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Platelet-Rich Plasma Injections Do Not Improve Ankle Osteoarthritis

November 17, 2021

Ankle (tibiotalar) osteoarthritis affects approximately 3.4% of adults and is associated with a reduced quality of life.  Effective non-surgical treatments are not available.  Based on data from four small case studies, autologous platelet-rich plasma (PRP) injections have been used with the hope that growth factors released from α-granules in platelets may modulate a regenerative response allowing affected tissue to heal.  A randomized clinical trial recently published in JAMA, however, does not support the use of PRP injections for patients with ankle osteoarthritis.  The multi-center, double blind trial randomized 100 patients with ankle osteoarthritis (mean age, 56 years; 45% female) to receive either two intra-articular PRP injections (n=48) six weeks apart or two placebo saline injections (n=52).  After 26 weeks of follow-up, both arms of the study reported a similar increase in the American Orthopaedic Foot and Ankle Society score measuring pain and function (mean increases of 10 points in the PRP arm and 11 points in the placebo arm; p=0.56).  Further research into potential treatments to improve function and relieve pain for osteoarthritis is needed.

Reference:

 Paget LDA, Reurink G, de Vos RJ, Weir A, et al. Effect of platelet-rich plasma injections vs placebo on ankle symptoms and function in patients with ankle osteoarthritis.  JAMA 2021; 326(16):  1595-1605

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