PRP Injections for Osteoarthritis in Elderly Patients

Regarding the issue of injecting high-concentration platelet-rich plasma in patients with degenerative knee osteoarthritis?

My mother is 78 years old and has a history of hypertension.
The cartilage in both of her knee joints has worn down or is no longer present.
She sometimes experiences sudden pain while walking.
A physician has diagnosed her and suggested knee replacement surgery.
I found information online about a cartilage regeneration minimally invasive procedure at Miaoli Hospital, as well as your article on the preliminary clinical experience of injecting high-concentration platelet-rich plasma (PRP) in patients with degenerative knee osteoarthritis.
Could you please tell me how long the effects of such treatments typically last, and how often she would need to return to the hospital for further treatment? Is this treatment suitable for elderly patients? Thank you for your response.

Aqi, 50~59 year old female. Ask Date: 2015/04/09

Dr. Shi Guozheng reply Orthopedics

The effects can last approximately nine months to a year.
After PRP injection, a follow-up appointment is required in about two weeks to assess the level of improvement.
Medications can also be used as adjunctive therapy.
Subsequently, follow-up visits should occur every one to three months.
If there is no improvement after about three months, another injection may be administered; if there is continuous improvement, another injection can be given approximately once a year.
Currently, the success rate is over 90%, with most patients reporting improvement.
Elderly patients can undergo the procedure as long as they do not have blood-related diseases or infections in the knee joint.
However, if the knee joint has deteriorated to the point where total knee arthroplasty is necessary, surgery is generally considered the best treatment option.
The current minimally invasive knee surgery techniques are quite advanced, with an average surgical duration of about fifty minutes.
Patients with underlying medical conditions can still undergo surgery as long as they adhere to their medication regimen.
The average hospital stay is about five days, and postoperative rehabilitation is relatively straightforward.
The average age of surgical patients at our hospital is around 75 years, with some patients over 90 years old still being eligible for surgery if their health is good.
Treatment options, whether surgery or PRP injection, can be chosen based on the patient's condition.

Reply Date: 2015/04/09

More Info

When considering PRP (Platelet Rich Plasma) injections for osteoarthritis, particularly in elderly patients like your mother, there are several important factors to take into account. PRP therapy has gained popularity as a treatment option for osteoarthritis due to its potential to promote healing and reduce pain. However, the effectiveness and safety of this treatment can vary based on individual health conditions, particularly in older adults with pre-existing medical issues.

Firstly, PRP therapy involves extracting a small amount of the patient's blood, processing it to concentrate the platelets, and then injecting this concentrated plasma into the affected joint. The platelets contain growth factors that can aid in tissue repair and regeneration. In the case of osteoarthritis, PRP aims to enhance the healing of damaged cartilage and reduce inflammation.

For elderly patients, such as your mother who is 78 years old and has a history of hypertension, it is crucial to evaluate her overall health before proceeding with PRP therapy. While PRP is generally considered safe, the presence of other health conditions can influence the treatment's appropriateness. For instance, if your mother has uncontrolled hypertension or other cardiovascular issues, these could pose risks during the procedure or affect her recovery.

Regarding the longevity of PRP treatment effects, studies suggest that patients may experience relief from symptoms for several months, typically ranging from 6 to 12 months. However, this can vary widely among individuals. Some patients may require repeat injections to maintain the benefits, while others may find that the effects diminish over time. It is essential to have realistic expectations and understand that PRP is not a cure for osteoarthritis but rather a management strategy to alleviate symptoms.

In terms of alternative treatments, especially for elderly patients, it is advisable to explore a comprehensive approach. This may include physical therapy, weight management, and the use of assistive devices to reduce joint stress. In some cases, if the osteoarthritis is severe and significantly impacts mobility, surgical options such as joint replacement may still be the most effective long-term solution.

Before proceeding with PRP therapy, it is essential to have a thorough discussion with your mother's healthcare provider. They can assess her specific condition, review her medical history, and determine whether PRP is a suitable option. Additionally, they can provide guidance on the expected outcomes, potential risks, and the need for follow-up treatments.

In conclusion, while PRP therapy can be a beneficial treatment for osteoarthritis, especially in younger patients, its application in elderly individuals requires careful consideration of their overall health status and specific joint condition. A multidisciplinary approach that includes lifestyle modifications, physical therapy, and possibly surgical options should be considered to ensure the best possible outcomes for your mother. Always consult with a qualified healthcare professional to make informed decisions about treatment options.

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