scholarly journals Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial

Cartilage ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Leonidas Roumeliotis ◽  
Vasileios S. Nikolaou ◽  
Efstathios Chronopoulos ◽  
Ioannis Sourlas ◽  
...  

Various systematic reviews have recently shown that intra-articular platelet-rich plasma (IA-PRP) can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb. A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the TMJ (grades: I-III according to the Eaton and Littler classification) was conducted. Group A patients (16 patients) received 2 ultrasound-guided IA-PRP injections, while group B patients (17 patients) received 2 ultrasound-guided intra-articular methylprednisolone and lidocaine injections at a 2-week interval. Patients were evaluated prior to and at 3 and 12 months after the second injection using the visual analogue scale (VAS) 100/100, shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), and patient’s subjective satisfaction. No significant differences between the baseline clinical and demographic characteristics of the 2 groups were identified. After 12 months’ follow-up, the IA-PRP treatment has yielded significantly better results in comparison with the corticosteroids, in terms of VAS score ( P = 0.015), Q-DASH score ( P = 0.025), and patients’ satisfaction ( P = 0.002). Corticosteroids offer short-term relief of symptoms, but IA-PRP might achieve a lasting effect of up to 12 months in the treatment of early to moderate symptomatic TMJ arthritis.

2018 ◽  
Vol 50 (05) ◽  
pp. 348-352 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Maria-Kyriaki Kaseta ◽  
Sotirios-Tsambikos Kazas ◽  
Panayiotis D Megaloikonomos ◽  
Andreas F Mavrogenis ◽  
...  

Abstract Background There have been several studies published comparing the ultrasound-guided with the “blind” infiltrations in the shoulder’s area. On the contrary, there is only very limited data regarding the necessity of ultrasound guidance in lateral epicondylitis. Materials and Methods A prospective, randomized, blinded at initial and follow-up evaluation, comparative clinical trial was conducted, involving 44 patients with a history of chronic persistent epicondylopathy. The patients were randomly divided into 2 groups of 22 people each. Group A patients underwent three ultrasound-guided betamethazone injections, while group B included those who underwent three “blind” injections, centered at the palpable point of maximum pain. The evaluation was done before and after (4 and 12 weeks) the injections using the Visual Analogue Scale for pain (VAS, 0–10) and the Roles & Maudsley score. Results There was not any significant statistical difference between the two groups as for mean VAS at 4 weeks (p = 0.150, t-test) and mean VAS at 12 weeks (p = 0.286, t-test). Furthermore, the final success rate, as measured by the Roles & Maudsley score, was slightly superior in group B (67 % of the patients with excellent or good results) when compared with group A (46 % of the patients), but without any statistical difference (p = 0.161, chi-square). Conclusion Our trial proved that an ultrasound-guided injection is not superior than a palpation-guided injection of corticosteroids in the treatment of lateral epicondylopathy.


Author(s):  
Vikram Sharma ◽  
Vivek Chandak

<p><strong>Background: </strong>Lateral epicondylitis is a common musculoskeletal disorder for which an effective treatment strategy remains unknown. Aim of the study was to examine whether a single injection of platelet-rich plasma (PRP) with needling is more effective than needling with placebo in reducing pain in adults with lateral epicondylitis. Study design used was randomized controlled trial.    </p><p><strong>Methods: </strong>A total of 66 patients with chronic lateral epicondylitis were randomized (1:1) to receive either a blinded injection of PRP (group A) or saline (placebo) group B. The primary end point was a change in pain using the VAS and patient-rated tennis elbow evaluation (PRTEE) questionnaire. The secondary outcome being improvement in function (PRTEE scores).<strong></strong></p><p><strong>Results: </strong>The VAS score and PRTEE score improved significantly in both the groups at all 3 follow-up examinations. Group A had significantly better results than the group B.</p><p><strong>Conclusions: </strong>PRP injection are safe and effective management strategy for lateral epicondylitis</p>


2016 ◽  
Vol 6 (2) ◽  
pp. 90
Author(s):  
Samaresh Chandra Hazra ◽  
Agha Masood Choudhury ◽  
Lubna Khondker ◽  
Md. Shirajul Islam Khan ◽  
Muhammad Munir Rashid

