Retrospective analysis of platelet rich plasma injections for ankle osteoarthritis in athletic population

Osteoarthritis (OA) of the ankle, often post-traumatic in origin, is a common cause of pain and disability, particularly in young and athletic individuals. Platelet-rich plasma (PRP) has emerged as a valuable orthobiologic option due to its regenerative and anti-inflammatory properties. This study aimed to evaluate the efficacy of intra-articular PRP in patients with ankle OA, identify potential prognostic factors, and define the patient profile most likely to benefit, with a focus on athletes. This single-centre, real-world retrospective study assessed pain and function using Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores over a 36-month follow-up. PRP was prepared using a specific standardized method and administered in an outpatient setting. Outcomes were analyzed by OA grade, sex, and athletic status. Laboratory assays quantified platelet and leukocyte concentrations and interleukin-1 receptor antagonist (IL-1ra) release. PRP treatment led to rapid and sustained improvements in both pain and function. The study included 178 subjects. Mean VAS scores decreased from 6.6 at baseline to 2.4 at 6 months and remained stable through 36 months. Mean AOFAS scores improved from 49.4 to 81.4 at 6 months and were maintained thereafter. Benefits were greatest in milder OA grades and in athletes, most of whom returned to sport. Age, sex, sporting status, and OA grade were significant predictors of functional outcomes at both 6 and 24 months. The overall failure rate was low (5.6%). Laboratory analysis demonstrated a 5.4-fold platelet enrichment, moderate leukocyte content, and a sixfold increase in IL-1ra levels, reflecting a cellular composition consistent with the anti-inflammatory property of the preparation. Intra-articular PRP prepared with a standardized method appeared to provide safe, sustained clinical benefits in ankle OA, particularly in younger and athletic patients with early-stage disease. A double-blind controlled trial will be necessary to further validate these findings.