Adult knee cartilage avascular and aneural nature , which results in a low regenerative capacity, and thus limited healing potential for the joint. OA is the result of a long chain of events, loss and breakdown of articular cartilage is the endpoint of this process, the entire process and progression of OA involves a combination of mechanical, cellular, and biochemical processes . The joint destruction that occurs in the early stages of OA leads to an imbalance of the inflammatory mediators of the joint, resulting in further cartilage degeneration, degeneration of the extracellular matrix, systemic inflammation, chondrocyte apoptosis, osteophyte formation, and bone remodeling.
Platelet Rich Plasma (P.R.P.) is made up from patient’s own blood. It contains at least 2 times more platelet than whole blood. P.R.P. plays critical roles in maintaining tissue homeostasis and regulating the inflammation and coagulation responses of the body , such as chondrocyte apoptosis inhibition, bone and vessel remodeling, inflammation modulation, and collagen synthesis.
Platelet releases growth factor from α-granules. These growth factors, along with coagulation factors, cytokines, chemokines, and other proteins stored within the platelet, have been shown to stimulate chondrocyte and chondrogenic MSC proliferation, promote chondrocyte cartilaginous matrix secretion, and diminish the catabolic effects of pro-inflammatory cytokines. These all helps in regeneration of cartilage.
PRP also appears to stimulate endogenous HA production and assist with mesenchymal stem cell survival and proliferation.
P.R.P. has two types, one is leukocyte rich(LR) & another is leukocyte poor(LP). LP-PRP has better results than LR-PRP.