Knee Pain

Almost everyone, especially among elderly experience knee pain. It happens mostly because they aged. It may also be the result of a sudden injury. For example, torn ligaments or meniscus. Meniscus is a crescent-shaped wedges of cartilage within the knee. It designed to distribute your body weight across the joint. This kind of injuries often occurs in people like athletes who often run, jump or lift heavy items. On the other hand, some knee injuries happen over a longer duration of time. Sports and jobs that require frequent bending of the knees could cause the wear and tear of the joint cartilage, leading to arthritis, most commonly osteoarthritis (OA).

4 Main Structures of Knees:

i. bones

ii. cartilage

iii. ligaments

iv. tendons

Our knees are made up of four main structures: bones, cartilage, ligaments, and tendons. The thigh bone (femur), the shin bone (tibia) and the knee cap (patella) meet to form the knee. According to the Arthritis Foundation, these structures and components put the knee at risk of all kinds of injuries, making it one of the most vulnerable joints in our body.

Platelets are one of the components in the blood, and they are best known for their ability to aid in blood clotting. Platelets also contain numerous proteins called the growth factors. It interacts with local cells and signals them to initiate cell division and migration to promotes cell regeneration and healing of the damaged structures of the knees.

Currently, there is no study on the number of Malaysians suffering from osteoarthritis. However, estimated that more than 60 per cent of the worldwide population aged 65 and above has some form of the disease.

In the Global Burden of Disease 2010 Study, estimated that 251 million people suffered from knee OA worldwide.

Methods of Managing Knee Arthritis:

i. Traditional Methods

Traditional methods of managing knee pain caused by osteoarthritis (OA) include anti-inflammatories, physical therapy, cortisone injections, and surgery. In the past decade, researchers have examined whether injections of platelet-rich plasma (PRP) can be used to manage OA of the knee.

ii. PRP Therapy for Knee Pain

Platelet-rich plasma therapy is a simple and minimally invasive intervention which is feasible to deliver in primary care to treat osteoarthritis of the knee joint.

The process involves taking plasma from a small amount of the person’s blood and injecting it into the knee. In this treatment, your doctor takes a sample of your blood and spins it in a machine called a centrifuge to pull out your blood’s platelets and plasma.

What are the benefits of PRP therapy to Knee Arthritis?

Growth factors can found in platelets in your blood. PRP operates under the theory that injecting growth factors from the blood into an injured area. It helps to form new tissues. That is supposed to reduce inflammation in the fabric. When growth factors interact with local cells, they signal them to initiate cell division and migration. These growth factors promote tissue formation.

A recent meta-analysis Trusted Source from 2017 reviewed 14 randomised controlled trials with a total of 1,423 participants. It found that PRP appears to be effective in managing pain associated with knee OA. Researchers noted that, compared with placebo, PRP injections significantly reduced pain scores at 3-, 6-, and 12-month follow-ups. And compared with controls, PRP significantly improved physical function at these follow-ups.

In September 2015, doctors writing in the medical journal Arthroscopy suggested that platelet-rich plasma (PRP) injection significantly improved patient-reported outcomes in patients with symptomatic knee osteoarthritis at 6 and 12 months postinjection. Meanwhile, PRP was superior to hyaluronic acid injections or viscosupplementation and placebo injections.

This study demonstrated that one shot of PRP injection, decreased joint pain more and longer-term, alleviated the symptoms and enhanced the activity of daily living and quality of life in short-term duration in comparison with a corticosteroid.

Contraindications for PRP Knee Injections

i. Critical Thrombocytopenia

Critical thrombocytopenia is also known as platelet-poor plasma. It happens when a person lack of platelet in their red blood cell.

ii. Intra-Articular Steroid Knee Injections

Besides, the other contraindication in the patients is intra-articular steroid knee injections with the bacteremia, sepsis, periarticular or intra-articular infections. The significant skin breakdown at the target site, known hypersensitivity to the steroid injection, intra-articular or osteochondral fracture at the target site, severe joint destruction, joint prosthesis, or uncontrolled coagulopathy: Critical thrombocytopenia

Most studies have found few or no side effects, and suggest that platelet-rich plasma is a safe, less invasive alternative to knee surgery. Because injections involve the person’s blood, an allergic or other adverse reaction is less likely than with other injections.

In addition, the side effects of PRP injections are very limited because, since the injections are created from your own blood, your body will not reject or react negatively to them.

According to the American Journal of Physical Medicine & Rehabilitation. Our preliminary findings support the application of autologous PRP as an effective and safe method in the treatment of the initial stages of knee osteoarthritis.

Some physicians may use PRP as a single dose treatment rather than as part of a comprehensive knee osteoarthritis treatment program. Used this way, as a single dose, PRP may not be as effective.

The injection site might be tender after the injection, but should not be painful. Some people develop a bruise or small wound at the site of the needle.

Following treatment, physical therapy can help restore movement to the joints, reduce the risk of future injuries, and prevent the condition worsening.