Summary

Although the symptomatology generated by KOA was worse in women when compared to men, treatment with PRP was effective, ultimately achieving a higher improvement in women providing comparable final follow‐up outcomes between men and women.

Abstract

The purpose of this study was to evaluate the impact of gender on the efficacy of platelet‐rich plasma (PRP) in patients with knee osteoarthritis (KOA), comparing their short‐term response between men and women.

Four hundred‐eighteen patients (529 knees) were included. Patients were treated with three injections of PRP on a weekly basis. Blood and PRP samples were randomly tested. Patients were asked to complete the knee injury and osteoarthritis outcome score (KOOS) and 12‐item short form survey (SF‐12), at baseline and 6 months. Success rates were calculated according to a reduction in the pain score of at least 9.3 points [minimal clinically important improvement (MCII)]. Patients were also asked to complete the hospital anxiety and depression scale (HADS) and the pain catastrophizing scale (PCS) in order to determine the influence of the psychological component in the perception and management of pain. Comparative tests and multivariate regression were performed.

The PRP had a platelet concentration factor of 2.0X compared to blood levels, with no leucocytes or erythrocytes. KOOS scores showed an increase from baseline to 6 months (p < 0.0001). Platelet concentration in women was significantly higher than that in men (p < 0.05), although there were no differences in platelet levels between responders and nonresponders. There was an increase in the physical component summary (PCS) (p < 0.0001) and mental component summary (MCS) (p < 0.01) of the SF‐12. The number of knees of women with MCII was 156 out of 262 (59.6%), whereas the number of knees of men was 136 out of 267 (50.9%) (p = 0.0468). Women had worse baseline scores on pain (p = 0.009), PCS (p < 0.0001) and MCS (p < 0.0001). Patients with worse scores on the psychologic scores (HADS and PCS) showed greater baseline pain (p < 0.0001). Females showed significantly worse scores on all psychologic scales and subscales (p < 0.05) except for the PCS magnification subscale.

Although the symptomatology generated by KOA was worse in women when compared to men, treatment with repeated injections of PRP was effective, ultimately achieving a higher improvement in women providing comparable final follow‐up outcomes between men and women.