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Updated: Jul 27, 2026
Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
Effectiveness of intradiscal platelet rich plasma for discogenic low back pain without Modic changes: A randomized
M O Schepers1, D Groot1, E M Kleinjan1
1Rugpoli Twente, De Eiken 3, 7491HP, Delden, the Netherlands.
Objective:
To determine if autologous platelet-rich plasma (PRP) injection into a degenerative intervertebral disc, without Modic changes on magnetic resonance imaging (MRI), improve pain and function.
Design:
Prospective, randomized controlled study.
Setting:
Outpatient spine practice (Stichting Rugpoli, Netherlands).
Participants:
Adults with chronic low back pain referred to Stichting Rugpoli, according to the Dutch General Practitioners Guidelines, unresponsive to conservative treatment, without Modic changes on MRI.
Methods:
Provocation discography was performed to confirm the suspected disc was the source of pain. Participants were randomized to receive 1.0 cc intradiscal PRP (intervention) or 1.0 cc Saline with 0.2g Kefzol (control). Data on pain (Numeric Rating Scale), physical function (Roland Morris Disabilty Questionnaire, RMDQ), and participants' general perceived health (SF-12) were collected at 1 week, 4 weeks, 2 months, 6 months, 9 months and 1 year. A repeated-measures analysis (mixed model) was used for comparing the outcomes of the groups.
Results:
Of the initial 98 (49 intervention, 49 control) patients randomized, 89 (91%) (44 intervention, 45 control) with complete outcome data were analyzed. Groups were balanced at baseline. After twelve months no differences between groups were found in the average pain (improved 21/44 in intervention vs 16/45 in control, p = 0.244), the disability scores (RMDQ minimal 3 points improvement 22/44 in intervention vs 24/45 in control, p = 0.753) and the SF-12 (mean difference physical health -1.19, 95% CI -5.39 to 2.99, p = 0.721, and mental health -0.34, 95% CI -3.99 to 3.29, p = 0.834). One serious adverse event occurred (spondylodiscitis) after intervention.
Conclusion:
Participants who received intradiscal PRP showed no significant improvement in pain or functionality compared to the control group at 1 year follow up.
