Is Umbilical Cord-Derived Platelet-Rich Plasma a Valid Alternative to Conventional Orthobiologics Post-Knee Arthroscopy?

Background: Orthobiologic treatments such as autologous platelet-rich plasma (A-PRP) and mesenchymal stem cells (MSCs) are widely used for knee osteoarthritis (OA). Umbilical cord-derived PRP (UCD-PRP), with its standardized composition and high growth factor content, has emerged as a promising allogeneic alternative, though comparative data are limited. Purpose: To compare the short-term clinical outcomes of UCD-PRP versus adipose tissue-derived MSCs (ADT-MSCs) following debridement and lavage arthroscopy in patients with early-stage knee OA. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 225 patients with Kellgren-Lawrence grade I-II knee OA treated with either UCD-PRP (n = 75) or ADT-MSCs (n = 150) after arthroscopy. Outcomes assessed at baseline, 6, and 12 months included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and Visual Analog Scale (VAS) for pain. Multivariate analysis assessed predictors of outcome. Results: Both groups showed significant functional and pain improvements from baseline at all follow-up points. The UCD-PRP group demonstrated superior pain reduction on VAS at 3 and 6 months compared with ADT-MSCs (ΔVAS at 3 months, p = 0.042; at 6 months, p = 0.0065). Functional scores (WOMAC, KOOS, and IKDC) showed no significant between-group differences at 12 months. Higher BMI was independently associated with poorer clinical outcomes (p < 0.001). Conclusion: UCD-PRP provides superior short-term pain relief compared with ADT-MSCs following knee arthroscopy for early OA, with comparable functional outcomes at 12 months. Its standardized, allogeneic preparation and minimal donor-site morbidity make UCD-PRP a promising orthobiologic option for knee OA management. Level of Evidence: Level III.