Platelets contain growth factors and cytokines that are important in inflammation reduction, necrotic cell removal, soft tissue healing, and bone mineralization. Steps in administering include obtaining blood through a usual venous draw, putting the blood through a centrifuge to obtain plasma with a high concentration of platelets, and then injecting the platelet-rich plasma (PRP) into the arthritic joint. Transforming growth factor-beta, present in PRP, has been associated with chondrogenesis in cartilage repair. PRP increases chondrocyte proliferation and may have clinical effects on degenerative cartilage. PRP increased HA concentration, stabilizing angiogenesis in 10 patients with osteoarthritic knees.1,13
Total knee arthroplasty and total hip arthroplasty are considered after conservative treatments have failed. Surgery can be contraindicated in the setting of medical comorbidities including obesity or due to a patient’s unwillingness/inability to complete the postoperative rehabilitation process.
The newest advances in arthritis treatments include the following: biologic treatments including PRP as discussed previously, stem cell therapy, vitamin C/D, and new developments in acupuncture techniques.