DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175660

The role of platelet rich plasma injection in the management of early osteoarthritis of the knee

Yeshwanth Subash, Kamalakumar K., Lydia M.

Abstract


Background: Osteoarthritis of the knee is a degenerative disorder associated with significant morbidity in the form of pain, knee stiffness and decrease in the functional capacity of the affected limb leading to a decrease in the quality of life for the patient. Various modalities of treatment are available for the management of this condition. The aim of this study was to evaluate the role of platelet rich plasma (PRP) injection in the management of early osteoarthritis of the knee and to compare the functional outcome with the studies of various authors as available in literature.

Methods: 60 patients with Kellgrenn and Lawrence grade 1 and 2 osteoarthritis of the knee were studied from January 2014 to January 2015 and were followed up for a period of 1 year.

Results: There were 39 males and 21 female patients in our study with the right side being more commonly affected. There was a significant decrease in the VAS score and the WOMAC score at 1, 3, 6 and 12 months follow up as compared to the pre-injection baseline scores. All patients were satisfied with the procedure in terms of functional outcome.

Conclusions: PRP injection is a cost effective, safe and efficient procedure with easily reproducible results and gives good functional results in terms of pain relief, improvement of range of movements and mobility, and improves the quality of life in patients with early osteoarthritis of the knee.


Keywords


Osteoarthritis, PRP, Injection, WOMAC

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References


Richmond J, Hunter D, Irrgang J, Jones MH, Snyder-Mackler L, Van Durme D, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis (OA) of the knee. J Bone Joint Surg Am. 2010;92:990-3.

Rankin EA, Alarcon GS, Chang RW. NIH consensus statement on total knee replacement December 8-10, 2003. J Bone Joint Surg Am. 2004;86:1328-35.

Maricar N, Callaghan MJ, Felson DT, O’Neill TW. Predictors of response to intra-articular steroid injections in knee osteoarthritis. A systematic review. Rheumatology. 2013;52:1022-32.

Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;(2):CD005321.

Brouwer RW, Jakma TSC, Verhagen AP, Verhaar JAN, Bierma-Zeinstra SMA. Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Syst Rev. 2005;(1):CD004020.

Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008;(4):CD004376.

Nuesch E, Rutjes AWS, Husni E, Welch V, Juni P. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2009;(4):CD003115.

Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Data- base Syst Rev. 2005;(2):CD002946.

Wandel S, Juni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: Network meta-analysis. BMJ. 2010;341:4675.

Moreland LW. Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: Mechanisms of action. Arthritis Res Ther. 2003;5:54-67.

Brief AA, Maurer SG, Di Cesare PE. Use of glucosamine and chondroitin sulfate in the management of osteoarthritis. J Am Acad Surg. 2001;9:71-8.

Sheth U, Simunovic N, Klein G, Fu F, Einhorn TA, Schemitsch E, et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: A meta-analysis. J Bone Joint Surg Am. 2012;94:298-307.

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.

Park SI, Lee HR, Kim S, Ahn MW, Do SH. Time-sequential modulation in expression of growth factors from platelet- rich plasma (PRP) on the chondrocyte cultures. Mol Cell Biochem. 2012;361:9-17.

Wu CC, Chen WH, Zao B, Lai PL, Lin TC, Lo HY, et al. Regenerative potentials of platelet-rich plasma enhanced by collagen in retrieving pro-inflammatory cytokine-inhibited chondrogenesis. Biomaterials. 2011;32:5847-54.

Spreafico A, Chellini F, Frediani B, Bernardini G, Niccolini S, Serchi T, et al. Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes. J Cell Biochem. 2009;108:1153-65.

Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, et al. Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods. 2009;15:431-5.

Li M, Zhang C, Ai Z, Yuan T, Feng Y, Jia W. Therapeutic effectiveness of intra-knee-articular injection of platelet- rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2011;25:1192-6.

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.

Miyakoshi N, Kobayashi M, Nozaka K, Okada K, Shimada Y, Itoi E. Effects of intraarticular administration of basic fibroblast growth factor with hyaluronic acid on osteochondral defects of the knee in rabbits. Arch Orthop Trauma Surg. 2005;125:683-92.

Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: From early degeneration to osteoarthritis. Arthroscopy. 2011;27:1490-501.