To Evaluate the Functional Outcome of Platelet Rich Plasma Therapy in Osteoarthritis of Knee

  • Jati S Study performed at Department of Orthopaedics, Sri Aurobindo Medical Science & Post Graduate Institute, Indore (M.P.)
  • Bansal H Study performed at Department of Orthopaedics, Sri Aurobindo Medical Science & Post Graduate Institute, Indore (M.P.)
  • Garg A Study performed at Department of Orthopaedics, Sri Aurobindo Medical Science & Post Graduate Institute, Indore (M.P.)
  • Jain S Study performed at Department of Orthopaedics, Sri Aurobindo Medical Science & Post Graduate Institute, Indore (M.P.)
Keywords: Platelet rich plasma, Osteoarthritis, WOMAC score

Abstract

Background: Osteoarthritis of knee is a chronic, degenerative condition associated with pain, deformity, disability, difficulty in movements and reduction in the quality of life. This study aims to assess the efficacy of intra-articular injection of autologous platelet rich plasma (PRP) therapy in the management of osteoarthritis of knee.

Material and methods: 50 patients with symptomatic knee osteoarthritis were treated by 5 ml autologous intra-articular PRP injection and were assessed for pain, quality of life and rate of satisfaction by WOMAC score.

Results: 50 cases (KL grade II 18 and grade III 22) were included in the study. In KL grade II, the mean WOMAC score, pretreatment was 57.11 ± 6.36, which improved to 53.76 + 7.6 (p=0.000) at 2 weeks, to 31.97 ± 4.51 (p=0.001) at one month, to 26.97 ± 3.47(p=0.001) at 3 months and to 22.11 ± 2.99 (p=0.001) at final follow-up of 6 months. In KL grade III, the mean WOMAC score pretreatment was 59.21 ± 5.63, which improved to 55.76 ± 7.6 (p=0.000) at 2 weeks, to 48.79 ± 5.42 (p=0.001) at one month, to 36.46 ± 4.36 (p=0.001) at 3 months, and to 32.12 ± 2.66 (p=0.001) at final follow-up of 6 months.

Conclusion: Use of single PRP intra-articular injection in the management of osteoarthritis knee provides excellent pain relief, improvement in quality of life and high rate of satisfaction, which is more effective in the early stages of osteoarthritis than the advanced stage. Relief starts immediately and it increases gradually with time. PRP is a safe, easy, minimally invasive and cheap alternative in the management of knee osteoarthritis.

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References

Buckwalter JA, Martin JA, Brown TD. Perspectives on chondrocyte mechanobiology and osteoarthritis. Biorheology. 2006;43(3,4):603-9.

Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edi. J Am Acad Orthop Surg. 2013 Sep;21(9):571-6.

Beitzel K, McCarthy MB, Russell RP, Apostolakos J, Cote MP, Mazzocca AD. Learning about PRP using cell-based models. Muscles Lig Tend J. 2014 May 8;4(1):38-45.

Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)-the development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96.

Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. J Cutan Aesth Surg. 2014 Oct-Dec;7(4):189-97.

Kohn MD, Sassoon AA, Fernando ND. Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clin Orthop Relat Res. 2016 Aug;474(8):1886-93.

Hsu WK, Mishra A, Rodeo SR, Fu F, Terry MA, Randell P, Canale ST, Kelly FB. Platelet-rich plasma in orthopaedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2013 Dec;21(12):739-48.

Buckwalter JA, Mankin HJ, Grodzinsky AJ. Articular cartilage and osteoarthritis. Instr Course Lect. 2005;54:465-80.

Pearle AD, Warren RF, Rodeo SA. Basic science of articular cartilage and osteoarthritis. Clin Sports Med. 2005 Jan;24(1):1-12.

Goldring MB, Otero M, Plumb DA, Dragomir C, Favero M, El Hachem K, Hashimoto K, Roach HI, Olivotto E, Borzì RM, Marcu KB. Roles of inflammatory and anabolic cytokines in cartilage metabolism: signals and multiple effectors converge upon MMP-13 regulation in osteoarthritis. Eur Cell Mater. 2011 Feb 24;21:202-20.

Everts PA, Knape JT, Weibrich G, Schönberger JP, Hoffmann J, Overdevest EP, Box HA, van Zundert A. Platelet-rich plasma and platelet gel: a review. J Extra Corpor Technol. 2006 Jun;38(2):174-87.

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004 Apr;62(4):489-96.

Goldring MB. The role of the chondrocyte in osteoarthritis. Arthritis Rheum. 2000 Sep;43(9):1916-26.

Akeda K, An HS, Okuma M, Attawia M, Miyamoto K, Thonar EJ, Lenz ME, Sah RL, Masuda K. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage. 2006 Dec;14(12):1272-80.

Frazer A, Bunning RA, Thavarajah M, Seid JM, Russell RG. Studies on type II collagen and aggrecan production in human articular chondrocytes in vitro and effects of transforming growth factor-beta and interleukin-1beta. Osteoarthritis Cartilage. 1994 Dec;2(4):235-45.

Pujol JP, Chadjichristos C, Legendre F, Bauge C, Beauchef G, Andriamanalijaona R, Galera P, Boumediene K. Interleukin-1 and transforming growth factor-beta 1 as crucial factors in osteoarthritic cartilage metabolism. Connect Tissue Res. 2008;49(3):293-7.

Schmidt MB, Chen EH, Lynch SE. A review of the effects of insulin-like growth factor and platelet derived growth factor on in vivo cartilage healing and repair. Osteoarthritis Cartilage. 2006 May;14(5):403-12.

Martin JA, Buckwalter JA. The role of chondrocyte-matrix interactions in maintaining and repairing articular cartilage. Biorheology. 2000;37(1-2):129-40.

Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculo skelet Disord. 2012 Nov 23;13:229.

Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, Azma K. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculo skelet Disord. 2015 Jan 7;8:1-8.

Patel HR, Tankshalj KV, Patel ZM, Bhalodiya HP.The preponderance of side of involvement in Osteoarthritis knee. J Indian Orthop Rheumatol Assoc. 2016;2(2):70-2.

Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage. 2005 Sep;13(9):769-81.

Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Zamanabadi MN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clin Interv Aging. 2018 Jan 4;13:73-9.

Vamshi R, Bheemisetty V, Bollabathini R, Mahadevuni. A prospective study of intra-articular injections of platelet rich plasma in early osteoarthritis knee joint. Int J Res Orthop. 2018 Jan;4(1):133-40.

UsluGüvendi E, Aşkin A, Güvendi G, Koçyiğit H. Comparison of Efficiency Between Corticosteroid and Platelet Rich Plasma Injection Therapies in Patients with Knee Osteoarthritis. Arch Rheumatol. 2017 Nov 2;33(3):273-81.

Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2016 Mar;32(3):495-505.

Published
2021-06-30
How to Cite
1.
Saket Jati, Himanshu Bansal, Garg A, Shubham Jain. To Evaluate the Functional Outcome of Platelet Rich Plasma Therapy in Osteoarthritis of Knee. ojmpc [Internet]. 2021Jun.30 [cited 2021Sep.28];27(2):80-4. Available from: https://ojmpc.com/index.php/ojmpc/article/view/135
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Original Article