A group of doctors from China published new research in Clinical Rheumatology on PRP platelet Rich Plasma. Traditionally PRP is injected inside the joint, however our recent understanding of arthritis suggests that by targeting the subchondral bone beneath cartilage we may better influence the disease process. In the study doctors followed 82 patients over 18 months. Patients either received PRP injection into the joint and bone (Group A) into the joint alone (Group B) or Hyaluronic Acid injections into the joint ( A viscous lubricant known to have anti-inflammatory properties). Overall the group that had PRP injected into bone along with the joint outperformed the other groups providing significant pain relief and improved function, suggesting that targeting the subchondral bone is superior to simple joint injection for knee osteoarthritis in moderate to moderately severe knee arthritis. The authors will do further research to build upon these findings.
At The Orthohealing center, we have been injecting into bone for advanced arthritis for approximately 3 years with positive results. However we use larger volumes of PRP (without white blood cells) & also inject bone marrow concentrate which we found is a potent regulator of inflammation and stimulator of healing. In the study it was not clarified if Ultrasound or x-ray guidance was used to ensure accurate needle placement which has been shown to correlate with less pain and more accurate needle placement. More research & collaboration like this is needed to advance the field & combat the arthritis epidemic.