Combined use of platelet rich plasma and micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses

Osteoarthritis, also known as degenerative joint disease (DJD), is defined as a progressive and permanent long-term deterioration of the cartilage surrounding the joints. There is no known cause for primary DJD. However, there are a wide variety of causes for secondary DJD, such as trauma, abnormal wear of joints and cartilage, or a congenital defect present at birth such as an improperly formed hip. One of the most popular methods used to biologically enhance healing in the fields of orthopaedic surgery and medicine includes the use of autologous blood products, namely, platelet rich plasma (PRP). Reports suggest that PRP, presumably containing high levels of platelet growth factors, may promote the recovery of the affected cartilage. This case series presents clinical and radiographic findings of three dogs with osteoarthritis of the elbow and knee joints. Pain score were assessed by CBPI (Canine Brief Pain Inventory). Treatment with three-fold intra-articular application of PRP, obtained by double centrifugation method, resulted in significant improvement in the function of the affected joint. Therefore, it could be concluded that PRP was clinically effective in the treatment of osteoarthritis in these three cases.

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The effect of platelet-rich plasma in patients with early hip osteoarthritis: a pilot study

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnaa044 ◽

2020 ◽

Author(s):

Victor Ortiz-Declet ◽

David A Iacobelli ◽

Muriel R Battaglia ◽

Cammille C Go ◽

David R Maldonado ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Hip Osteoarthritis ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Harris Hip Score ◽

Post Injection ◽

Mri Findings ◽

Outcome Score ◽

Patient Reported

Abstract We investigate whether platelet-rich plasma (PRP) injections can improve symptoms and function in patients with mild to moderate osteoarthritis (OA). Data were prospectively collected and retrospectively reviewed for all patients receiving PRP intra-articular hip injections between February 2017 and June 2017. The inclusion criteria were patients with a well-preserved joint space (Tönnis 0 or 1) whose magnetic resonance imaging (MRI) findings demonstrated degenerative joint disease or a Tönnis grade of 2. The patient-reported outcomes (PROs) used were the modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome TOOL (iHOT-12), Single Assessment Numeric Evaluation (SANE) and Mental and Physical aspects of the Veteran RAND 12 Item Health Survey (VR-12M and VR-12P). The visual analog scale (VAS) was utilized to indicate pain. Nine patients (11 hips) were eligible for inclusion. All PROs and VAS improved from pre- to post-injection. These improvements were present at the 3-month follow-up visit and stable until the 12-month follow-up. There was statistically significant improvement for mHHS (P < 0.001), HOS-ADL (P = 0.006), iHOT-12 (P = 0.003) and VR-12M (P = 0.005) at 12 months post-injection. Similarly, VAS improved from 4.1 to 2.3, although the change was not statistically significant. PRP injections significantly improved PROs in all measured scales at time points up to a year after intervention, except for VR-12P and HOS-SSS. In conclusion, patients with early OA of the hip had significant improvement of patient-reported functional outcomes up to 12 months after PRP intra-articular injections.

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Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients

European Radiology ◽

10.1007/s003300050646 ◽

1999 ◽

Vol 9 (1) ◽

pp. 145-152 ◽

Cited By ~ 24

Author(s):

G. F. Bachmann ◽

E. Basad ◽

K. Rauber ◽

M. S. Damian ◽

W. S. Rau

Keyword(s):

Physical Activity ◽

Clinical Study ◽

Knee Joint ◽

Degenerative Joint Disease ◽

Joint Disease

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Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study

Sports Health A Multidisciplinary Approach ◽

10.1177/19417381211011074 ◽

2021 ◽

pp. 194173812110110

Author(s):

Mattia Alessio-Mazzola ◽

Lamberto Felli ◽

Roberto Trentini ◽

Matteo Formica ◽

Andrea Giorgio Capello ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Symptomatic Relief ◽

Case Series ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Level Of Evidence ◽

Meniscal Lesions ◽

Activity Scale ◽

Tegner Activity Scale

Background: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. Hypothesis: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. Study Design: Prospective case series. Level of Evidence: Level 4. Methods: A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. Results: Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale ( P = 0.03) and WOMAC ( P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months ( P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. Conclusion: PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. Clinical Relevance: This research supports the use of autologous PRP injections for symptomatic DMLs.

