Comparing PRP and Cortisone for Knee Osteoarthritis


PRP as an Alternative to Cortisone

A January 2024 study in Annals of Medicine and Surgery reviewed 42 research trials involving 3,696 patients. The findings suggested that "PRP is an effective treatment for knee osteoarthritis when compared with hyaluronic acid, corticosteroid, and placebo." The study highlighted that PRP could offer an alternative to cortisone, with researchers noting its potential to provide symptomatic relief while avoiding the side effects associated with cortisone.

Cortisone’s Limitations

Cortisone injections are often prescribed for immediate pain relief, primarily by reducing inflammation. However, they do not address the underlying degeneration and may carry risks such as:

  • Accelerated osteoarthritis progression.
  • Subchondral insufficiency fractures.
  • Complications like osteonecrosis or rapid joint destruction.

Clinical Comparisons Between PRP and Cortisone

Short-Term and Long-Term Effects

  • A study in The Journal of Sports Medicine and Physical Fitness (41) compared one-time PRP and cortisone injections for Grade II and III knee osteoarthritis. PRP demonstrated superior pain relief, improved quality of life, and sustained benefits over time compared to cortisone.

  • An October 2020 study found that PRP’s benefits extended to long-term outcomes (up to 180 days), outperforming cortisone in pain reduction and functional improvement.

Radiographic Progression

A 2022 study in Clinical Rehabilitation assessed one-year outcomes of PRP, cortisone (triamcinolone hexacetonide), and saline. While cortisone showed immediate symptom improvement, PRP resulted in less radiographic progression of osteoarthritis, indicating its potential for slowing joint degeneration.

Head-to-Head Studies

Six-Month Outcomes

A September 2022 study in Cureus involved 29 patients with mild-to-moderate bilateral knee osteoarthritis. One knee received PRP, and the other received corticosteroid injections. While both treatments showed improvements in pain, stiffness, and function, PRP provided slightly better outcomes at six months.

Twelve-Month Outcomes

A July 2020 study in The Journal of Orthopaedic Surgery and Research highlighted that while PRP and cortisone showed similar short-term improvements, PRP offered statistically significant advantages in pain relief and functional scores at one year.

Mechanisms and Healing Process

PRP works by stimulating tissue repair through the body’s inflammatory response, whereas cortisone suppresses inflammation without promoting healing. Over time, cortisone can inhibit the body’s natural repair mechanisms, potentially leading to faster joint degradation. PRP’s regenerative properties, on the other hand, address the underlying damage and promote long-term healing.

Safety and Side Effects

PRP

  • Derived from the patient’s blood, PRP is considered a safe option with minimal risk of adverse effects.
  • PRP reduces the risk of accelerated degeneration, as it promotes healing rather than suppressing inflammation.

Cortisone

  • Associated with side effects like bone loss, joint instability, and rapid osteoarthritis progression.
  • No reliable imaging methods currently exist to predict which patients are at higher risk of these complications.

Comparative Effectiveness: PRP, Cortisone, and Other Treatments

Key Findings from Meta-Analyses

  • A May 2022 study in The Journal of Clinical Medicine evaluated PRP, cortisone, hyaluronic acid, and placebo. PRP showed the greatest pain reduction and functional improvement at 3, 6, and 12 months.
  • A March 2023 meta-analysis reviewed 16 trials and found PRP to be the most effective intervention for pain and stiffness, outperforming cortisone and hyaluronic acid.

Long-Term Benefits

A March 2022 study in The American Journal of Sports Medicine analyzed 40 reviews involving over 3,000 participants. While PRP and cortisone offered comparable short-term relief, PRP’s long-term benefits were superior, particularly in reducing radiographic progression of osteoarthritis.

Combining PRP with Physical Therapy

A May 2024 study in Molecular Biotechnology explored PRP’s synergy with physical therapy. Combining PRP with exercise therapy significantly outperformed standalone treatments, enhancing inflammation control and rehabilitation in knee osteoarthritis patients.

Conclusion

While cortisone provides immediate but temporary symptom relief, it does not address the underlying causes of knee osteoarthritis and carries significant risks over time. PRP, on the other hand, offers a regenerative alternative, promoting long-term healing with minimal side effects. Patients should consider their individual needs and consult with their healthcare providers to determine the most appropriate treatment approach.



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Pioneering regenerative medicine for over a decade, TriCell PRP stands as the global leader in Double-Spin PRP technology, trusted across Europe, Asia-Pacific, and the Middle East.

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