An evaluation of a low-cost platelet-rich plasma for osteoarthritis of the knee: A pilot study

Purpose

To assess the characteristics and effectiveness of low-cost platelet-rich plasma (LC-PRP) for knee osteoarthritis (OA) by evaluating its composition and effect on pain, function, satisfaction, safety and cost-effectiveness.

Methods

Level IV evidence single-arm prospective cohort pilot study of 20 subjects (30 knees total) with mild-to-moderate knee OA. Two LC-PRP injections were performed, 3 weeks apart. Platelet extraction/yield, patient-reported outcomes and incidence of adverse events were assessed with a primary endpoint of 6 months. A cost-effectiveness analysis of LC-PRP compared to corticosteroid injection was conducted.

Results

On average, this LC-PRP preparation method allowed for recovery of 85% of platelets. Significant mean differences in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (total, pain and function) and global assessment score were observed at all follow-up points compared to baseline (p < 0.05 for 1, 3, 6 and 12 months). Satisfaction was noted in 90% of patients at 6 months and 75% of patients at 12 months. No significant adverse events were reported. LC-PRP was less costly ($654 vs. $1308) and yielded more QALYs (0.846 vs. 0.708) than corticosteroid injections. Per injection costs were estimated to be $10 for corticosteroid and $11 for LC-PRP.

Conclusions

This pilot study demonstrates that LC-PRP ($11) may significantly benefit patients with knee OA. LC-PRP appears to be a safe, cost-effective means for improving pain and function in knee OA.

Level of Evidence

Level IV.