Precision Assessment of Platelet Rich Plasma for Joint Preservation
Precision Assessment of Platelet Rich Plasma for Joint Preservation
Knee Osteoarthritis (OA) is a leading cause of premature disability in Veterans who develop
 knee OA at higher rates and younger ages than the population in general. For those with
 symptomatic early knee OA, who are years to decades away from meeting clinical indications
 for knee replacement surgery, knee injections have been a key treatment option. In recent
 years, platelet rich plasma (PRP) injections have gained increasing attention for improving
 pain and function in patients with knee OA. Basic science studies also suggest that PRP may
 also potentially stimulate repair responses to articular cartilage. However, the mechanisms
 of action of PRP in the treatment of knee OA are unknown. Because autologous blood is used,
 the PRP composition differs between patients. It is also unknown whether these differences in
 PRP composition affect clinical outcomes. This study will address these gaps and provide
 critical new and objective information on PRP treatment effects in Veterans and additional
 women with early knee OA important to improving clinical use of this new treatment.
Because very little is known about either the mechanisms of action or objective clinical
 outcomes of PRP treatment for knee OA, the investigators propose a prospective "pre-post"
 study that will permit us to identify areas where more rigorous clinical outcomes and
 mechanistic research may be warranted. The proposed work includes special elements of: (1)
 quantitative metrics to assess clinical outcomes, (2) correlation of candidate beneficial
 proteins with clinical outcomes, and (3) proteomic evaluation of the injected PRP. This work
 will use an innovative multi-disciplinary, personalized approach to evaluate the effects of
 PRP composition on both function, as assessed by patient-reported outcomes and gait analysis,
 and cartilage matrix structure as assessed by quantitative MRI
Inclusion Criteria:

 -  symptomatic early knee OA

 -  full weight-bearing status

 -  have elected to receive PRP treatment

 -  Male veterans

 -  Female veterans or non-veterans

 Exclusion Criteria:

 -  inflammatory arthritis, gout or recurrent pseudogout

 -  symptomatic OA of other lower extremity joints

 -  BMI >35 kg/m2

 -  use of walking, orthopedic, or prosthetic assistive device

 -  severe systemic disease defined as American Society of Anesthesiologists (ASA) 3 or
 above56

 -  inability to have MRI

 -  pregnant or intending to become pregnant during the study

 -  predominantly patellofemoral disease