Clinical Pathway Management for Platelet-Rich Plasma Therapy in Kellgren-Lawrence Grade I and II Knee Osteoarthritis: A Prospective, Multicenter, Double-Blind Randomized Controlled Trial.

In 30 seconds

This multicenter, double-blind randomized controlled trial compared a standardized platelet-rich plasma (PRP) pathway with physician-directed conventional PRP care in patients with Kellgren-Lawrence grade I or II knee osteoarthritis. The pathway combined standardized patient selection, quality-controlled leukocyte-poor PRP, ultrasound-guided injections, staged rehabilitation, and systematic follow-up. At 12 months, the pathway group had greater improvements in pain and function; the between-group mean difference in visual analog scale pain change was -2.98 (95% CI, -3.64 to -2.32). Adverse events were also less frequent with the pathway.

Key findings

• At 12 months, VAS pain change favored the pathway over conventional care (MD, -2.98 [95% CI, -3.64 to -2.32]; P < .001).
• At 12 months, WOMAC total and IKDC changes favored the pathway (MD, -8.63 [95% CI, -11.35 to -5.90] and MD, 10.25 [95% CI, 8.37 to 12.13], respectively; both P < .001).
• Adverse events occurred in 17 of 115 pathway patients (14.8%) versus 36 of 113 conventional-care patients (31.9%) (P = .003).
• Satisfaction was greater with the pathway (odds ratio, 1.79 [95% CI, 1.11-2.89]; P = .017); mean costs were CN¥15,199.9 versus CN¥14,754.4.

Why it matters

The findings suggest that how PRP care is organized may influence patient-reported pain, function, satisfaction, and adverse events in early-grade knee osteoarthritis. The trial evaluates a bundled care pathway rather than PRP against placebo, so its results inform comparison between two approaches to delivering PRP care, not whether PRP itself is effective.

What to keep in mind

The pathway components were bundled, preventing attribution of outcomes to any single component, and there was no placebo group; the trial therefore does not establish PRP efficacy or component-specific effects.