An Overview of Hip and Knee Osteoarthritis
For a multitude of factors, many people will develop osteoarthritis (OA) as they age, with the most significant risk factors being obesity, previous joint injuries, genetics, older age, and being of the female gender. In its simplest terms, OA results from wear and tear of the joints over time. Typically, it presents with joint stiffness and painful joints that are aggravated by prolonged standing or walking. It often develops in large weight-bearing joints like the hip and knee. If you have or suspect OA, it is important to see your family physician and physiotherapist ensure the best possible management of your condition.
What is PRP (Platelet-Rich Plasma)?
PRP is a type of injection that is directed specifically into the affected area, in this case, either your hip or knee joint. You may have heard of people going for prolotherapy or cortisone shots and PRP is a very similar procedure. With a PRP injection, first, you have your own blood drawn and specially prepared so that only the plasma (a part of your blood containing platelets) remains. This part of your blood contains a lot of growth factors, so essentially a concentrated amount of your body’s own healing-stimulating chemicals are injected into the damaged joint. The effect of the injection is to restart the inflammation process and facilitate healing. The injections are performed by a highly trained physician and should ideally be completed with ultrasound guidance.
How do I know if I should get a PRP injection?
PRP is not for everyone and there are many components your physiotherapist and family physician will consider before referring you for an injection. Before PRP is considered, you should complete at least three months of conservative care. Conservative care simply means doing the treatments that have been shown by the research to be effective for most people and that are the safest options. For hip and knee OA, this includes weight loss, pain medications, and lower body strengthening exercises. If after three months of conservative care, you are still experiencing significant pain and your day-to-day function is impaired, then your health care team will start to evaluate other options, including a referral for a PRP injection. Even with a PRP injection, it is still important to continue conservative care treatments as PRP is not a cure for hip and knee OA.
What does the research say about PRP injections and are they safe?
PRP is still quite a new area of research, meaning there is not enough evidence out there to make clear recommendations. However, the existing evidence appears supportive of PRP for decreasing pain and improving hip and knee function. There are particularly promising results for knee OA. Other considerations are that PRP is not covered by health insurance. As such, you are required to pay for the injection independently and one injection costs around $500. As for safety, adverse events do occur with PRP injections, the most common being increased pain during and for several days after the injection. Other more serious adverse events, such as infection, can occur but are very rare.
That’s a lot of information to consider! What are the key points?
- Before considering PRP, make sure you have completed at least three months of conservative treatment (lower body strengthening exercises, weight-loss, and low-grade pain medications) guided by your family physician and physiotherapist. This is the safest option and they are strongly supported by research.
- If your knee or hip OA is still significantly painful and is impacting your day-to-day activities, consider asking your family physician or physiotherapists about PRP.
- There are risks and benefits to all procedures so be sure you and your health care team discuss all the options before proceeding with a PRP injection.
- The research on PRP is limited; however, an increasing number of studies have shown positive effects for decreasing hip and knee pain as well as improving function and mobility.