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Seminar: Clinical Prediction of Patient Reported Outcomes and Platelet-Rich Plasma Treatment Success

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    Meghan Miller
    Background: Platelet-rich plasma (PRP) is increasingly used to treat knee osteoarthritis (OA), but the numerous different preparation methods lead to significant heterogeneity in PRP content. Clinical indications and research regarding effectiveness must be developed for each unique PRP formulation. The purpose of this work is to describe a standard preparation method and clinical outcomes using the Angel concentration system (Arthrex; Naples, FL, USA) for knee OA.

    Hypothesis: A single injection of PRP will result in improved patient-reported outcomes at three month follow-up with increased age, body mass index (BMI), and more severe osteoarthritis grade predicting worse outcomes.

    Study Design: Retrospective cohort study

    Methods: A review of the electronic medical record was performed on 134 consecutive cases for patients who elected PRP injection therapy for knee pain. Ninety knees (65 patients) met criteria for inclusion. All patients had whole blood processed at 0% hematocrit using the Angel concentration system (104cc whole blood for unilateral OA, 156cc whole blood for bilateral OA). International Knee Documentation Committee (IKDC) subjective scores completed at baseline and 3 month follow-up were collected and analyzed.

    Results: Overall IKDC score improved from 42.3 + 14.1 pre-injection to 59.7 + 17.5 at 3 months post-injection (+/- 0.001). OF the 90 knees injected with PRP, 57% met criteria for a positive response at 3 months post-injection with an average final IKDC score of 66.5 + 15.0 (Delta = 24.7 + 10.9). Increased patient age (p=0.008) and BMI (p=0.008) were associated with lower 3 month subjective IKDC scores.

    Conclusion: A single PRP injection created at the 0% hematocrit setting yielded a positive response exceeding the minimum clinically important difference in 57% of patients with knee OA. Increased patient age and BMI are associated with lower patient-reported outcomes at 3 months post-injection.

    Clinical Prediction of Patient Reported Outcomes and Platelet-Rich Plasma Treatment Success

    Osteoarthritis affects roughly 10-15% of adults aged 60 or older. Prevalence is likely to increase due to the aging population and increase in obesity rates. Patients have many conservative treatment options available to them, but choosing the right one can often be difficult. This trial and error approach to step therapy may prolong the amount of time a patient is in pain and cost additional expenses in the search for an effective treatment. We analyzed our patient population in hopes of determining variables or characteristics that might aid in the treatment decision-making process. Employing data analytics in patient care may provide additional information to an often multivariate endeavor. I will give details on our study design, rationale, analysis, and implications of our latest research regarding "patient-data" driven decision making.

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