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Clinical Cohort Study in Canine Patients, to Determine the Average Platelet and White Blood Cell Number and Its Correlation with Patient’s Age, Weight, Breed and Gender: 92 Cases (2019–2020)

Veterinary Sciences ◽

10.3390/vetsci8110262 ◽

2021 ◽

Vol 8 (11) ◽

pp. 262

Author(s):

Isabel de Marcos Carpio ◽

Anita Sanghani-Kerai ◽

Miguel A. Solano ◽

Gordon Blunn ◽

Alexandra Jifcovici ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Pearson Correlation ◽

Clinical Status ◽

White Blood Cells ◽

Cell Number ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Male Population ◽

Significant Difference ◽

Platelet Number

Due to its easy preparation and that it is well tolerated, the use of autologous platelet-rich plasma (PRP) has become increasingly popular in regenerative medicine. However, there are still no clear guidelines on how it should be classified or whether the individual canine patient’s clinical status can influence its quality. Objective: This study aims to show if the weight, age, sex, neutered status or breed of canine patients have any correlation with the composition of PRP. Design: A blinded count of the platelets and white blood cells (WBC) was performed from 111 samples from 92 client owned dogs undergoing treatment for degenerative joint disease (DJD). The results were analysed using Pearson correlation test, ANOVA test or Student T-test. Results: There is a positive correlation between the number of platelets and WBC in canine patients of different breeds, but there was no significant difference on the platelet number and WBC number among the different breeds. The weight of the patient is also directly correlated to the platelet number (p = 0.003) but not WBC number. WBC number was negatively correlated to the weight of the patient. The sex and age of the patient did not affect platelets and WBC number, although WBC number is increased in non-neutered male population (p = 0.003). However, it would be interesting to investigate whether the growth factors released from the platelet granules are affected by patient variables in a canine population. Conclusions: Our results show that it is possible to obtain good quality autologous PRP, irrespective of age, sex, neutered status or weight of the patient, for PRP regenerative therapy.

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Platelet-rich plasma intra-articular injections as an alternative treatment for knee osteoarthritis: a systematic review

Timisoara Physical Education and Rehabilitation Journal ◽

10.1515/tperj-2017-0015 ◽

2017 ◽

Vol 10 (19) ◽

pp. 46-51

Author(s):

Elena Sîrbu ◽

Șerban Gligor ◽

Corina Pantea

Keyword(s):

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Cartilage Degeneration ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Primary Analysis ◽

Beneficial Effects ◽

Inappropriate Treatment ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee

Abstract Knee osteoarthritis is a degenerative joint disease characterized by cartilage degeneration and hypertrophic lesions of the epiphyseal bone. It is a disabling condition that causes difficulties of locomotion and severe complications in case of inappropriate treatment. There is growing evidence proving the beneficial effects of using platelet-rich plasma (PRP) in the treatment of knee osteoarthritis. The aim of the present paper is to review the recent scientific literature on the treatment of knee osteoarthritis with platelet-rich plasma presenting the current opinion on this subject. Methods: We analys several studies about PRP who were identified using online databases: EBSCO, ScienceDirect, Scopus and PubMed. Results: After the primary analysis we selected a total of 23 relevant studies. The analysis focused on different PRP administration techniques and methods used in knee osteoarthritis. Conclusions: PRP is most widely used in incipient and moderate symptomatic knee osteoarthritis. Most studies show a significant decrease in pain and significant improvement in joint functionality. These results were mostly obtained after a short follow-up period (6 months-1 year) and also this treatment has a small number of side effects.

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The Role of Wnt Pathway in the Pathogenesis of OA and Its Potential Therapeutic Implications in the Field of Regenerative Medicine

BioMed Research International ◽

10.1155/2018/7402947 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Maria De Santis ◽

Berardo Di Matteo ◽

Emanuele Chisari ◽

Gilberto Cincinelli ◽

Peter Angele ◽

...