<p><strong>Background:</strong> For better management of lichen planus a clinical trial of oral methotrexate is necessary in ow· country. Objective: The objective of this study is to evaluate efficacy and safety ofmethotrexate therapy in the treatment of lichen planus.</p><p><strong>Methods:</strong> It was a prospective randomized controlled clinical trial conducted in the department of Dermatology and Venereology, BSMMU, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Cases (group-A, n=23) were treated with methotrexate (10 mg) single morning dose and control (group-B, n=21) were treated with mini pulse betamethasone (5mg) single morning dose on 2 consecutive days during the period of 12 weeks. <strong></strong></p><p><strong>Results:</strong> Clinical parameters were measured by follow up clinical examination. Morphological lesion of lichen planus improved 95. 7% in group-A and only 28.6% improved in group-B. At the end of study 82.6% bad no complaints of itching in group-A and 100% had no complaints of itching in group-B. 16(69.6%) patients in group-A were completely cured clinically but 10(47.6%) in group-B. Anemia 3(14.2%) and edema 12(57.1 %) developed in group-B but none in group-A. In group-B, dyspepsia 15(71.4%), acne 10(47.6%),mooning face 8(38.1%), striae 8(38.1%) and hyper­trichosis 4(19.0%) developed but none in group-A lntermittenr diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher amog group-8 compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A.</p><p><strong>Conclusion:</strong> The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus.</p>


Author(s):  
Hassan Amir Us Saqlain ◽  
Syed Sajid Hussain ◽  
Niaz Hussain Keerio ◽  
Masood Ahmed Qureshi ◽  
Nuresh Kumar Valecha ◽  
...  

Objective: This study aims to evaluate the effect of platelet rich plasma (PRP) and compare between single and double dose regimens among patients diagnosed with osteoarthritis admitted to the orthopedic department of Al Qassimi Hospital Sharjah, United Arab Emirates. Methods: 200 patients were allocated into two groups in this randomized clinical trial. Patients were chosen to participate in this study after an informed consent. The trial took place at the Al Qassimi Hospital Sharjah, United Arab Emirates from July 2019 to July 2020. All patients had knee osteoarthritis, half of them received single dose PRP (group A) and the other half received double dose PRP (group B). All patients were adults and older than 18 years of age. Patients were followed up using Western Ontario and McMaster Universities Arthritis Index (WOMAC). The follow up was done prior to the administration of PRP, at 1 month, 3 month and 6 months after administration. Data was analyzed using SPSS program. Ethical approval was gained from the hospital as well as from patients. Results: The mean age of the patients was 48.5 ± 8.3 years. The study included 200 participants, among them, 60 were females and 140 were males. There was improvements in all parameters of WOMAC at 3 and 4 weeks following administration of PRP. The effect of PRP continued until 6 months of follow up with no differences between the two groups. Group A baseline WOMAC parameters (pain, stiffness, physical function and total score) mean score were 15.8, 6.24, 43.01 and 65.22 respectively. At the follow up, the mean scores were 4.73, 1.78, 13.88 and 19.56 respectively. This shows significant improvement. On the other hand, group B baseline mean scores were 16.31, 6.81, 40.89 and 64.77 respectively. At the final follow up of group B, the parameters mean scores were 4.40, 1.11, 13.64 and 20.27 respectively. Both groups were compared to each other and no benefit for the double dose over the single dose (P value, 0.66). Conclusion: Previous results suggests improvement in functionality in both groups of the trial. There was pain and stiffness relief among all patients. It is concluded that double dose has no additional effect to the single dose regimen.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Yutaka Nagata ◽  
Hirozo Goto ◽  
Hiroaki Hikiami ◽  
Tatsuya Nogami ◽  
Makoto Fujimoto ◽  
...  

We evaluated the effect of keishibukuryogan (KBG; Guizhi-Fuling-Wan), a traditional Japanese (Kampo) formula, on endothelial function assessed by reactive hyperemia peripheral arterial tonometry (Endo-PAT2000) in patients with metabolic syndrome-related factors by controlled clinical trial with crossover design. Ninety-two patients were assigned to group A (first KBG-treatment period, then control period; each lasting 4 weeks, with about one-year interval) or group B (first control, then KBG-treatment). In forty-nine (27, group A; 22, group B) patients completing all tests, the mean value of the natural logarithmic-scaled reactive hyperemia index (L_RHI) increased and those of serum nonesterified fatty acid (NEFA), malondialdehyde, and soluble vascular cell adhesion molecule 1 decreased significantly during the KBG-treatment period, but not during the control period, and 4-week changes of L_RHI, NEFA, and malondialdehyde between the 2 periods showed significance. These results suggest that KBG has beneficial effect on endothelial function in patients with metabolic syndrome-related factors.


