EULAR guidelines on injection of platelet rich plasma in knee osteoarthritis

European League Against Rheumatism has presented an expert consensus on the first clinical practice recommendations for platelet-rich plasma (PRP) injections in knee osteoarthritis at the European Congress of Rheumatology (EULAR) annual meeting.

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.

Studies in the past have revealed that platelet-rich plasma is a safe and efficient therapeutic option for the treatment of knee osteoarthritis. It was demonstrated to be significantly better than hyaluronic acid. The researchers also found that the efficacy of PRP increases after multiple injections.

The main recommendations include-

1. Intra-articular injections of PRP is an efficient treatment of early or moderate symptomatic knee osteoarthritis and may be useful in severe knee osteoarthritis (Kellgren-Lawrence grade IV).

2. Platelet-rich plasma injections should be proposed as second-line therapy, after the failure of non-pharmacological and pharmacological symptomatic treatment

3. Intra-articular platelet-rich plasma treatment may include 1 to 3 consecutive injections (median score, 9; appropriate).

4. Platelet-rich plasma injections should not be performed in osteoarthritis flare-up with significant effusion.

5. Leukocyte-poor PRP is preferred for knee osteoarthritis treatment.

6. Platelet-rich plasma injection should not be mixed with injectable anesthetic or corticosteroid.

7. Intra-articular injections of platelet-rich plasma constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis (median score, 8; appropriate).

8. Platelet-rich plasma injections should be performed under ultrasound or fluoroscopic guidance (median score, 8; uncertain).

For further reference log on to :

Efficacy and Safety of An Intra-Articular Injection of JTA-004, a Novel Enhanced Protein Solution, in Knee Osteoarthritis Pain: a Randomised, Double-Blind Controlled Phase II/III Study. Abstract FRI0400