Keyword(s):

Total Joint Replacement ◽

Platelet Rich Plasma ◽

Weight Bearing ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Loss Of Function ◽

Biological Drugs ◽

Therapeutic Implications ◽

Pubmed Database

Introduction. Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation, subchondral damage, and bone remodelling, affecting most commonly weight-bearing joints, such as the knee and hip. The loss of cartilage leads to joint space narrowing, pain, and loss of function which could ultimately require total joint replacement. The Wnt/β catenin pathway is involved in the pathophysiology of OA and has been proposed as a therapeutic target. Endogenous and pharmacological inhibitors of this pathway were recently investigated within innovative therapies including the use of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Methods. A review of the literature was performed on the PubMed database based on the following inclusion criteria: article written in English language in the last 20 years and dealing with (1) the role of Wnt-β catenin pathway in the pathogenesis of osteoarthritis and (2) pharmacologic or biologic strategies modulating the Wnt-β catenin pathway in the OA setting. Results. Evidences support that Wnt signalling pathway is likely linked to OA progression and severity. Its inhibition through natural antagonists and new synthetic or biological drugs shares the potential to improve the clinical condition of the patients by affecting the pathological activity of Wnt/β-catenin signalling. Conclusions. While further research is needed to better understand the mechanisms regulating the molecular interaction between OA regenerative therapies and Wnt, it seems that biologic therapies for OA exert modulation on Wnt/β catenin pathway that might be relevant in achieving the beneficial clinical effect of those therapeutic strategies.

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Efficacy of intra-articular injection of combined platelet-rich plasma and hyaluronic acid in knee degenerative joint disease (182)

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00300 ◽

2021 ◽

Vol 9 (10_suppl5) ◽

pp. 2325967121S0030

Author(s):

Pietro Randelli ◽

FILIPPO RANDELLI ◽

Fabio Sciancalepore ◽

Chiara Fossati ◽

Stefano Pasqualotto ◽

...

Keyword(s):

Hyaluronic Acid ◽

Conservative Treatment ◽

Current Literature ◽

Platelet Rich Plasma ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Knee Oa ◽

Significant Difference ◽

Early Oa

Objectives: Osteoarthritis (OA) of the knee is a debilitating disease whose prevalence has increased across the world with aging population. Platelet-Rich Plasma (PRP) and Hyaluronic Acid (HA) injections appear to be two of the main strategies for conservative treatment of early knee OA. The effectiveness of both treatments, however, is still under debate because contrasting results have been described in the current literature. Some pre-clinical studies evaluated the association of PRP and HA with encouraging results, highlighting the possibility of a synergistic effect between the two compounds and suggesting a possible use through combined intra-articular injections. The aim of this prospective randomized controlled double-blind clinical trial is to evaluate the efficacy of intra-articular injections of PRP and HA for the treatment of early stages of knee degenerative joint disease in improving joint function and reducing pain, compared to the intra-articular injections of PRP and HA alone. Methods: Patients with knee early OA were prospectively enrolled and then double-blinded randomly divided into three groups of fifty-eight subjects each: HA alone, PRP alone and PRP+HA group. Patients received three intra-articular injections with two-week interval period among each dose. Patients clinical outcome was evaluated through five questionnaires [The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Tegner Activity, Visual Analogue Scale (VAS), Knee injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) Subjective Knee Form] before the treatment (T0) and after 3, 6 and 12 months from the first injection. Patients’use of paracetamol and supplementary analgesia for knee pain during the study was collected. Results: One hundred and seventy-four patients were enrolled in this study (age, 30-80 years; 108 females and 66 males) and 162 completed the 12-month follow-up. All patients showed significant clinical improvement after treatment. The analysis of covariance (ANCOVA) did not show statistically significant differences among the three groups for all the variables analysed at 6 and 12 months of follow-up (p>0.05).No significant differences were found in terms of adverse events (p=0.49) among the three groups of patients (p=0.92).The demand for paracetamol and supplementary analgesics was generally low and there were no significant differences among the groups (p=0.23 and p=0.56, respectively). Conclusions: Injections treatments for early knee OA are an important conservative therapeutic strategy. To date, the current literature presents many contrasting studies about the effectiveness of PRP or HA, but only a few consider the combined use of PRP and HA as attractive therapeutic option. Our study has not shown any significant difference in clinical and functional outcomes among the three experimental groups, suggesting a substantial equivalence of these three treatments. Thus, cost-effectiveness is in favor of HA injections in the conservative treatment of early OA.

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