Investigating Orthobiologics after Platelet-Rich Plasma and Photobiomodulation Treatment of Knee Osteoarthritis- MHSRS 2024
Karikari n, rossi r, gabler g, grogan s, schroeder j, free k, lopez p, dannenbaum j, hager n, metzger e, isaacson b, wagner l, pasquina p
Abstract accepted for poster presentation at the 2024 Military Health System Research Symposium
Lower extremity musculoskeletal injuries (MSKIs) are the primary reason for limited duty in Active-Duty Service Members (ADSMs). MSKIs account for 60% of limited duty days and 65% of medical nondeployability in ADSMs. Knee Osteoarthritis (KOA) - a degenerative joint disease resulting in cartilage loss due to wear and tear or by a force applied to the knee - is frequent in the United States Military with over 20,000 cases detected in ADSMs over a 10-year period. Photobiomodulation (PBM) and Platelet-rich Plasma (PRP) have both emerged as promising treatments for boosting knee function and decreasing stiffness and pain. Ideal PBM dosage, optimal PRP treatment, and the biological cascade of each treatment as well as the potential additive treatment of PRP and PBM together merits further investigation. This study aims to assess the effect PBM has on PRP injections for KOA treatment through evaluations of synovial and serum inflammatory and reparative biomarkers. The treatments are compared through four arms: Physical Therapy (PT) vs PT + PRP vs PT + PBM vs PT + PRP + PBM. The relationship between pain, function and treatment is analyzed in addition to the biomarkers obtained from participant biologics. These aims seek to inform KOA treatment practices and improve ADSMs return to duty.
All participants completed a blood draw and knee joint aspiration at the baseline and again at 6-weeks post-baseline. Each participant was randomized to PT, + PBM, +PRP, or + PRP + PBM. PBM was delivered three times a week for three weeks. PRP was injected at the baseline. Further data collection was completed through the Defense and Veteran’s Pain Rating Scale, Single Assessment Numeric Evaluation, Knee Injury and Osteoarthritis Outcome Score, The Veterans RAND 12 Item Health Survey questionnaires and activity logs to monitor participant progression. Participants completed the study at 6 weeks and provided a second blood draw and knee aspiration at that time
Both PRP and PBM have shown promise in aiding healing and slowing the progression of KOA. When applied together, these interventions may improve outcomes for ADSMs suffering from KOA. This has the potential to positively impact the health and performance of our warfighters.