AAPM&R'S Practice Guidance: Orthobiologic Management of Osteoarthritis of the Knee (Member Resource)-Session Recording

Video Transcription

Video Summary

Dr. David Lee introduces a session on the AAPMNR Practice Guideline concerning the orthobiologic management of knee osteoarthritis (OA), featuring key contributions from Dr. Pratham Jayaram and Jenny Yuan. The discussion revolves around the process of creating guidance for orthobiologics, specifically platelet-rich plasma (PRP) for knee OA. This guideline aims to bridge gaps in existing literature, providing more focused guidance for physiatrists while acknowledging that other societies have attempted similar tasks but often lack relevance to physiatry.<br /><br />Key aspects of PRP in knee OA treatment include distinguishing between leukocyte-rich and leukocyte-poor PRP, the importance of dosage and platelet concentration, and the aspiration of synovial fluid to optimize treatment impacts. Current evidence suggests PRP may be effective for mild to moderate knee OA but is less so for severe cases. Discussion also touches on using image guidance for precise injections, considerations for combining PRP with other therapies, and safety concerns surrounding red blood cells in injections.<br /><br />The session highlights the need for rigorous research in context-specific uses of PRP, patient selection, and the importance of personalized approaches based on individual patient needs. Moreover, the guidance advises against using local anesthetics within the joint due to potential chondrotoxic effects and recommends further studies on pre-procedural optimizations and post-injection protocols to improve outcomes.<br /><br />Ultimately, the guideline seeks to empower physiatrists with evidence-backed recommendations while inviting interdisciplinary collaboration to elevate PRP's role in managing knee OA. Future research is aimed at improving formulation specificity and understanding patient demographics to better stratify treatment efficacy.

Keywords

orthobiologic management

knee osteoarthritis

platelet-rich plasma

PRP treatment

physiatry guidance

leukocyte-rich PRP

synovial fluid aspiration

image-guided injections

personalized treatment

chondrotoxic effects