Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis (original) (raw)
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Platelet-Rich Plasma Treatment in Symptomatic Patients With Knee Osteoarthritis
Sports Health: A Multidisciplinary Approach, 2012
Background: With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treat cartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA).Purpose: To determine the effectiveness of intra-articular PRP injections in active patients with knee OA and to evaluate clinical outcomes in patients with and without previous surgical treatment for cartilage lesions.Study Design: Case series.Materials and Methods: Fifty patients with knee OA were followed for a minimum of 12 months. All were treated with 2 intra-articular injections of autologous PRP. Twenty-five patients had undergone a previous operative intervention for cartilage lesions, whereas 25 had not. Operated patients had undergone either cartilage shaving or microfracture. Multiple evaluative scores were collected at pretreatment and at 6 and 12 months posttreatment. The required sample of patients was determined beforehand by using statistical power analysis; In...
[Purpose] To assess the effects of different numbers of platelet-rich plasma (PRP) applications on pain and physical function in grade 3 knee osteoarthritis (OA). [Subjects and Methods] A total of 102 patients with grade 3 knee OA were randomly divided into three groups: Group 1 received a single injection of PRP, Group 2 received two injections of PRP two weeks apart, Group 3 received three injections of PRP at 2-weeks intervals. All patients were evaluated with a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Timed-Up and Go test (TUG) before the treatment and at 1, 3 and 6 months after the treatment. [Results] Ninety-eight patients (15 males, 83 females) completed the study. The mean ages of the patients were 53.5±6.6, 54.9±5.3, and 55.1±5.6 years in Group 1, Group 2, and Group 3, respectively. Statistically significant improvements were noted in all of the evaluated measures in all of the groups. The mean differences of Group 1-Group 2 and Group 1-Group 3 WOMAC total, WOMAC pain, WOMAC stiffness, and WOMAC function scores were statistically significant. [Conclusion] PRP is an effective treatment for functional status and pain in moderate knee osteoarthritis and a minimum of two injections is appropriate.
Short term results of platelet rich plasma in early stages of osteoarthritis knee
Innovative Publication, 2016
Introduction: Osteoarthritis of knee is a most common form of arthritis spread rampantly today. Platelet-rich plasma injections enhance cartilage repair and relieve osteoarthritis Symptoms. Thus it delays the need for joint replacement. Objective: To investigate the effect of platelet-rich plasma (PRP) on progression of early stages of osteoarthritis knee. Methodology: A case series study of 50 patients was carried out. Results were analyzed on the basis of following scores: WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) KSS (Knee Society Score) VAS (Visual Analogue Scale) Results: There were no significant adverse event observed. Statistically significant results in the Western Ontario and McMaster Universities Osteoarthritis Index and KSS and VAS scorings were recorded in patients who received PRP injections after a 3 and 6 months follow up. Conclusions: Our study suggests that autologous PRP can be used as an effective and safe method in the treatment of the early stages of osteoarthritis. But further studies are needed to confirm these finding and to investigate the long term effects of autologous PRP.
Scientific Reports, 2021
Despite encouraging results reported with regards to Platelet-rich plasma (PRP) application in osteoarthritis (OA) knee, still critical issues like conclusive structural evidence of its efficacy, standard dose and good manual method of preparation to obtain high yield remains unanswered. Present study is an attempt to optimise the dose and concentration of therapeutic PRP and its correlation with structural, physiologic efficacy with a new manual method of PRP preparation. A total of one hundred and fifty patients were randomized to receive either PRP (10 billion platelets) or hyaluronic acid (HA; 4 ml; 75 patients in each group) and followed up till 1 year. An addition of filtration step with 1 µm filter in manual PRP processing improved platelet recovery upto 90%. Significant improvements in WOMAC (51.94 ± 7.35 vs. 57.33 ± 8.92; P < 0.001), IKDC scores (62.8 ± 6.24 vs 52.7 ± 6.39; P < 0.001), 6-min pain free walking distance (+ 120 vs. + 4; P < 0.001) persisted in PRP com...
