Management of Knee Osteoarthritis in Italy: A Cost-Utility Analysis of Platelet-Rich-Plasma Dedicated Kit Versus Hyaluronic Acid for the Intra-Articular Treatment of Knee OA

2017 ◽  
Author(s):  
Salvatore Russo ◽  
Stefano Landi ◽  
Paolo Landa
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Knee Oa

scholarly journals The visk study: a cost utility analysis of intra articular hyaluronic acid for knee osteoarthritis

2013 ◽  
Vol 21 ◽  
pp. S149
Author(s):  
J. Hermans ◽  
M. Reijman ◽  
H. Verburg ◽  
S.M. Bierma-Zeinstra ◽  
M.A. Koopmanschap
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis

scholarly journals How to Choose Platelet-Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis in Overweight or Obese Patients: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Pan Luo ◽  
Zhencheng Xiong ◽  
Wei Sun ◽  
Lijun Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Obese Patients ◽  
Knee Oa ◽  
Significant Difference ◽  
Better Than

Objective. The purpose of this meta-analysis was to determine whether platelet-rich plasma (PRP) was better than hyaluronic acid (HA) for the treatment of knee osteoarthritis (OA) in overweight or obese patients. Design. Two reviewers independently used the keywords combined with free words to search English-based electronic databases according to Cochrane Collaboration guidelines, such as PubMed, Embase, ScienceDirect, and Cochrane library. The pooled data were analyzed using RevMan 5.3. Results. Ten randomized controlled trials (RCTs) with 1096 patients were included. During the first two months of follow-up, there was no significant difference between the two groups. At the 3rd, 6th, and 12th months of follow-up, the pooled analysis showed that PRP was better than HA for the treatment of knee OA in overweight or obese patients. There were significant differences between the two groups at Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (3 months: MD = −1.35, [95% CI: −2.19 to −0.50], P=0.002, I2 = 0%; 6 months: MD = −7.62, [95% CI: −13.51 to −1.72], P=0.01, I2 = 88%; 12 months: MD = −12.11, [95% CI: −20.21 to −4.01], P=0.003, I2 = 94%). Conclusions. For overweight or obese patients with knee OA, intra-articular injection of PRP in a short time was not necessarily superior to HA, but long-term use was better than HA in pain and functional relief.

scholarly journals AB0597 COMPLIANCE WITH CLINICAL PRACTICE GUIDELINES IN KNEE OSTEOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1335.2-1335
Author(s):  
M. Yasmine ◽  
L. Souebni ◽  
S. Miladi ◽  
A. Fazaa ◽  
S. Mariem ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Clinical Practice ◽  
Knee Osteoarthritis ◽  
Alternative Medicine ◽  
General Practitioners ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Platelet Rich Plasma ◽  
Knee Oa ◽  
Comprehensive Management

Background:Knee osteoarthritis (OA) is a leading cause of disability among older adults. Recently, evidence-based guidelines for the comprehensive management of osteoarthritis (OA) were developed by the American College of Rheumatology (ACR).Objectives:The aim of this study was to assess compliance of doctors with ACR 2019 clinical practice guidelines for the management of knee OA.Methods:We conducted a prospective study including rheumatologists and general practitioners. The doctors were invited to answer a structured questionnaire via Google Form. The outcomes of interest concerned the medical management of knee OA as well as alternative medicine.Results:The study included 100 doctors: 75 rheumatologists and 25 general practitioners. Almost half of them (49%) have been practicing medicine for more than 10 years. Forty four percent of doctors see between 10 to 20 patients with knee OA per month and 47% of them declared seeing more than 20 patients. Regarding the pharmacological treatment of knee OA flares, oral Non-steroidal Anti-inflammatory drug (NSAIDs) was the initial molecule of choice (91%) followed by grade I analgesics (86 %) and topical NSAIDs (68%). Tramadol and non-Tramadol opioids as well as intraarticular glucocorticoid injections were prescribed respectively in 41% and 46 % of cases. Glucosamine and chondroitin sulfate were prescribed in 49% and 54% of cases respectively and as a combination in 20% of cases. The reasons for non-prescribing these molecules were non-affordable prices (n=19), a lack of efficacy (n=6) and potential sides effects (n=1). Seventy three percent of doctors prescribe hyaluronic acid injections, with a frequency of three weekly injections in 38.7 % of cases and according to the response to the first injection in 61.3% of cases. The combination of both corticosteroids and hyaluronic acid injection was preferred in 38% of cases. The majority of doctors (84%) referred their patients to physical therapy as a first-line prescription (82.1%) or after medical treatment failure (17.9%). The use of alternative medicine was at follows: acupuncture (42.7%), prolotherapy (28.1%) and platelet-rich plasma injections (16.7%). Thirty eight doctors recommended against alternative medicine.Conclusion:Our study showed a poor compliance to guidelines regarding the use of intra-articular injections and alternative medicine. Even though, these guidelines provide direction for clinicians, doctors and patients should engage in shared decision-making that accounts for patients’ values, preferences, and susceptibilities.Disclosure of Interests:None declared.

