Platelet Lysate and Osteoarthritis of the Knee: A Review of Current Clinical Evidence

Gupta, Ashim; Maffulli, Nicola

Abstract

Introduction: Osteoarthritis (OA) of the knee affects millions of people with sizable socioeconomic burden. Conventional treatment modalities are prioritized, turning to surgical intervention only when they have failed. However, these traditional modalities have shortcomings, only aiming to reduce pain rather than targeting the underlying pathophysiology. Recently, the use of biologics, including autologous peripheral blood-derived orthobiologics (APBOs), has increased and demonstrated great promise for the management of knee OA. Platelet-rich plasma (PRP) is the most widely used APBO, but its efficacy is still uncertain, attributed to lack of standardized formulation protocols, characterization, and patient variables. To overcome the limitations posed by PRP, the use of other APBOs such as platelet lysate (PL) has been considered. This review summarizes the outcomes of clinical studies involving PL to manage OA of the knee. Methods: Multiple databases (Scopus, Embase, PubMed, and Web of Science) were searched employing terms “platelet lysate” and “knee osteoarthritis” for articles published in the English language to August 15, 2024, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Only three clinical studies fulfilled our search and inclusion criteria. Intra-articular injection of three doses of PL injected every 3–4 weeks is safe and efficacious, resulting in statistically significant improvements in different patient-reported outcome measures at 6–12 months follow-up. Conclusion: The existing published peer-reviewed literature suggests that intra-articular injection of PL is safe and can decrease pain and increase function in patients with knee OA. Nonetheless, given the dearth of pertinent literature, more adequately powered, multicenter, prospective, non-randomized and randomized controlled studies with extended follow-up are needed to confirm the effectiveness of PL in knee OA. Further comparative studies to help clinicians in choosing the best APBO for knee OA treatment are also warranted.

Citation

Gupta, A., & Maffulli, N. (2024). Platelet Lysate and Osteoarthritis of the Knee: A Review of Current Clinical Evidence. Pain and Therapy, 13(6), 1377-1386. https://doi.org/10.1007/s40122-024-00661-y

• Journal Article Type: Article
• Acceptance Date: Sep 10, 2024
• Online Publication Date: Sep 28, 2024
• Publication Date: Dec 1, 2024
• Deposit Date: Oct 11, 2024
• Publicly Available Date: Nov 12, 2024
• Journal: Pain and Therapy
• Print ISSN: 2193-8237
• Electronic ISSN: 2193-651X
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 6
• Pages: 1377-1386
• DOI: https://doi.org/10.1007/s40122-024-00661-y
• Keywords: Patient reported outcome measures, Platelet-rich plasma, Autologous blood-derived orthobiologics, Platelet lysate, Knee osteoarthritis
• Public URL: https://keele-repository.worktribe.com/output/950325
• Publisher URL: https://link.springer.com/article/10.1007/s40122-024-00661-y
• Additional Information: Received: 15 August 2024; Accepted: 10 September 2024; First Online: 28 September 2024; : ; : Ashim Gupta is an Editorial Board member of Pain and Therapy. Ashim Gupta was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Ashim Gupta and Nicola Maffulli declares that he has no other competing interests.; : This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.