Adverse event following platelet rich plasma injection for the management of early Osteoarthritis of knee – A report of 4 cases

Abstract

Osteoarthritis is the leading cause of chronic disability affecting more than 80% of people over the age of 55. Several treatment options are there for early Osteoarthritis (OA) knee, like- rest, ice, brace, NSAIDs, intra-articular corticosteroid, Intra-Articular Hyaluronic Acid (IAHA), and intra-articular platelet-rich plasma (PRP) injection. Growth factors in PRP (PDGF, IGF, VEGF) promote matrix synthesis, cell growth, and migration, thus facilitating protein transcription. Several studies regarding PRP injection in the management of OA knee support this line of management without any documented complications of PRP at the knee joint.We report 4 cases of acute inflammation related to PRP injection for the treatment of OA knee. Two patients developed mild inflammation which was treated with oral medication on an outpatient basis. Another two patients developed moderate to severe inflammation which warranted surgical intervention.Intraarticular PRP injection has been reported in the literature as a successful modality of treatment in OA knee without any significant adverse effect. We are reporting four cases of adverse events following intraarticular PRP injection. Two cases were mild inflammations while the other two were moderate to severe. All four patients recovered and the outcome was satisfactory compared to the pre-injection status. The exact cause for the reaction after PRP injection in the knee is not known. Further study is needed for the cause of the inflammatory reaction.