Efficacy and safety of platelet rich plasma in primary osteoarthritis of the knee joint
International Journal of Orthopaedics Sciences, 2020
Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of disability in people aged 50years and older. It is the clinical and pathologic outcome of a range of disorders that results in structural and functional failure of synovial joints. At first, articular cartilage may be the primary injury site but eventually all structures, synovium, muscle, capsule, ligaments and meniscal cartilage are involved. This prospective study was conducted in 60 patients of age 35-70years with grade1-2 osteoarthritis attending orthopedics OPD in a tertiary care centre. Having diagnosed by American College Of Rheumatology Criteria and staged as per Ahlback's radiological grading along with detailed history of secondary causes and pathological factors inducing osteoarthritis were ruled out.The age of the patients in our study ranged from 35-70 years with the mean age of 53.75 years. Female predominance was noted with females 40 (66.7%) and males constituting 33.3% (20 cases) in our study. In our study majority cases (n=46) presented with grade 2 while rest of the patients presented with grade 1 disease. VAS score depicted decrease in mean of 6.45 at baseline to 3.76 after six months. The improvement was statistically significant with p value (0.002). Total WOMAC score was noted at the end of six months and depicted by p value of (0.000). No complications related to PRP injection were reported. Platelet rich plasma has a role in the treatment of osteoarthritis which in our study is supported by the improvement seen in VAS and WOMAC scores. This improvement is possibly due to the anti inflammatory properties or due to release of various growth factors. PRP may also influence the overall joint homeostasis by reducing hyperplasia of the synovial membrane and modulating cytokines level.
Cureus, 2022
Background: Osteoarthritis of the knee is one of the most common degenerative diseases and the fourth leading cause of years lived with disability at the global level. This study assessed the efficacy of plateletrich plasma (PRP) in osteoarthritis of knees as to changes in cartilage thickness and clinical and functional outcomes. Methods: Thirty participants with Kellgren-Lawrence grade two and grade three osteoarthritis knee who satisfied the inclusion and exclusion criteria were enrolled in this prospective interventional study after taking written informed consent. Each participant received three doses of two ml intraarticular platelet-rich plasma at an interval of seven days. Clinical assessment was determined using the Visual Analogue Scale (VAS) and Knee Osteoarthritis Outcome Score (KOOS) on Day 0, Day 90, and Day 180. Cartilage thickness (femoral and trochlear cartilage) was measured pre (Day 0) and post-PRP (Day 180) under ultrasound guidance. Results: The mean VAS score for pain was 7.4 before treatment which changed to 5.3 (p= <0.0001) on Day 90 and 3.37 (p= <0.0001) on Day 180 post-PRP. The mean total KOOS was 19.16 ± 10.73 before treatment which improved to 37.42 ± 9.88 (p= <0.0001) and 49.98 ± 8.82 (p= <0.0001) at 90 days, and 180 days post-injection, respectively. The mean cartilage thickness (femoral and trochlear cartilage) improved from baseline (day 0) to final follow-up on day 180, which was statistically significant and implied cartilage repair following PRP administration. Conclusion: This study supports the efficacy of PRP in the management of osteoarthritis knee by improvement in pain, joint stiffness, and activities of daily living, as well as aids in the repair and regeneration of articular cartilage.
