Comparison between 25% dextrose prolotherapy and single dose of platelet rich plasma in the management of pain and improvement of functional outcome in patients suffering from primary knee osteoarthritis: a randomized controlled trial

Background: One of the most prevalent and disabling diseases worldwide, which decreases patients' quality of life (QoL) is knee osteoarthritis. However, pharmacological and non-pharmacological treatments, apart from complications, could not desirably control the disease. Limited studies are available in management of primary osteoarthritis of knee with prolotherapy with 25% dextrose and platelet rich plasma (PRP). Objective was to compare between 25% dextrose prolotherapy and single dose of PRP injection in the management of pain and improvement of functional outcome in patients suffering from primary knee osteoarthritis.Methods: A comparative study was conducted to see the effectiveness of 25% dextrose prolotherapy and PRP in primary osteoarthritis (OA) of knee in the management of pain and improvement of functional outcome in sixty-six patients in age group of 50 to 70 years attending PMR department OPD, RIMS, Imphal between october2018 to April 2020. The first group received 6 ml injections of 25% dextrose 3 times at baseline, 1 month and 4th month, whereas the 2nd group received single dose of 5ml PRP at baseline.Results: In both the groups 50 mg of tramadol tablet and isometric strengthening exercise of quadriceps was given. Assessment was done at baseline, at 1, 4 and 8 months by visual analogue scale (VAS) and western Ontario and McMaster university arthritis (WOMAC) index. Statistically significant improvement was noted in VAS (5.91±0.82 to 2.65±0.94) and WOMAC score (45.25±6.68 to 20.25±7.67) at end of 8 month in first group.Conclusion: It was concluded that 25% dextrose was more effective than in management of primary osteoarthritis of knee.

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Comparison of the clinical effect of intra-articular injection of platelet-rich plasma and methylprednisolone in primary osteoarthritis of knee: a randomized controlled trial

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20195238 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1842

Author(s):

Darendrajit S. Longjam ◽

Joy S. Akoijam ◽

Meina S. Ahongshangbam ◽

Nilachandra S. Longjam

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Platelet Rich Plasma ◽

Controlled Trial ◽

Osteoarthritis Of The Knee ◽

Womac Pain ◽

Osteoarthritis Of Knee ◽

Primary Osteoarthritis ◽

Steroid Group

Background: Osteoarthritis of knee is one of the commonest musculoskeletal disorder causing mobility impairment affecting 3.3% in urban areas and 5.5% in rural areas. Intra-articular injection of Platelet-Rich Plasma (PRP) delivers activated platelets that may reduce inflammation, provide pain relief, improve function and stimulate possible cartilage regeneration at the site of worn cartilage area of the knee.Methods: Eighty patients with primary osteoarthritis of the knee fulfilling inclusion and exclusion criteria were recruited in the study conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal from October 2014 to September 2017. Six ml of PRP prepared by conventional bench top centrifugation system was injected intra-articularly, two weeks apart in the PRP group. Steroid group received 80mg of methylprednisolone, two weeks apart by the same technique. The outcome variables (VAS and WOMAC score) were measured before starting intervention (baseline) and at 8 and 24-weeks post-intervention follow up.Results: Significant improvement seen in VAS, WOMAC-pain, stiffness and physical function and total scores in both the groups at 8- and 24-weeks follow-ups (p˂0.001). Steroid group showed better result than the PRP group in VAS (2.78±0.76 vs 3.58±1.03) and WOMAC-total (30.42±6.85 vs 36.25±10.87) scores at 8 weeks respectively (p˂0.001). But at 24 weeks follow-up, PRP showed significantly more effective than the steroid group in reducing pain (2.0±.0.87 vs 2.45±0.78) and disability (22.95±3.78 vs 25.25±6.67) respectively (p˂0.001).Conclusions: Intra-articular injection of methylprednisolone was found to be more effective in reducing pain and disability in primary knee osteoarthritis of KL grade 2 and 3 at the end of 8 weeks whereas 2 doses of PRP intra-articular injection 2 weeks apart was significantly more effective than methylprednisolone at the end of 24 weeks. However, the long-term benefit of PRP is to be determined by studies with a larger sample size and longer duration of follow-up.

