PRP Mesa answers for ongoing joint soreness

Easy movement and simple comfort can calm a flare

After too much activity, slowing down for a day may be kinder than complete rest. Easy movement keeps the joint from becoming stiffer. Warmth may ease an old ache, while a cold pack may settle new swelling, and you can choose what feels kinder.

A cane, a brace, or well-fitting shoes may take strain from the joint. Physical therapy can build the muscles that share the work. If you use pain medicine, ask your doctor to compare it with your other drugs, because that check isn't needless fuss.

PRP is a blood-based shot meant to support repair

Platelet-rich plasma is often called PRP. A clinician spins blood in a machine, moving platelets into a smaller amount of fluid that goes into a syringe before the clinician gives the shot. These blood cells, called platelets, take part in clotting and the first steps of repair.

The clinician places the shot inside a sore joint or into a sore tendon. Its purpose is to support repair signals in that spot, but relief isn't certain. In one large knee study, PRP and salt water gave the same pain result at 12 months.

Lasting soreness deserves an exam before a treatment choice

When sleep or daily tasks remain hard, another exam may be useful. QC Kinetix offers regenerative treatments, meaning non-surgical care prepared at the clinic with material taken from your blood. Its medical providers are the clinicians who examine you and review your health, and they may decide different care would suit you better.

Older X-rays, medicine names, and notes about painful movements may be useful at the visit. The clinician can describe the exam before any procedure comes up. Your questions are welcome, and you don't have to settle the matter during that first talk.

Sources

1. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

   U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.

2. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

3. A meta-analysis of eight studies (648 patients, mean age 59) judged at low risk of bias found PRP significantly better than intra-articular corticosteroid for knee OA symptoms at 3, 6 and 9 months (P<0.01), with the largest effects at 6 months (SMD -0.78; 95% CI -1.34 to -0.23) and 9 months (SMD -1.63; 95% CI -2.14 to -1.12). This is the strongest available case for PRP as a longer-acting alternative to a steroid shot.

   McLarnon M, Heron N — Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. BMC Musculoskeletal Disorders, 2021. DOI: 10.1186/s12891-021-04308-3.

4. A systematic review of 105 clinical PRP studies in orthopaedics published 2006-2016 found that only 11 (10%) described the preparation protocol clearly enough for another investigator to repeat it, and only 17 (16%) reported any quantitative metric of the final PRP composition. The authors concluded that the current reporting of PRP preparation and composition does not allow the PRP products actually delivered to patients to be compared between studies.

   Chahla J, Cinque ME, Piuzzi NS, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature. Journal of Bone and Joint Surgery (American), 2017. DOI: 10.2106/JBJS.16.01374.

5. Medicare's national coverage policy covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only within an approved coverage-with-evidence-development clinical study. There is no Medicare national coverage for PRP in osteoarthritis or tendinopathy, which is why these injections are billed to the patient as cash-pay.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS.gov, 2024.