AJSM July 2023 Podcast: Leukocyte-Rich Platelet-Rich Plasma Is Predominantly Anti-inflammatory Compared With Leukocyte-Poor Platelet-Rich Plasma in Patients With Mild-Moderate Knee Osteoarthritis: A Prospective, Descriptive Laboratory Study
Platelet-rich plasma (PRP) has been used
extensively in clinical practice to treat patients with symptomatic
knee osteoarthritis (OA). Leukocyte-poor PRP (LP-PRP) has been
clinically preferred over leukocyte-rich PRP (LR-PRP); however, it
is unclear which cytokine mediators of pain and inflammation are
present in LR-PRP and LP-PRP from patients with mild to moderate
knee OA in order to rationalize a specific formulation.
In conclusion, although numerous studies have
demonstrated the excellent safety profile of PRP in treating
patients with knee OA symptoms, a specific formulation has yet to
be determined. Although challenging to conduct, clinical trials are
needed that incorporate a mechanistic approach in all study arms in
order to assess the effect of all components in PRP formulations
(growth factor profile, leukocytes, RBCs, platelet dose) that not
only are responsible for improving symptoms but also could
contribute to disease-modifying effects. Our results expand on the
current literature and demonstrate novel findings in that LR-PRP
that was neutrophil-rich was predominantly anti-inflammatory
compared with LP-PRP with reduced neutrophil concentration in
patients with knee OA.
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