{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:28:11Z","timestamp":1792211291957,"version":"4.4.0"},"reference-count":55,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T00:00:00Z","timestamp":1625270400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010843","name":"Foundation for Physical Medicine and Rehabilitation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010843","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2021,7]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Platelet\u2010rich\u2010plasma (PRP) is used to treat knee osteoarthritis; however, mechanistic evidence of PRP effectiveness for pain relief is limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess molecular biomarkers and mesenchymal stem cells (MSCs) in synovial fluid during PRP treatment of the osteoarthritic knee joint.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Single blinded, randomized, placebo controlled pilot study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Veterans Affairs Medical Center.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Seventeen participants with mild to moderate knee osteoarthritis were randomized in a 2:1 placebo\u2010controlled ratio, receiving PRP or saline (placebo) intra\u2010articular injection into the knee joint.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Knee synovial fluid was analyzed before the respective injections and again 10 days following injection. Participants were followed up to 12 months completing visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires at intervals over that period.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The effects of PRP on synovial protein and MSC gene expression levels were measured by multiplex enzyme\u2010linked immunosorbent assay and quantitative polymerase chain reaction.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Novel biomarkers including levels of interleukin (IL)\u20105, IL\u20106, IL\u201010, and tumor necrosis factor\u2010\u03b1 were measured in synovial fluid 10\u2009days after PRP treatment. Altered gene expression profiles in MSCs from patients treated with PRP were observed for matrix metalloproteinases and inflammatory markers (IL\u20106, IL\u20108, CCL2, TNF\u2010\u03b1). A2M protease was significantly increased following PRP treatment (\n P<\/jats:italic>\n \u2009=\u2009.005). WOMAC scores declined for up to 3 months from baseline levels and remained low at 6 and 12 months in the PRP group. In contrast, WOMAC scores for patients receiving the saline injection were relatively unchanged for up to 12 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n We report significant changes for the biomarker A2M (\n P<\/jats:italic>\n \u2009=\u2009.005) as well as differences in expression of cellular markers and postulate that PRP modulates the local knee synovial environment by altering the inflammatory milieu, matrix degradation, and angiogenic growth factors. The PRP treatment group had less pain and stiffness and improved function scores.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.12561","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T15:59:16Z","timestamp":1611590356000},"page":"707-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Randomized, Placebo\u2010Controlled Analysis of the Knee Synovial Environment Following Platelet\u2010Rich Plasma Treatment for Knee Osteoarthritis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0496-1576","authenticated-orcid":false,"given":"Jason D.","family":"Tucker","sequence":"first","affiliation":[{"name":"iOrthoBiologix Charlotte NC"},{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University Health System Richmond VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance 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Technology Saint Louis University St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"McClure","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Virginia Commonwealth University Richmond VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter V.","family":"Quagliano","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hunter Holmes McGuire Veterans Affairs Medical Center Richmond VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline C.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department or Pathology, Hunter Holmes McGuire Veterans Affairs Medical Center Richmond 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