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Updated: Aug 18, 2025
Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
Aging Affects the Efficacy of Platelet-Rich Plasma Treatment for Osteoarthritis
Kuntal Chowdhary1, Amrita Sahu, Hirotaka Iijima
1From the Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (KC, AS, HI, SS, FA); Institute for Advanced Research, Nagoya University, Nagoya University, Nagoya, Japan (HI); Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (JB-S, FA); Department of Environment and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (FA); Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania (FA); Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania (FA); and McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (FA).
Objective:
Despite the increased use of platelet-rich plasma in the treatment of osteoarthritis, whether and how age of the platelet-rich plasma donor affects therapeutic efficacy is unclear.
Design:
In vitro, male osteoarthritic human chondrocytes were treated with platelet-rich plasma from young (18-35 yrs) or old (≥65 yrs) donors, and the chondrogenic profile was evaluated using immunofluorescent staining for two markers of chondrogenicity, type II collagen and SOX-9. In vivo, we used a within-subjects design to compare Osteoarthritis Research Society International scores in aged mouse knee joints injected with platelet-rich plasma from young or old individuals.
Results:
In vitro experiments revealed that platelet-rich plasma from young donors induced a more youthful chondrocyte phenotype, as evidenced by increased type II collagen ( P = 0.033) and SOX-9 expression ( P = 0.022). This benefit, however, was significantly blunted when cells were cultured with platelet-rich plasma from aged donors. Accordingly, in vivo studies revealed that animals treated with platelet-rich plasma from young donors displayed a significantly improved cartilage integrity when compared with knees injected with platelet-rich plasma from aged donors ( P = 0.019).
Conclusions:
Injection of platelet-rich plasma from a young individual induced a regenerative effect in aged cells and mice, whereas platelet-rich plasma from aged individuals showed no improvement in chondrocyte health or cartilage integrity.
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