DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20195160

Outcome of staged injection of autologous platelet rich plasma in treatment of mild to moderate knee osteoarthritis

Rajat Gupta, Ram Avtar, Krishan Kumar

Abstract


Background: Autologous platelet-rich plasma (PRP) offers an easy solution for delivering multiple growth factors needed for tissue repair. Intra-articular injections of PRP have been proposed as a simple low cost minimally invasive way to obtain the concentration of growth factors and biologically active molecules to promote cartilage healing in osteoarthritic (OA) knee joint. The objective of the present study was designed to evaluate the clinical efficacy of autologous platelet rich plasma injection in mild to moderate osteoarthritic knee and to assess the role of serial staged autologous platelet rich plasma injection.

Methods: 50 patients with mild to moderate osteoarthritis of knee were divided into two groups. Group A was given staged injection of freshly prepared autologous PRP in the affected knee. Group B was given single injection of PRP. The Results were evaluated on the basis of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire and visual analog scale (VAS) before treatment and 3 weeks, 8 weeks, 16 weeks and 24 weeks after treatment.

Results: At 24-weeks follow up the following observations were made; the MeanVAS in Group A decreased to 3.30 whereas in Group B it increased to 4.54. The Mean WOMAC score in Group A was reduced to a mere28.64 in Group A and in Group B it was 39.76.

Conclusions: It is concluded from our study that concomitant use of serial staged injection (two) of PRP over four months is more effective than single injection in patients with mild to moderate OA of knee.


Keywords


Platelet-rich plasma, Osteoarthritic knee, WOMAC

Full Text:

PDF

References


Cisternas M, Murphy L, Sacks J, Solomon D, Pasta D, Helmick C. Alternative methods for defining osteoarthritis and the impact on estimating prevalence in a US population-based survey. Arthritis Care Res. 2016;68:574–80.

Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc. 2017;25(2):485–92.

Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR, et al. Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee. American College of Rheumatology. Arthritis Rheum, 1995;38:1541–6.

Gerwin N, Hops C, Lukas A. Intraarticular drug delivery in osteoarthritis. Adv Drug Deliv Rev. 2006;58:226-42.

Kelgren J, Lawrence JS. Radiological assessment of arthritis. Annals of Rheum Dis. 1957;16(4):494–502.

Dohan Ehrenfest DM, Andia I, Zumstein MA, Zhang CQ, Pinto NR, Bielecki T. Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J. 2014;4(1):3-9.

Mishra A, Harmon K, Woodall J, Vieira A. Sports Medicine Applications of Platelet Rich Plasma. Curr Pharmaceu Biotechnol. 2012;13:1185-95.

Bielecki TM, Gazdzik TS, Arendt J, Szczepanski T, Krol W, Wielkoszynski T. Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances: an in vitro study. J Bone Joint Surg British Volume. 2007;89:417-20.

Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-64.

Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc. 2010;18:472-9.