DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175661

A prospective study of intra-articular injections of platelet rich plasma in early osteoarthritis knee joint

Rentala Vamshi, Vivekananda Bheemisetty, Raju Bollabathini, Vishwanath Mahadevuni

Abstract


Background: Platelet-rich plasma (PRP) is a natural concentrate of autologous blood growth factors experimented in different fields of medicine in order to test its potential to enhance tissue regeneration. The aim of our study is to study the effects of intra articular injections of autologous “Platelet Rich Plasma“ in the osteoarthritis of knee joint and to assess the functional outcome after injecting platelet rich plasma in osteoarthritic knee joints and compare the results with standard studies and draw conclusions.

Methods: This is a prospective study done on 161 Kellgren-Lawrence radiological grade I and grade II knee joints, between August 2013 and March 2016 which, were treated with PRP intra-articular injections. The procedure consisted of injection of 8 ml platelet concentrate into the knee joint with an 18- gauge needle without local anaesthetic. Patients were assessed with WOMAC (Western Ontario McMaster Universities Arthritis Index) scoring pre injection of PRP and post injection period of 1 month and 6 months. A reduction in WOMAC score is suggestive of improvement in the patient’s condition.

Results: There is a significant improvement in WOMAC score of all the patients and the results sustained for more than 6 months. Though there is clinically better results are seen in grade I knee joints than grade II knee joints, these results are statistically not significant.

Conclusions: Osteoarthritis (Grade I and Grade II) of Kellgren Lawrence radiological grading does give relief from pain, stiffness and improves functionality without any major side effects and can be recommended as a viable modality of treatment. 


Keywords


Platelet rich plasma, Kellgren Lawrence radiological grading, WOMAC score, Osteoarthritis knee

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References


Osteoarthritis. Mayo Clinic Website. Available at: http://www.mayoclinic.org/diseases-conditions/osteoarthritis/basics/definition/con-20014749. Accessed October 2, 2014.

Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Pub Health. 1994;84(3):351-8.

Global Economic and Health Care Burden of Musculoskeletal Disease, 2001, World Health Organization. Available at: www.boneandjoint decade.org. Accessed on 3 August 2017.

Gabriel SE, Crowson CS, Campion ME, O'Fallon WM. Direct medical costs unique to people with arthritis. J Rheumatol. 1997;24(4):719–25.

Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, et al. Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study Arthritis Rheum. 2001;44:2065-71.

Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010;107:152-62.

Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, et al. Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study Arthritis Rheum 2001;44:2065-71.

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. The Am J Sports Med. 2013;41:356-64.

Pietrzak WS, Eppley BL. Platelet rich plasma: Biology and new technology. J Craniofac Surg. 2005;16:1043–54.

Werner S, Grose R: Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003;83:835–70.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet rich plasma. Am J Sports Med. 2006;10:1–515.

Barrett S, Erredge S: Growth factors for chronic plantar fasciitis. Podiatry Today. 2004;17:37–42.

Kon E, Mandelbaum B, Buda R. Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis. Arthoscopy Related Surg. 2011;27(11):1490–501.

Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:528–35.

Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, et al. Platelet-rich plasma versus hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trail. BMC Musculoskelet Disord. 2012;213:229.

Spakova T, Rosocha J, Lacko M, Harvanova D, Gharaibeh A. Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil. 2012;91:411-7.

Kon E, Buda R, and Filardo G, 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.

Cerza, Carni S, Carcangiu A, Di Vavo I, Schiavilla V, Pecora A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40(12):2822-7.

Sanchez M, Anitua E, Azofra J. Injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study, Clin Experim Rheumatol. 2008;26:910-3.

Sánchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007;35:245-51.