so you've had pain in your knee for a long time you've tried a home exercise program
you've tried physical therapy you've tried oral pain medications
you may have even tried cortisone injections take a look at these results
they are amazing pain improvement and functional improvement sustained for over
one year data from multiple randomized controlled trials show that prp injections work and they work
really well for the treatment of knee osteoarthritis let's talk about prp injections
hey everyone my name is dr jeff peng we're going to talk about platelet-rich plasma injections also
known as prp injections and we're going to talk about them in the use of treating knee arthritis
once considered experimental platelet-rich plasma injections were only available to the top of the
top athletes as well as in clinical trials tiger woods kobe bryant rafael nadal alex rodriguez
what do all these all-time great athletes have in common when they got injured
they all used platelet-rich plasma injections to help them recover quicker from their injuries
now prp injections have become widespread in the treatment of professional athletes
college athletes weekend warriors the industrial athlete and pretty much anyone else who wants to
live an active and healthy lifestyle but are limited by painful conditions prp injections
fall under this big umbrella category called orthobiologics also known as regenerative medicine
it's being used to treat a variety of orthopedic conditions such as injuries to
muscles tendons ligaments bones and joints but do they really work what do clinical trials
tell us about people who get prp injections for the treatment of their orthopedic problems let's
take a deep dive into one of the most studied and most supported indications for prp injections and
that's in the use of treating knee arthritis now people who suffer from knee arthritis can attest
to the fact that this condition can be incredibly painful and can be debilitating and our current
treatment options right now in the treatment of knee arthritis is really just mediocre at best so
how does prp injections compared to all our other treatment options i've included a small sample of
the rapidly growing body of evidence looking at using prp injections to treat knee osteoarthritis
let's go through some of these studies this was a randomized double-blind placebo-controlled
trial comparing prp injections to placebo and the authors concluded
intra-articular injections of platelet-rich plasma can provide clinically significant functional
improvement for at least one year in patients with mild to moderate osteoarthritis of the knee
this prospective randomized control trial directly compared prp injections to steroid injections
and they found that prp injections demonstrated a statistically significant improvement over steroid
injections in a one-year follow-up time period this study was a meta-analysis of 20 different
randomized control trials comparing prp injections to hyaluronic acid injections and the authors
concluded intra-articular platelet-rich plasma injections appeared to be more efficacious than
hyaluronic acid injections for the treatment of knee osteoarthritis in terms of short-term
functional recovery moreover prp injections was superior to hyaluronic acid injections in terms of
long-term pain relief and functional improvement the growing body of medical literature shows
that platelet-rich plasma injections are better at improving short and long-term pain relief as well
as functional improvement and that's compared to placebo compared to cortisone injections compared
to hyaluronic acid injections and potentially compared to not doing anything at all and the
reason for that is that we are understanding that osteoarthritis is a chronic progressive disease
it tends to get worse over time and that's why we see people go from mild to moderate to severe
to bone on bone osteoarthritis so we need to change the way we think about osteoarthritis
and platelet-rich plasma injections allow us to do that think about it this way we don't wait for
someone to have a heart attack or a stroke before we say hey we should probably treat
your high blood pressure if you have high blood pressure whether you have any symptoms or not
we treat it because if we don't it's going to lead to a heart attack it's going to lead to a
stroke and we need to think about osteoarthritis in this same way if you have osteoarthritis if we
don't treat it it will get worse and that's where platelet-rich plasma injections can
potentially provide treatment this study is titled platelet-rich plasma injections
delay the need for knee arthroplasty and what is knee arthroplasty knee arthroplasty means a knee
replacement surgery the authors conclude these data suggest that the application of prp in knee
osteoarthritis patients is a treatment that could delay total knee arthroplasty here's my takeaway
from all of these studies prp injections are safe they're effective at treating knee osteoarthritis
symptom relief can be sustained for at least one year and prp injections can potentially delay
the progression of osteoarthritis as indicated by delaying the need for a knee replacement surgery