scholarly journals A Systematic Review of Current Clinical Practice Guidelines on Intra-articular Hyaluronic Acid, Corticosteroid, and Platelet-Rich Plasma Injection for Knee Osteoarthritis: An International Perspective

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110302
Author(s):  
Mark Phillips ◽  
Mohit Bhandari ◽  
John Grant ◽  
Asheesh Bedi ◽  
Thomas Trojian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Clinical Practice ◽  
Knee Osteoarthritis ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Platelet Rich Plasma ◽  
Symptom Relief ◽  
Current Evidence ◽  
Knee Oa

Background: There are many clinical practice guidelines (CPGs) for the prevention, diagnosis, and treatment of knee osteoarthritis (OA). They differ by region, considering local health care systems, along with cultural and economic factors. Currently, there are conflicting CPG recommendations across the various publications, which makes it difficult for clinicians to fully understand the optimal treatment decisions for knee OA management. Purpose: To summarize the current published CPG recommendations for the role of injections in the nonoperative management of knee OA, specifically with the use of intra-articular hyaluronic acid (IA-HA), intra-articular corticosteroids (IA-CS), and platelet-rich plasma (PRP). Study Design: Systematic review. Methods: A comprehensive search identified all nonoperative knee OA CPGs within the ECRI (formerly Emergency Care Research Institute) Guidelines Trust database, the Guidelines International Network database, Google Scholar, and the Trip (formerly Turning Research Into Practice) database. Guideline recommendations were categorized into strong, conditional, or uncertain recommendations for or against the use of IA-HA, IA-CS, or PRP. Guideline recommendations were summarized and depicted graphically to identify trends in recommendations over time. Results: The search strategy identified 27 CPGs that provided recommendations. There were 20 recommendations in favor of IA-HA use, 21 recommendations in favor of IA-CS use, and 9 recommendations that were uncertain or unable to make a formal recommendation for or against PRP use based on current evidence. Most recommendations considered IA-HA and IA-CS use for symptom relief when other nonoperative options are ineffective. IA-CS were noted to provide fast and short-acting symptom relief for acute episodes of disease exacerbation, while IA-HA may demonstrate a relatively delayed but prolonged effect in comparison. The CPGs concluded that PRP recommendations currently lack evidence to definitively recommend for or against use. Conclusion: Available CPGs provide recommendations on injectables for knee OA treatment. General guidance from a global perspective concluded that IA-CS and IA-HA are favored for different needed responses and can be utilized within the knee OA treatment paradigm, while PRP currently has insufficient evidence to make a conclusive recommendation for or against its use.

scholarly journals The Role of Platelet Rich Plasma in the Treatment Algorithm of Knee Osteoarthritis

2017 ◽  
pp. 63-69
Author(s):  
George Chang Chien
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Treatment Algorithm ◽  
Recovery Process ◽  
Joint Disease ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Knee Oa

