Therapeutics
Shahina Sarker, MD
Assistant Professor
Savar Upuzilla health Complex
Dhaka, Dhaka, Bangladesh
Md. Muhibbur Rahman, N/A, MD
Junior Consultant & Head, Physical Medicine and Rehabilitation Department,
Government Employee’s Hospital, Dhaka.
Dhaka, Dhaka, Bangladesh
A 50-year-old female with BMI 28.6 kg/m² presented with two-year history of bilateral knee pain, worsening over the past 2 months, aggravated by walking, stair climbing, squatting. Examination showed effusion, painful flexion, and crepitus. Radiographs revealed grade 2 OA in the right and grade 3 in the left knee. Baseline VAS was 4/10 (left) and 5/10 (right), and WOMAC was 70/96.
PRP was prepared using an I-STEM kit via double-spin centrifugation, yielding 6 mL per knee. After the first injection, VAS and WOMAC remained unchanged at 1 week and 1 month but improved at 2 months (VAS 5–6/10, WOMAC 58/96) and 3 months (VAS 7/10, WOMAC 55/96). A second injection at 3.5 months led to further improvement at 2 months (VAS 8/10, WOMAC 50/96), stabilizing thereafter with >50% overall improvement.
Discussions:
Knee osteoarthritis is a progressive degenerative condition involving cartilage loss and synovial inflammation. Platelet-rich plasma has emerged as a biological treatment capable of modulating the joint environment through concentrated growth factors such as PDGF, TGF-β, VEGF, and IGF-1, which support chondrocyte activity and reduce inflammation [1,2]. Clinical trials and meta-analyses show PRP provides superior and longer-lasting pain and functional improvement compared with placebo, corticosteroids, and hyaluronic acid [3,4]. Leukocyte-poor PRP is preferred due to lower inflammatory response, and double-spin techniques help achieve optimal platelet concentration [5,6]. Evidence suggests multiple injections yield better outcomes than a single dose [5,7]. Physiotherapy—including quadriceps strengthening—can further enhance recovery [8]. PRP is generally safe, with minimal transient side effects [9,10]. In this case, two PRP injections led to meaningful improvement despite moderate OA and elevated BMI, supporting PRP as an effective therapy.
Conclusions: This case highlights the effectiveness and safety of PRP therapy in moderate knee osteoarthritis. The patient achieved over 50% improvement in pain and function with no adverse events.
