Yet More Evidence For PRP Superiority Over Cortisone for Knee Osteoarthritis
- Sam Oltman
- Apr 29
- 3 min read
Samuel G Oltman, ND, RMSK
A recently published meta-analysis of the last 60 years of research examines the effectiveness of Platelet Rich Plasma (PRP) and cortisone in treating knee osteoarthritis. Unsurprisingly, and in line with the whole of the scientific literature, PRP was shown to be superior to cortisone for knee osteoarthritis pain with less side effects.
Here are the key findings:
Corticosteroid Injections: Corticosteroids, "cortisone", injections have been widely used for decades and are supported by numerous studies. They are known for providing rapid pain relief in knee osteoarthritis patients. However, the benefits are often short-term, and repeated use may lead to potential side effects, including cartilage degradation*.
*This particular point cannot be overstated: Knee osteoarthritis is a disease of the joint that results from cartilage degradation. Cortisone, the common "treatment" for knee osteoarthritis, makes cartilage degradation worse. The proposed treatment for the disease makes the disease worse. This is the standard?
Platelet-Rich Plasma Injections: PRP injections have gained popularity in recent years. The review indicates that PRP may offer longer-lasting pain relief and improved joint function compared to cortisone injections. However, the evidence base for PRP is still evolving, and studies vary in terms of PRP preparation methods and patient selection criteria. The most important indicator in PRP quality is the Platelet Dose.
Amount of Evidence: PRP injections for the treatment of knee OA have been documented in the literature by a higher number of studies in a larger number of patients compared with cortisone injections. Moreover, the number of high level of evidence trials focusing on PRP evaluation surpassed those evaluating cortisone for knee OA patients. PRP is a more thoroughly studied treatment with better results, yet cortisone remains the choice for conventional medicine.
We continually need higher quality evidence. This is always a caveat at the end of large reviews. Patient selection, PRP preparation, and platelet dose have all been studied and are the reasons why we make PRP the way we do.
The conventional medicine systems that have incorporated PRP tend to do it poorly. They use kits that don't allow for proper concentration. They don't draw enough blood. They don't test the platelet count of the product they make. They don't always use ultrasound guidance for the injection. Expertise specifically in this domain is required and is what you get at Cascade Regenerative Medicine.
The simple question to ask to find out if the doctor you're seeing takes PRP seriously: "Do you know the platelet dose that will be used in my treatment?"
It can be difficult to pin down the reasons why, given the preponderance of evidence, PRP is not more widely used, why it's not taken seriously by conventional medicine, and why it's not covered by most insurance plans. Medical research takes a long time to be integrated, there is a bias toward single-compound pharmaceuticals, and your insurance company isn't interested in your long term health, are possible explanations. See this article for a more in-depth explanation of the "evidence-base" in orthopedic medicine.
At Cascade Regenerative Medicine we are built to be responsive to evolving scientific evidence and nimble in changing to our patients' needs. We use cortisone in the rare cases that it makes sense for the patient, after a thorough explanation of all the pros and cons. We are the region's leader in PRP production and precision, ultrasound-guided, joint treatment. If you don't want to wait any longer for the best treatment available, see what expertly-made, precision-delivered PRP looks like at Cascade Regenerative Medicine and schedule a visit with us today.
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