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An Assessment of the effect of Platelet Rich Plasma in the Osteoarthritis of the Knee

Stem Cell Research International ◽

10.33140/jscr.03.02.2 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

Knee Osteoarthritis ◽

Functional Outcome ◽

Joint Replacement ◽

Platelet Rich Plasma ◽

Womac Score ◽

Good Alternative ◽

Osteoarthritis Of The Knee ◽

Joint Replacement Surgery ◽

Knee Oa

Introduction: Osteoarthritis (OA) is estimated to be the fourth leading cause of disability. With prevalence as high as 17 to 60.6%. With a 100% increase in prevalence of knee osteoarthritis since the mid-20th century. No specific cure for OA appears to exist. Most of the patients have no option but to undergo joint replacement surgery which again is an option not without risk and limitations. Therefore, there is need for a treatment option which could avoid or delay a joint replacement and make patient comfortable till surgery becomes an absolute indication. The available interventional therapies are visco-supplementation and PRP therapy which help in delaying the disease progression. This study was undertaken with the aim to assess the functional outcome of the therapeutic values of Platelet Rich Plasma (PRP) in knee osteoarthritis. Materials and Method: The present study was conducted in the Department of Orthopaedics, Rohilkhand Medical College, Bareilly. All the patients affected by a Unilateral or Bilateral knee osteoarthritis of all radiological grades (grade 1-4), attending the department from November 2016 to October 2017 were invited to participate in the study. It is a prospectivestudy of 50 cases. The patients were administered with 3 doses of intra-articular PRP and were followed up till 6 months post PRP therapy. The cases of knee OA were radiologically classified by the Kellegren Lawrence Grade. The functional outcome in the patients was assessed by the WOMAC, IKDC and VAS scores. Results: A significant change in WOMAC score was observed. The range of change in WOMAC score at 1 week to 6 months follow-up was 9.85% to 24.84%. Changes in WOMAC score at all the follow up visits were statistically significant (p<0.001).A subsequent decline in pre-treatment VAS score (Pain) was also observed at follow up visits at 1 week (1.15±0.69; 18.18%), 3 months (2.07±1.03; 32.63%) and 6 months (2.29±1.29; 36.14%). Conclusion: PRP is a very good alternative treatment modality in patients with knee OA from KL grade 1 to grade 3 to delay the progression of the disease and also it provided significant symptomatic improvement along with improvement in the functional outcome of the patients without any severe side-effects.

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Platelet-Rich Plasma Injections for Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-Blinded Clinical Trial

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116689386 ◽

2017 ◽

Vol 5 (2) ◽

pp. 232596711668938 ◽

Cited By ~ 33

Author(s):

Nayana Joshi Jubert ◽

Luciano Rodríguez ◽

Maria Mercedes Reverté-Vinaixa ◽

Aurora Navarro

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Late Stage ◽

Platelet Rich Plasma ◽

Short Form ◽

Controlled Trial ◽

Young Patients ◽

Knee Oa ◽

Symptomatic Knee

Background: Intra-articular injections of platelet-rich plasma (PRP) to treat symptoms of knee osteoarthritis (OA) have been successfully used in young patients and in the early stages of disease. No previous studies have analyzed outcomes of PRP injections during the late stages. Hypothesis: PRP reduces pain and leads to a more effective and lasting functional recovery than corticosteroid with local anesthetic. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 75 patients with symptomatic knee OA (Kellgren-Lawrence grade 3 to 4) were enrolled in this study between August 2013 and July 2014. Patients were randomized to treatment either with a single leukocyte-reduced PRP or corticosteroid intra-articular injection. The primary variable was visual analog scale assessment at 1 month. Secondary outcomes were the Knee injury and Osteoarthritis Outcome Score (KOOS) and Short Form–36 (SF-36) at 1, 3, and 6 months after treatment. Patient satisfaction at final follow-up was assessed. Both groups were homogeneous and comparable in baseline characteristics. Results: All variables improved in both groups. Statistical differences between groups were not found for the majority of the outcome variables, although the magnitude of improvements tended to be greater in the PRP group. Quality-of-life differences between values at 3 and 6 months versus baseline increased significantly more in the study group ( P = .05 and .03, respectively), and so did general health perception differences at 6 months ( P = .018). Conclusion: A single PRP intra-articular injection is effective for relieving pain and improving activities of daily living and quality of life in late-stage knee OA. For patients with late-stage knee OA who are 67 years or older, 1 intra-articular injection of PRP has similar results to 1 shot of corticosteroid.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175660 ◽

2017 ◽

Vol 4 (1) ◽

pp. 128

Author(s):

Yeshwanth Subash ◽

Kamalakumar K. ◽

Lydia M.

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Platelet Rich Plasma ◽

Cost Effective ◽

Functional Results ◽

Womac Score ◽

Osteoarthritis Of The Knee ◽

Early Osteoarthritis

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.

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Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines

Pharmaceuticals ◽

10.3390/ph14030205 ◽

2021 ◽

Vol 14 (3) ◽

pp. 205

Author(s):

Dragan Primorac ◽

Vilim Molnar ◽

Vid Matišić ◽

Damir Hudetz ◽

Željko Jeleč ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Symptom Relief ◽

Topical Administration ◽

Symptomatic Therapy ◽

Therapy Options ◽

Professional Societies ◽

Inflammatory Drugs ◽

The Right

Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient’s response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient’s quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.

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