Treatment of Knee Osteoarthritis in a Military Cohort Using Platelet-Rich Plasma

Osteoarthritis is a devastating condition affecting an estimated 240 million people world-wide and is associated with significant morbidity and medical costs. Platelet-rich plasma has demonstrated success for the treatment of knee osteoarthritis with minimal adverse events. While US military service members experience osteoarthritis at a younger age and an increased frequency compared to nonmilitary populations, there is a paucity of research studies evaluating platelet-rich plasma in this high-risk population. This study is the first to evaluate the treatment response of US active-duty military and veterans receiving platelet-rich plasma injections for knee osteoarthritis. Using retrospective Knee Osteoarthritis Outcome Score (KOOS) data collected to evaluate the treatment response of platelet-rich plasma for knee osteoarthritis, we analyzed the data by age, sex, military rank, and number of injections for statistical significance. Despite a significant dropout rate during the study, we found 2 injections were superior to 1, 3, or 4 injections in reaching statistical significance for improvement in patient pain and function. Third and fourth injections saw a decrease in KOOS across all subcategories. Our data differed from non-military PRP studies which supports 3 injections provides the greatest improvement in pain and function. As a retrospective observational cohort study, we were unable to control for variables of treatment frequency and duration making it difficult to generalize our results to that of current literature. However, we did see a potential for additional platelet-rich plasma injections being superior with regards to improvement in pain and function. While there remains a scarcity of data within the military receiving platelet-rich plasma for knee osteoarthritis, future larger, prospective, double-blinded, randomized control trial studies could support platelet-rich plasma as an effective treatment option in this high-risk population.