that was a quick summary of the evidence behind the use of prp injections for the treatment
of knee arthritis but now i want to help you understand the why and the how behind prp what
are the platelets doing why does prp work how does platelet-rich plasma injections potentially delay
the progression of knee osteoarthritis and if you understand the concept behind all of this you will
start to see why so many orthopedists and sports medicine specialists are so excited about using
prp injections to help treat those who suffer from painful conditions and the best way to understand
this is to use the following analogy let's say that i fall and have a big cut over my forearm
it's red it's hot it's swollen it's angry it hurts over time a scab forms over this cut scab falls
off you get this pink white looking granulation tissue and if i give it a few months i got brand
new skin this entire healing process is initiated and controlled by platelets our platelets are
responsible for tissue healing tissue remodeling tissue proliferation and most importantly
in controlling pain and inflammation and so what we're doing with a platelet-rich plasma injection
is we're taking your own platelets out concentrating it and then injecting it
under ultrasound guidance back into an area that has been irritated or injured and this is why we
think prp injections have so much potential in the treatment of orthopedic conditions
now historically we gave cortisone injections and cortisone is a steroid it's a very
strong pain medication and it's a very strong anti-inflammatory medication think of it like
getting a big dose of ibuprofen but for anyone who's ever taken ibuprofen you know the effects
of ibuprofen are temporary and the same is true of cortisone injections look at this graft on the
left shows people who got cortisone injections and notice that they do get pain relief but their pain
levels get higher and higher with time now look at the people who got prp injections these effects
are sustained prp injections provide better pain relief and better functional outcomes sustained
for at least one year and we think the reason for that is because prp injections contain an
incredible amount of growth factors and this can help with tissue healing and providing pain relief
and just like how my laceration will continue to remodel over time the effects of platelet-rich
plasma injections can be sustained for a long period of time here lies
the potential explanation for how prp injections may delay the progression of knee osteoarthritis
as evidenced by the delay need for a knee replacement recall that osteoarthritis is the
gradual wear and tear and the loss of articular cartilage and every time articular cartilage gets
damaged or injured they release a bunch of toxic enzymes and proteins into the joint this toxic
environment is what is causing all the symptoms that people who suffer from knee arthritis are so
familiar with the stiffness the pain the warmth the inflammation the restricted range of motion
the locking the clicking all of this is caused by that toxic environment and the problem with this
is the higher amount of toxic enzymes and proteins in that joint what that does is it weakens your
articular cartilage all the healthy articular cartilage that is still intact is slowly weakened
and when they start dying off they then release a bunch of toxic enzymes and proteins this then
further weakens the rest of the healthy remaining articular collagen and when they get injured they
then release a bunch of toxic enzymes and proteins and this results in an avalanche effect and this
is why we see people go from mild to moderate to severe to bone on bone osteoarthritis in the span
of a short time and what platelet-rich plasma injections can do is introduce a huge amount
of growth factors and by introducing these growth factors we try to reset the internal environment
of the joint we go from an environment that is really toxic and inflammatory all the way down
to one that's more normal one that's more neutral and by doing so we break this avalanche effect
that is causing the progression of osteoarthritis and we try to slow that down a lot of my patients
who have learned about platelet-rich plasma injections have decided to proceed with treatment
many of these patients have decided to do it concurrently with either a home exercise
program or physical therapy many people who have symptoms that are relatively well controlled
still also continue to proceed with treatment and that's to try to maintain the environment of their
joint to hopefully delay the progression of their osteoarthritis thanks for watching please share
this video with anyone who you know has arthritis especially if they have osteoarthritis of the knee
prp injections are new and the more people who learn about it the more people who can benefit
from it i'm also going to be making a video of all the frequently asked questions that i get on
prp injections i will also be making more videos on prp injections and all the other indications
that it has been shown to be beneficial you can find me on social media as well i'm on
twitter @jeffreypengmd i also write on my blog at jeffreypengmd.com thanks for watching