Leukocyte-rich PRP for Knee Osteoarthritis: Current Concepts. 

Mar 10

Leukocyte-rich PRP for Knee Osteoarthritis: Current Concepts. 

Osteoarthritis is one of the most debilitating degenerative conditions affecting more than a third of the population of active individuals over the age of 65. Upon onset of clinical manifestations, osteoarthritis (OA) may become increasingly destructive regarding disease progression with respect to the microenvironment. Investigations into the leukocyte concentration in PRP formulations and its effect on the healing process in OA has created some controversy in evidence-based practice. It is well known that the inflammatory phase is integral to the process of wound healing.  TOBI Faculty, Dr. Lana and colleagues, have published an article in the Journal of Clinical Orthopedics and Trauma that investigates the presence of leukocytes in PRP formulations and highlights the interactions between neutrophils and activated platelets in the release of anti-inflammatory molecules as an effect of leukocyte-rich PRP (L-PRP). 

In conclusion, leukocyte concentration from the buffy coat layer during PRP processing may contribute some positive immune modulation effects towards the regenerative phase in the inflammatory process. Alpha granules secreted by platelets provide a source of growth factors that aid in the appreciate outcomes of tissue repair, while interactions between neutrophils and activated platelets elicit an anti-inflammatory shift within the healing cascade. Lastly, a phenotypic switch from M1 to M2 macrophages also provides an important shift towards repair mechanisms within the microenvironment.  Although the overall effectiveness of L-PRP in the treatment of OA has shown some positive results, more investigation is needed to analyze the outcomes for varying degrees of OA and usher in a general consensus. 

Congratulations to TOBI Faculty, Dr. Lana and colleagues, on this important publication. Access the article here

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