Evaluation of Platelet Rich Plasma Therapy in Osteoarthritis Of Knee
Background: Knee osteoarthritis (OA) is common entity in adults causing disability and decreased work productivity. Management of early OA is not established showing varied results of conservative and medical treatment. We evaluated the functional outcome of intra-articular injection of platelet rich plasma (PRP) for management of early stages of OA knee.
Material and Methods: 30 patients of OA knee, Kellgren type II or III, more than 40 years’ age, were treated with 4 ml of intra-articular autologous PRP injection and were assessed by improvement in functional outcome as seen by WOMAC and VAS score.
Results: The mean age was 54.17 ± 8.18 years (range 44 to 78 years). 14 (46.7%) were males and 16 (53.3%) were females. 11 (36.7%) patients had KL grade 2 and 19 (63.3%) patients had KL grade 3 osteoarthritis. The mean pre-procedural WOMAC score of 47.67 ± 6.50 improved to 23.70 ± 5.88, 23.57 ± 5.12 and 25.80 ± 5.69 at one, three and six months after the PRP injection, respectively. The mean pre-procedural VAS score of 5.37 ± 0.85, improved to 1.43 ± 1.04, 1.43 ± 0.63 and 1.73 ± 0.58 at one, three and six months after the PRP injection, respectively. Pain at injection site was seen in 1 (3.3%) patient and 1 (3.3%) patient developed superficial infection.
Conclusion: PRP therapy provides pain relief and improves the functional outcome in early stages of Osteoarthritis of Knee.
2. Dhillon MS, Patel S, John R. PRP in OA knee – update, current confusions and future options. SICOT J 2017;3:27:1-6.
3. Goyal D, Garg RS, Sagy M, Singh GD. Role of platelet rich plasma in osteoarthritis knee. Int J Orthop sci. 2017;3(3):280-2.
4. Bland JH. The reversibility of osteoarthritis: a review. Am J Med. 1983;74(6A):16-26.
5. Lee KS, editor. Platelet-rich plasma injection. Seminars in musculoskeletal radiology. New York: Thieme Medical Publishers; 2013.
6. Boswell SG, Cole BJ, Sundman EA, et al. Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy 2012;28(3):429–39.
7. Akeda K, An HS, Okuma M, et al Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartil 2006;14(12):1272–80.
8. Pereira RC, Scaranari M, Benelli R, et al. Dual effect of platelet lysate on human articular cartilage: a maintenance of chondrogenic potential and a transient pro-inflammatory activity followed by an inflammation resolution. Tissue Eng Part A 2013;19(11–12):1476–88.
9. Yang SY, Ahn ST, Rhie JW, et al. Platelet supernatant promotes proliferation of auricular chondrocytes and formation of chondrocyte mass. Ann Plast Surg 200;44(4):405–11.
10. Spreafico A, Chellini F, Frediani B, et al. Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes. J Cell Biochem 2009;108(5):1153–65.
11. Gaissmaier C, Fritz J, Krackhardt T, et al. Effect of human platelet supernatant on proliferation and matrix synthesis of human articular chondrocytes in monolayer and three-dimensional alginate cultures. Biomaterials 2005;26(14):1953–60.
12. Sundman EA, Cole BJ, Karas V, et al. The anti-inflammatory and matrix restorative mechanisms of platelet rich plasma in osteoarthritis. Am J Sports Med 2014;42(1):35–41.
13. Anitua E, Sanchez M, Nurden AT, et al. Platelet released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford) 2007;46(12):1769–72.
14. Van Buul GM, Koevoet WL, Kops N, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. Am J Sports Med 2011;39(11):2362–70.
15. Sanchez M, Anitua E, Azofra J, et al. Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 2008;26:910–3.
16. Cerza F, Carnì S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intraarticular infiltration in the treatment of gonarthrosis. Am J Sports Med 2012:40:2822–7.
17. Kon E, Mandelbaum B, Buda R, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid visco-supplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy 2011;27:1490–1501.
18. Spakova T, Rosocha J, Lacko M, et al. Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil 2012;91:411–7.
19. Li M, Zhang C, Ai Z, et al. Therapeutic effectiveness of intra-knee-articular injection of platelet-rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong JianWai Ke Za Zhi 2011;25(10):1192–6.
20. Say F, Gürler D, Yener K, et al. Platelet-rich plasma injection is more effective than hyaluronic acid in the treatment of knee osteoarthritis. Acta Chir Ortho Traumatol Cech 2013;80(4):278–83.
21. Lana JF, Weglein A, Sampson S, et al. Randomized controlled trial comparing hyaluronic acid, platelet-rich plasma and the combination of both in the treatment of mild and moderate osteoarthritis of the knee. J Stem Cells Regen Med 2016;12(2): 69–78.
22. Filardo G, Di Matteo B, Martino Di, et al. Platelet-rich plasma intra-articular knee injections show no superiority versus visco-supplementation: a randomized controlled trial. Am J Sports Med 2015;43(7):1575–82.
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