for you, or if you have reservations, there are alternative treatments for osteoarthritis, including physical therapy, lifestyle modifications (such as weight loss and exercise), and other injection therapies like hyaluronic acid or corticosteroids. Surgical options, such as arthroscopy or joint replacement, may also be considered in more severe cases.

In conclusion, PRP therapy can be a viable option for treating osteoarthritis, but it is essential to consider individual health factors, including past medical history and current health status. Always consult with your healthcare provider to determine the best course of action tailored to your specific needs and circumstances.

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