Author(s):  
Shakun Singh ◽  
Rachna Chaudhary ◽  
Vandana Dhama ◽  
Anu Singh ◽  
Urmila Karya

Background: To study the impact of Vitamin A supplementation in anaemia during Pregnancy and thus improving maternal and fetal outcome a Randomized double blind controlled clinical trial was conducted in Department of Obstetrics and Gynaecology, L.L.R.M. Medical college Meerut involving 250 pregnant women in late pregnancy 18-28 weeks with haemoglobin levels <11 g% (7-11 g%)..Methods: The study subjects were divided into two groups: Group A (n=125): Received daily supplement containing Iron (60 mg elemental iron) + Folate (500 mcg) + Vitamin A 20,000 IU weekly for a minimum of 12 weeks. Group B (n=125): Received daily supplement containing iron (60 mg elemental iron) + Folate (500 mcg) for a minimum of 12 weeks.Results: Maximum patients were uneducated belonging to low socioeconomic status. The mean haemoglobin values in Group A and Group B increased from 9.674±1.05 and 9.53±1.04 to 12.2±0.89 and 10.82±1.06 respectively after supplementation. Similarily Serum Ferritin levels increased from 15.96±2.94 and 15.70±2.83 to 78.40±17.82 and 58.64±11.93. Mean corpuscular volume, packed cell volume and red blood cell counts also increased significantly. Maximum haemoglobin levels were achieved with both vitamin A and iron supplementation. The proportion of women who became non anaemic was 97.17% in Group A vs 68.69% in Group B.Conclusions: Vitamin A supplementation improves anaemia and also dramatically improves iron stores in anaemic pregnant women.


Author(s):  
Vithal Prakash Puri ◽  
Anil Kumar Gaur

<p class="abstract"><strong>Background:</strong> The heel pain is the most common problem worldwide and it was associated with plantar fasciitis (PF). The condition of treatment is very complex. Platelet-rich plasma (PRP) and injection of corticosteroids is the treatment of PF. This study was designed to access the effect of local PRP and local corticosteroid injection in PF patients.</p><p class="abstract"><strong>Methods:</strong> Sixty patients (between 29 to 60 years of age) with chronic PF were randomized prospectively in single tertiary care center in India. The study conducted from December 2013 to December 2015. All the patients were enrolled according to inclusion criteria and divided into two groups randomized. In group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Visual analog scales (VAS) were filled by all the included patients. The follow-up scheduled at one and six months after complete enrolment of patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Between both the groups the significantly different observed at one and six months follow-up from the baseline. At one month follow-up significantly improvement in mean VAS score were observed in group B (p&lt;0.001). At six months follow-up significantly improvement in mean VAS score were observed in group A (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The present study concluded from the significance difference between both the groups proved promising form of treatment in chronic PF patients. Both the treatment was safe and effective in relieving pain improving function at different time period.</p><p> </p>


Author(s):  
Mona Sune ◽  
Pradeep Sune

Introduction: Fibrin glue is a biological tissue adhesive and acts on the principle of final stages of the coagulation cascade. The cost of commercially available products is very high and not affordable for the patients of low socio-economic strata. As an alternative, pterygium surgery was done using patient’s own blood to adhere the conjunctival autograft to scleral bed by the process of coagulation of fibrin from the oozing blood from the blood vessels under the flap. Aim: To compare autologous blood and fibrin glue for adhering conjunctival autografts after pterygium excision. Materials and Methods: It was a randomised clinical trial. Total 97 subjects with primary pterygium who visited the Ophthalmology Department were randomised into two groups. In group A (n=31), patients had undergone pterygium excision wherein conjunctival autograft was attached by fibrin glue. In group B (n=66) the graft was attached by autologous blood present on the scleral bed. Mean operative time for the procedures were compared. Follow- up was done for 12 months and all subjects were examined for postoperative pain, foreign body sensation, inflammation, graft stability and recurrence. Results: The mean age of patients in group A was 48.32±14.3 years (21-65 years), and in group B was 54.48±15.67 (23-74 years). Mean operating time in group A was 23.21±9.4 minutes and 13.7±4.3 minutes in group B, (p-value=0.001). Postoperative pain of mild degree was present in all the 31 (100%) subjects of group A. In group B, pain was absent in 32 (48.5%) and mild degree in 34 (51.5%) subjects. No recurrence was found in both the groups. Mean follow-up period was 11.4 months. Conclusion: This study concludes that autologous blood is a useful alternative method for graft attachment in pterygium surgery without the untoward complications related to fibrin glue.


Sign in / Sign up

Export Citation Format

Share Document