Retrospective Study of Platelet-Rich Plasma and Its Uses in Knee Pain in a District General Hospital in the United Kingdom

TL;DR

This study examines how platelet-rich plasma injections help manage knee pain in a UK hospital, finding mixed results with some patients needing further treatment.

Contribution

The study provides real-world data on PRP injection outcomes for knee pain in a UK district hospital setting.

Findings

32.56% of patients were successfully discharged after PRP injections.

9.30% of patients still required total knee replacement despite PRP treatment.

Most patients needed additional follow-ups or further injections.

Abstract

Introduction

Knee pain and knee osteoarthritis (kOA) are increasingly prevalent pathologies presenting to primary care and secondary care alike, contributing to worsening financial burdens shouldered by the NHS. Platelet-rich plasma (PRP) is an established option in the management of knee pain. This study primarily aims to analyse the use of intra-articular PRP injections in the treatment of knee pain, especially kOA.

Material and methods

A total of 43 patients who visited the elective clinics between 1 January 2024 and 1 January 2023 over a 12-month period and underwent PRP injection treatment for knee pain were identified, and data were obtained through the computerised patient data. All patients included in the study had already trialled simple analgesics and conservative measures with no success. PRP therapy was used in conjunction with the analgesics and conservative measures. Pain relief duration following the injection was studied. Analysis included whether these patients could be successfully discharged, defined as discharged without further recall or attendance, only needed a telephone follow-up (TFU), or had to be listed for further treatment (including arthroscopy, repeated intra-articular injections, imaging, or arthroplasty). The patients who were discharged were able to manage their pain after the PRP successfully with simple analgesia, whereas prior to the PRP, they were unable to.

Results

The number of women presenting at the clinic was significantly higher than men (33 women vs 10 men, p < .00001). A total of 37 out of 43 patients had the full three-course of injections (86.05%), three patients had two injections (6.98%), and three patients only needed one injection (6.98%). After the respective course of injections, 14 patients (32.56%) were successfully discharged from the clinic, and a further six only needed TFU (13.95%). A total of 16 patients (37.21%) needed a further face-to-face follow-up (FTF) or investigations, and three patients (6.98%) needed further PRP injections. Four patients (9.30%) were subsequently listed for a total knee replacement (TKR) despite the PRP injections.

Conclusion

PRP remains a valid option in the management of knee pain; the efficacy and the duration of pain relief, however, are unpredictable. Further research is yet to be done to establish how other factors positively or negatively impact the use of PRP, double-blinded trials on outcomes with patients who are smokers versus non-smokers after PRP injections, and prospective studies on decreasing alcohol consumption, weight loss, and dietary changes would be of great benefit in assessing the interplay of PRP injections with other variables.

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