Platelet-Rich Plasma and Autologous Conditioned Serum: Non-Cellular Biologic Therapies for Neuroimmune Modulation and the Treatment of Arthritis Pain
Osteoarthritis (OA) affects more than 50 million in the United States (Lawrence et al Part II Arthritis Rheum 58(1):26-35, 2008); however, most of these individuals are not considered surgical candidates. Alternative treatment options such as medications, intra-articular corticosteroid or hyaluronic acid injections, or radiofrequency nerve ablations can reduce pain and improve function in some individuals, but many others are left in a state of “orthopedic limbo”: conservative therapies are insufficient, and surgery is not an option. Biologically based regenerative pain medicine therapies such as platelet-rich plasma (PRP) and autologous conditioned serum (ACS) offer new options for these patients and are used with increasing frequency in the United States. In this chapter, I will discuss the neuroimmune alterations that drive the development of osteoarthritis, the mechanisms of action of these biologically based, non-stem cell therapies, and clinical outcomes with the use of PRP and ACS.