Efficacy of Intra-Articular Autologous Platelet Rich Plasma Application in Knee Osteoarthritis
Archives of Rheumatology, 2015
Osteoarthritis (OA) is a chronic, non-inflammatory rheumatologic disease which affects the synovial joints. It is characterized with joint cartilage degeneration, subchondral bone changes, and synovitis. 1 Nonsteroid antiinflammatory drugs, glucosamine, chondroitin sulfate and hyaluronic acid are generally used for reducing inflammation and relieving pain in patients with OA. However, these have limited effect on reducing chondrocyte degeneration and improving regeneration. 2 Medications protecting or healing the cartilage are still at experimental stage. These include applications of cytokine inhibitors, gene therapy, artificial chondrocytes, and growth factor (GF). 3 Growth factor increases the synthesis of chondrocyte matrix and stimulates chondrogenic cell proliferation. 4 It reduces the activation of nuclear factor kappa B which has an important role in the pathogenesis of OA, by inhibition of inflammatory process which is induced by interleukin-1 beta. 5 Platelet alpha granules contain ABSTRACT Objectives: This study aims to evaluate the efficacy of autologous platelet rich plasma applications on pain, functional status, and cartilage regeneration in advanced knee osteoarthritis. Patients and methods: A total of 82 patients (13 males, 69 females; mean age 63.5±9.3 years; range 40 to 88 years) with chronic knee pain for the last one year, who had grade 3-4 knee osteoarthritis according to Kellgren-Lawrence Scale and visual analog scale value of higher than 5, who did not receive physical therapy for the last six months, and did not respond to treatment despite use of nonsteroidal antiinflammatory drugs and analgesics at least for the last three months were enrolled in the study. Totally 103 knee joints of 82 patients were applied intra-articular platelet rich plasma in the beginning, and first and second weeks of treatment. Platelet rich plasma was applied to both knees in 20 patients. Patients were evaluated clinically with visual analog scale, functionally with Western Ontario and McMaster Universities Osteoarthritis Index, and six-minute walk test before application and after application at first and second weeks, and third and sixth months. Cartilage thicknesses were measured by ultrasound before treatment and at third and sixth months after treatment. Obtained results were compared. Results: Compared to values before treatment, patients' visual analog scale values were significantly decreased at third and sixth months after treatment (p<0.001). When compared according to Western Ontario and McMaster Universities Osteoarthritis Index, all values improved significantly after treatment (p<0.001). Results of six-minute walk test improved at third and sixth moths after treatment compared to results before treatment (p<0.05). Cartilage thicknesses increased significantly after treatment at third and sixth months compared to before treatment (p<0.05). Conclusion: We believe that platelet rich plasma treatment is an effective, reliable, easily applied and low cost application in terms of pain, functional status as well as cartilage regeneration even in patients with advanced osteoarthritis.
Role of platelet rich plasma in patients of osteoarthritis knee-a prospective study
IP Innovative Publication Pvt. Ltd, 2017
Introduction: In the present study, we evaluated the effects of 2 courses of PRP injections with 3 weeks interval, on patient's quality of life and functional ability. Materials and Method: It was a prospective study carried out on 55 patients (14 males & 41 females) in the Department of Orthopedics', Era's Lucknow Medical College, Lucknow, and Uttar Pradesh from Sep 2015 to March 2016. Age >40 years, Knee arthralgia (>3 months) and Radiologic evidence of articular damage (grades 1-3 of Kellgren-Lawrence scale) based on knee Osteoarthritis criteria of American College of Rheumatology were enrolled in our study. Two intra-articular injections of Platelet Rich Plasma (PRP) at 3 weeks interval was given and patient was regularly followed up after 3 rd week, 6 th week, 3 months & 6 months of the 1 st injection Results: Mean scores of all WOMAC parameters improved significantly compared to before treatment. Each Parameter of the WOMAC Score was compared with baseline score at each follow-up. Reduction in the mean pain, mean physical function and mean total womac scores from base line scores were observed during the course of 1 st (3 weeks) &2 nd (6 weeks) follow-ups then after marginal increase in scores were reported during 3 rd (3 months) and 4 th (6 months)follow ups but difference in mean of all scores were significant with the respective base line scores. Conclusion: The results of our study showed that intra-articular knee injections of Autologous Platelet Rich Plasma (PRP) are effective in reducing joint pain, stiffness and improve knee functions in early knee Osteoarthritis.