Osteoarthritis (OA) is a progressive joint disease associated with both mechanical and biologic abnormalities of the articular cartilage and subchondral bone. In normal cartilage, a delicate balance exists between matrix synthesis and degradation; in OA, however, cartilage degradation exceeds synthesis. Treatment modalities include nonpharmacological, pharmacological, and surgical approaches. Intrarticular platelet rich plasma (PRP) has emerged as promising treatment for early stages of knee OA. PRP is an autologous blood product defined as a volume of plasma that has a supraphysiologic platelet count. PRP can accelerate the physiological recovery process, relieve pain, and contains anti-inflammatory and anti-bacterial activity. Although the mechanisms for these complex interactions are not completely understood, they are attributed to the more than 30 bioactive proteins contained in the alpha granules of platelets including growth factors and proteins, such as fibrin, fibronectin, vitronectin and thrombospondin. Several studies now have demonstrated that intraarticular PRP injections are safe and effective treatment to reduce pain and improve quality of life through increased function in knee OA. The available literature suggests that PRP is a better option than hyaluronic acid for many knee OA patients. We identified 12 comparative studies that demonstrated superiority of PRP as compared to hyaluronic acid for knee OA. Considering what is known about the deleterious effects of local anesthetic and corticosteroids on soft tissue health, it may be time for a shift in the knee OA treatment algorithm to favor early intervention for regenerative therapies including platelet rich plasma. Key words: Platelet rich plasma, hyaluronic acid, knee pain, knee osteoarthritis, arthritis, chondrotoxicity

scholarly journals Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1193
Author(s):  
Oliver Dulic ◽  
Predrag Rasovic ◽  
Ivica Lalic ◽  
Vaso Kecojevic ◽  
Gordan Gavrilovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Side Effects ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Grade Ii

Background: In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentrate (BMAC), Platelet-rich Plasma (PRP), or Hyaluronic acid (HA) in the OA treatment. Methods: Patients with knee pain and osteoarthritis KL grade II to IV were randomized to receive a BMAC, PRP, and HA injection in the knee. VAS, WOMAC, KOOS, and IKDC scores were used to establish baseline values at 1, 3, 6, 9, and 12 months. All side effects were reported. Results: A total of 175 patients with a knee osteoarthritis KL grade II-IV were randomized; 111 were treated with BMAC injection, 30 with HA injection, and 34 patients with PRP injection. There were no differences between these groups when considering KL grade, BMI, age, or gender. There were no serious side effects. The mean VAS scores after 3, 7, 14, and 21 days showed significant differences between groups with a drop of VAS in all groups but with a difference in the BMAC group in comparison to other groups (p < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (p < 0.001) in WOMAC, KOOS, KOOS pain, and IKDC scores, and in addition, there were differences between these scores in the BMAC group in comparison with other groups, except for the PRP group in WOMAC and the partial IKDC score. There were no differences between the HA and PRP groups, although PRP showed a higher level of clinical improvement. Conclusions: Bone marrow aspirate concentrate, Leukocyte rich Platelet Rich Plasma, and Hyaluronic acid injections are safe therapeutic options for knee OA and provide positive clinical outcomes after 12 months in comparison with findings preceding the intervention. BMAC could be better in terms of clinical improvements in the treatment of knee OA than PRP and HA up to 12 months. PRP provides better outcomes than HA during the observation period, but these results are not statistically significant. More randomized controlled trials and high quality comparative studies are needed for direct correlative conclusions.

Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in Treatment of Knee Osteoarthritis (Systematic Review and Meta-analysis)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Atef Mohamed El-beltagy ◽  
Zeiad M Zakaria ◽  
; Mohamed Abdel-Samei Ibrahim
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Observational Studies ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Knee Oa ◽  
Vas Score ◽  
Significant Difference ◽  
Meta Analyses

Abstract Background Although PRP is one of the options in the management of knee OA, its effectiveness and wide application is still controversial. Therefore, we conducted the present systematic review and meta-analysis to compare the safety and effectiveness of PRP versus HA injection for knee OA. Objective The purpose of this study is to compare between the efficacy of intra-articular injections of Platelet-Rich Plasma versus Hyaluronic Acid in treatment of knee osteoarthritis. Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results The overall effect favoured PRP over HA for WOMAC function score, WOMAC pain score, WOMAC stiffness score, and WOMAC total score; mostly 6 and 12 months after treatment. According VAS score, we found that the overall effect favoured PRP over HA at 12 months only. In contrary, the overall effect did not favour PRP over HA for VAS score at 3 and 6 months. PRP is superior to HA for IKDC scores at 6 and 12 months with similar results at 3 months. Conclusion Intra-articular PRP injection is more effective in terms of pain relief and function improvement at short-term follow-up in the treatment of knee OA than HA, and there is no significant difference in the risk of adverse events between PRP and HA. A randomized controlled trial with larger group sizes is necessary to find the predictors of the response to PRP and HA intra-articular injection.

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