Efficacy of Intra-articular injections of Platelet Rich Plasma (PRP) in Osteoarthritis Knee.

Authors

  • Editorial Board
  • Asad Ali Chaudhry Associate Professor Head of Department of Orthopaedics Punjab Rangers Teaching Hospital, Lahore
  • Seemal Masood House Officer, CMH, Lahore 6House Officer, Punjab Rangers Teaching Hospital, Lahore
  • Shehreena Zabreen Butt House Officer, CMH, Lahore 6House Officer, Punjab Rangers Teaching Hospital, Lahore
  • Shehryar Khalid Hameed House Officer, CMH, Lahore
  • Umair Ahmed House Officer, Punjab Rangers Teaching Hospital, Lahore
  • Merub M Dar House Officer, Punjab Rangers Teaching Hospital, Lahore
  • Akkad Rafiq Associate Professor Department of Orthopedic Surgery, Mohtarma Benazir Bhutto Medical College Mirpur Azad Kashmir
  • Usman Zafar Dar Associate Professor Orthopaedic Department Gujranwala Medical College, Gujranwala

Keywords:

Intra-articular injection, Knee, Osteoarthritis, Platelet-Rich Plasma.

Abstract

Objective: To determine the effectiveness of intra-articular injections of Platelet Rich Plasma (PRP) in early Osteoarthritis knee in terms of pain reduction and improvements in functional outcome.

Methods: This descriptive study was conducted in Department of Orthopedics Surgery Punjab Rangers Teaching Hospital Lahore/ Rahbar Medical and Dental College Lahore from 23rd March 2018 to 23rd March 2021.All patients with early osteoarthritis knee fulfilling the inclusion criteria were administered two intra-articular pure PRP injections. Follow up assessment was done at 6 weeks, 3 months, 6 months and one year for pain reduction measured on Visual Analog Scale (VAS) and functional improvement assessed with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. The pre and post injection WOMAC and VAS values were compared P value calculated with  Student-t test. P value <0.05 was considered significant.

Results: Two intra-articular injections of PRP were administered to 84 knees in 61 patients. Female patients were 35(57.37%) and male 26(42.62%). The mean age was 61.5±2.3 years. Majority (60.71%,n=51) of knees had grade II Osteoarthritis while 33(39.28%) knees had grade I Osteoarthritis. In each follow up visit a significant improvement (P <0.05) in pain reduction(VAS) and functional outcome(WOMAC) was observed which persisted till last follow up visit at one year follow up. No complication was reported.

Conclusion: Two intra-articular PRP injections in early Osteoarthris knee yielded significant reduction in pain and improvement in functional outcome.

References

Messina OD, Wilman MV,Neira LF. Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res 2019;31:807-813.

Barbour KE, Helmick CG, Boring M, Zhang X, Lu H, Holt JB. Prevalence of Doctor-Diagnosed Arthritis at State and County Levels-United States, 2014. MMWR Morb. Mortal Wkl Rep 2016;65:489-494.

Michael JW, Schluter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010;107(9):152-162.

Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee osteoarthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med 2016;44:884-891.

Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA.Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med 2009; 37:2259-2272.

Sanchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet rich therapies in the treatment of orthopaedic sport injuries. Sports Med 2009; 39:345-354.

Engebretsen L, Steffen K, Alsousou J, Anitua E, Bachl N, Devilee R, et al. IOC consensus paper on the use of platelet-rich plasma in sports medicine. Br J Sports Med 2010; 44(15):1072-108.

Marx RE. Platelet-rich plasma (PRP): What is PRP and what is not PRP? Implant Dent 2001;10:25-228.

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;32(3):495-505.

Dai, W.L.; Zhou, A.G.; Zhang, H.; Zhang, J. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy 2017;33:659-670.

Laudy ABM, Bakker EWP, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med 2015;49:657-672.

Yaradilmis CYU, Demirkale I, Tagral AS, Okkaoglu MC, Ates A, Altay M. Comparison of two platelet rich plasma formulations with viscosupplementation in treatment of moderate grade gonarthrosis: A prospective randomized controlled study. J Orthop 2020;20:240-246.

Raeissadat SA, Ghorbani E,Taheri MS, Soleimani R, Rayegani SM, Babaee M, et al. MRI Changes After Platelet Rich Plasma Injection in Knee Osteoarthritis (Randomized Clinical Trial). J Pain Res 2020;13;65-73.

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis: Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29:1039-1049.

Kellgren JH, Lawrence JS. Radiological assessment of osteo arthrosis. Ann Rheum Dis 1957;16(4):494-502.

Dixon JS, Bird HA: Reproducibility along a 10 cm vertical visual analogue scale. Ann Rheum Dis 1981;40:87-89.

McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Care and Research 2001;45(5):453-461.

Kavadar G, Demircioglu DT, Celik MY, Emre TY. Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. J Phys Ther Sci 2015;27:3863-3867.

Rai D, Singh J, Somashekharappa T, Singh A. Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up. SICOT-J 2021;7: 6. doi: 10.1051/sicotj/2021003.

Guillibert C, Charpin C, Raffray M, Benmenni A, Dehaut FX, El-Ghobeira G, et al. Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee. Osteoarthritis: A Prospective Routine Care Study. Int J Mol Sci 2019;20:1327-1335.

Cole BJ, Karas V, Hussey K, Pilz K, Lisa A. Fortier. Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis. Am J Sports Med 2017; 45(2):339-346.

Migliorini F, Driessen A, Quack V, Sippel N, Cooper B, El-Mansy Y, et al. Comparison between intra?articular infiltrations of placebo, steroids,hyaluronic and PRP for knee osteoarthritis: a Bayesian network meta?analysis. Arch Orthop Trauma Surg 2020 doi: 10.1007/s00402-020-03551-y.

Shen L, Yuan T, Chen S, Xie X, Zhang C, The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2017;23:12(1):16.doi: 10.1186/s13018-017-0521-3.

Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Hollis G, et al. Clinical and MRI Outcomes After Platelet-Rich Plasma Treatment for Knee Osteoarthritis. Clin J Sport Med 2013;23:238-239.

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;41:356-364.

Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, et al. Platelet-rich plasma intraarticular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: From early degeneration to osteoarthritis. Arthroscopy 2011; 27(11);1490-1501.

Bottegoni C, Dei Giudici L, Salvemini S, Chiurazzi E, Bencivenga R, Gigante A. Homologous platelet-rich plasma for the treatment of knee osteoarthritis in selected elderly patients: An open-label, uncontrolled, pilot study. Ther Adv Musculoskelet Dis 2016; 8(2):35-41.

Tate K, Crane D. Platelet rich plasma grafts in musculoskeletal Medicine. Journal of Prolotherapy 2010; 2(2):371-376.

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Published

2021-11-18

How to Cite

Efficacy of Intra-articular injections of Platelet Rich Plasma (PRP) in Osteoarthritis Knee. (2021). Journal of Pakistan Orthopaedic Association, 33(04), 162-166. https://jpoa.org.pk/index.php/upload/article/view/581

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