PRP Tempe: what to try before you decide

What to try when the joint stays sore

First, change the task that sets off soreness. Walk less far or carry a lighter load. A brace can steady some sore knees. Medicine on the skin or by mouth may help too. Ask your doctor or pharmacist what's safe with your other medicines.

Give each change enough time to judge it. Don't stop a prescribed medicine because of a website.

Long use can leave a joint stiff and sore. A strain or fall can do the same. Stairs often bother a knee. Reaching high can bother a shoulder. Tell your doctor the exact motion and how soon the ache eases. That detail helps more than saying the joint always hurts.

When to have the cause checked before PRP

Book an exam if soreness keeps limiting the day. Go sooner when the joint often swells, catches, or gives way. Your doctor may check strength, motion, and swelling. An X-ray can show wear, but it can't show how daily movement feels.

Heat, redness, fever, or heavy swelling needs prompt care. Get help after a fall if you can't use the arm or leg. A new bend in the joint also needs quick care.

Platelet-rich plasma, or PRP, is a shot drawn from your blood. Spinning separates extra platelets, the small cells that clot a cut and help start repair. The medical provider gives the shot inside a sore joint or beside a sore tendon, a strong band between muscle and bone. Research differs from one problem to another. Have your doctor name the cause before you consider PRP.

Sources

1. The ESSKA-ICRS consensus applied the RAND/UCLA appropriateness method to 216 clinical scenarios for intra-articular PRP in knee OA. Only 84 scenarios (38.9%) were rated appropriate, 9 (4.2%) inappropriate and 123 (56.9%) uncertain. PRP was judged appropriate in patients aged 80 or under with KL grade 0-III osteoarthritis AFTER failed conservative non-injective or injective treatment; it was NOT considered appropriate as a first treatment, nor in KL grade IV (bone-on-bone) osteoarthritis, where 91.7% and 87.5% of scenarios respectively were uncertain.

   Kon E, de Girolamo L, Laver L, et al. — Platelet-rich plasma injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12320.

2. The 2019 ACR/Arthritis Foundation osteoarthritis guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-management programmes, tai chi, cane use, tibiofemoral bracing, topical and oral NSAIDs and intra-articular glucocorticoid injections for knee OA. Its conditional recommendations cover balance exercises, yoga, CBT, acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol. Anything offered before a course of the strongly recommended options is being offered out of order.

   Kolasinski SL, Neogi T, Hochberg MC, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

3. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

4. A meta-analysis of eight studies (648 patients, mean age 59) judged at low risk of bias found PRP significantly better than intra-articular corticosteroid for knee OA symptoms at 3, 6 and 9 months (P<0.01), with the largest effects at 6 months (SMD -0.78; 95% CI -1.34 to -0.23) and 9 months (SMD -1.63; 95% CI -2.14 to -1.12). This is the strongest available case for PRP as a longer-acting alternative to a steroid shot.

   McLarnon M, Heron N — Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. BMC Musculoskeletal Disorders, 2021. DOI: 10.1186/s12891-021-04308-3.

5. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

   U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.