Intraosseous and Intra-Articular Platelet-Rich Plasma for Severe Knee Osteoarthritis: A Real-World-Outcomes Initiative

<b>Background/Objectives:</b> The inconsistent clinical outcomes of platelet-rich plasma (PRP) therapy for knee osteoarthritis (KOA) highlight the need to elucidate PRP's therapeutic potential and influencing factors. Real-world evidence can provide valuable insights in a broad patient population. This study aims to analyze real-world data from KOA patients treated with PRP. <b>Methods:</b> Real-world data from 86 KOA patients treated with intraosseous combined with intra-articular (IO + IA) PRP injections were utilized to retrospectively evaluate the long-term effectiveness of this procedure and the impact of PRP characteristics and patient variables on treatment response. <b>Results:</b> The WOMAC score was reduced 2 months after completing the treatment procedure. Such a reduction was sustained throughout the follow-up time points, up to 18 months. The percentage of responders was between 55 and 67%. The PRP erythrocyte and leukocyte counts negatively correlated with the change in WOMAC score (ΔWOMAC). The PRP platelet count did not correlate with the WOMAC or the ΔWOMAC scores. The KL severity degree did not affect the responsiveness to treatment. Women reported a higher WOMAC score than men, both before and 2 and 3 months after PRP treatment. However, the ΔWOMAC score was not different between sexes within this period. A negative correlation trend was detected between the patient's age and the ΔWOMAC score. <b>Conclusions:</b> IO + IA PRP administration alleviated severe KOA symptoms with sustained relief for up to 18 months in most patients, potentially delaying the need for knee prostheses. The clinical efficacy was not influenced by narrow platelet dose variations but was negatively impacted by the leukocyte content in the long term, while sex and KOA severity had no influence.