PRP and Articular Cartilage: A Clinical Update

Table 2

Case series concerning PRP intra-articular injections for cartilage pathology.

PRP and intra-articular injections for cartilage pathology: case series
Authors	Year	Number of cases; (age and range in y)	Study	Level of evidence	Type of PRP	Procedure and observations	Clinical results
Sampson et al. [68]	2010	14; (age 18–87)	Case series	IV	L-PRP	3 L-PRP injections at 4-week interval;	Improvement at 52 weeks from baseline in Brittberg-Peterson VAS for Pain—resting, Pain—moving, and Pain—bent knee and in KOOS for Pain and Symptom Relief.
Kon et al. [70]	2010	91; (age 24–82)	Case series	IV	L-PRP	3 L-PRP injections at 3-week interval; before the injection: Ca-chloride was added to activate platelets; knee articular damage: grades 0–4 of Kellgren-Lawrence scale.	Improvement at 6 and 12 months from baseline in IKDC, objective and subjective, and EQ VAS; tendency of worsening between 6 and 12 months.
Wang-Saegusa et al. [69]	2011	261; (mean age )	Case series	IV	P-PRP	PRGF obtained following Anitua’s technique; 3 injections at 2-week interval.	Improvement at 6 months from baseline in VAS pain score, Lequesne Index, SF-36 physical, WOMAC Index for pain, stiffness and functional capacity.
Filardo et al. [71]	2011	90; (age 24–82)	Case series	IV	L-PRP	3 L-PRP injections at 3-week interval; before the injection: Ca-chloride was added to activate platelets; knee articular damage: grades 0–4 of Kellgren-Lawrence scale.	Improvement at 24 months from baseline in IKDC, objective and subjective, and EQ VAS; worsening of all scores between 12 and 24 months.
Napolitano et al. [72]	2012	27; (age 18–81)	Case series	IV	L-PRP	3 infiltrations of PRP at weekly intervals; calcium gluconate 10% was added; knee articular damage: chondropathy (Outerbridge 1-2), grades 1–3 of Kellgren-Lawrence scale.	Improvement at 6 months from baseline in Numerical Rating Scale (NRS) for subjective measurement of pain and the WOMAC index for patients with knee arthritis and cartilage disease.
Gobbi et al. [74]	2012	50; (age 32–60)	Case series	IV	L-PRP	2 infiltrations of PRP at 1 month interval; articular damage: grades 1–3 of Kellgren-Lawrence scale.	Improvement at 6 and 12 months from baseline in VAS for pain, IKDC subjective and objective score, KOOS Tegner and Marx scores.
Sánchez et al. [80]	2012	40; (age 33–84)	Case series	IV	P-PRF	3 infiltrations of PRP at weekly intervals; Calcium chloride was added; hip articular damage: Tonnis 2-3.	Improvement at 6 months from baseline in VAS, WOMAC Index, and the Harris pain subscale; no significant changes in pain scores between the 6- to 7-week and 6-month time points.
Torrero et al. [73]	2012	30; (age 18–65)	Case series	IV	L-PRP	Single intra-articular injection of PRP; knee articular damage: chondropathy (Outerbridge 1–3).	Improvement at 6 months from baseline in VAS and KOOS.
Jang et al. [77]	2013	90; (age 32–85)	Case series	IV	L-PRP	PRP obtained through Magellan Autologous Platelet Separator; knee articular damage: Kellgren-Lawrence Grade 1–3.	Improvement at 6 months from baseline in VAS and IKDC score; worsening from 6 to 12 months; negative correlation with age, Kellgren-Lawrence grade and presence of patellofemoral joint degeneration.
Raeissadat et al. [76]	2013	60; (mean age 57 ± 9)	Case series	IV	L-PRP	2 L-PRP injections at 4-week interval; no exogenous activation; knee articular damage: grades 1–4 of Kellgren-Lawrence scale.	Improvement at 6 months from baseline in WOMAC Index and the native (Farsi) edition of the SF-36 questionnaire (physical and mental).
Halpern et al. [75]	2013	15; (mean age 54; age 30–70)	Case series	IV	P-PRF	1 PRP injection (Cascade system); knee articular damage: grades 0–2 of Kellgren-Lawrence scale.	Improvement at 12 months from baseline in VAS and WOMAC Index.
Gobbi et al. [79]	2014	119; (age 40–65)	Case series	IV	P-PRP	3 PRP injections at a monthly interval; articular damage: Kellgren-Lawrence Grade 1-2; 50 cases received a second cycle at the completion of 1 year.	Improvement at 24 months from baseline in VAS, KOOS, Tegner and Marx scores; tendency of worsening from 12 to 24 months; at 18 months, greater improvement in patients who received the second cycle.
Mangone et al. [78]	2014	72; (age 52–82)	Case series	IV	L-PRP	3 L-PRP injections at 3-week interval; knee articular damage: Kellgren-Lawrence Grade 2-3.	Improvement at 12 months from baseline in WOMAC index, VAS at rest, and VAS in movement; WOMAC index improved only in the first 3 months.

y = years; PRP = Platelet-Rich Plasma; P-PRP = Pure PRP, with a low content of leukocyte; L-PRP = Leukocyte rich PRP; P-PRF = Pure Platelet-Rich Fibrin.