A study on the outcome of platelet-rich plasma in the management of primary osteoarthritis of knee in Northern Andhra Pradesh

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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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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204525 ◽

2020 ◽

Vol 7 (11) ◽

pp. 1717

Author(s):

Debasish Deb ◽

Yumnam Nandabir Singh ◽

Naorem Bimol Singh

Keyword(s):

Single Dose ◽

Knee Osteoarthritis ◽

Functional Outcome ◽

Platelet Rich Plasma ◽

Controlled Trial ◽

Womac Score ◽

Osteoarthritis Of Knee ◽

Primary Osteoarthritis ◽

Strengthening Exercise

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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