scholarly journals Hope, Hype, Hurdles & Future Perspective for PRP, PRP versus Hyaluronic Acid Injection in Osteoarthritis of Knee: A Review Article.

2020 ◽  
Vol 2 (1) ◽  
pp. e1-e12
Author(s):  
Ashok Kumar ◽  
Anikait Ghosh Kadamb ◽  
Krish Ghosh Kadamb
Keyword(s):  
Hyaluronic Acid ◽  
Knee Joint ◽  
Platelet Rich Plasma ◽  
Future Perspective ◽  
Osteoarthritis Of The Knee ◽  
Stiff Knee ◽  
Injection Interval ◽  
One Year

BackgroundComparative studies of platelet-rich plasma (PRP) and hyaluronic acid show variable results. PurposeA review was conducted to understand the current role of PRP and its efficacy versus hyaluronic acid in osteoarthritis (OA) of the knee joint. MethodsOut of 170 identified studies, 14 studies involving 1575 patients with 637 males and 938 females were selected based on PRISMA flow chart guidelines and were analyzed for the study. ResultsA standard PRP regimen consisting of 2–3 intra-articular injections (IA) of 4–6 mL of leucocyte poor PRP at 1–2 weekly intervals provides a better result than HA during the first 3–6 months, and which may continue up to one year. PRP and HA may have synergistic effect; pain and swelling are the two most com-mon complications with PRP, the incidence is more with leucocyte rich PRP (LP-PRP) and intra-osseous PRP treatment.ConclusionPRP provides hope and is more effective than hyaluronic acid in pain relief and improving the quality of life in mild to moderate osteoarthritis of the knee joint. However, hype, that is effective in all, irrespective of grades of OA, mal-aligned or stiff knee, ligamentous laxity, and can avoid joint replacement is a big hindrance in establishing it as a preferred treatment in OA knee. The author follows the above-mentioned PRP regimen; and recommends to combine leucocyte poor PRP with HA for IA injections & with LP-PRP injections along with the two most common painful points (medial collateral ligament, pesanisernius) in a highly painful OA knee. PRP may not address extra-articular causes of knee pain (mal-alignment, muscle wasting, tendinosis), should be corrected for optimum outcome. Contact sports, running, exercises putting pressure on knee and NSAID should be avoided during PRP treatment. Also, more randomized controlled trials are required to further standardize the PRP preparation, administration, injection interval & proper documentation of efficacy and complications in the regenerative registry.

scholarly journals Effectiveness of plasma with low concentration of platelets combined with hyaluronic acid compared with platelet rich plasma in the conservative treatment of knee osteoarthritis. A retrospective study

2020 ◽  
Author(s):  
Michelangelo Palco ◽  
Domenico Fenga ◽  
Paolo Rizzo ◽  
Bruno Cavalieri ◽  
Demetrio Milardi ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Functional Status ◽  
Repeated Measures ◽  
Platelet Rich Plasma ◽  
High Concentration ◽  
Low Concentration ◽  
One Year ◽  
Change In Mean

Abstract Background: Knee osteoarthritis (KO) is one of the most common joint diseases, often determining knee pain and reduction of mobility with impact on the overall quality of life of the patients. Intra-articular injections of different formulations of platelet rich plasma (PRP) are an increasingly common non-surgical treatment for KO. Recently, in order to combine the antinflammatory effect of platelet rich plasma and the viscosupplementation effect of hyaluronic acid, a formulation of plasma with relatively low concentration of platelets and very few leukocytes combined with hyaluronic acid (PRP+HA) has been proposed. The purpose of this study is to retrospectively compare the effectiveness of plasma with high concentration of platelets and leukocytes (L-PRP) with PRP+HA in patients with mild to moderate (Kellegren-Lawrence scale II-III grade) KO.Materials and Methods: Among the 51 patients included, 28 have been treated with L-PRP, while 23 with PRP+HA. A retrospective evaluation at baseline (T0), after 3 months (T1) and 1 year (T2) has been performed. The outcome analyzed are the Knee Society Score(KSS), the Visuo Analogic Scale (VAS) (at T0,T1 and T2) and the Knee injury and Osteoarthritis Outcome Score(KOOS) (T0 and T2).We evaluated change in mean scores within group among different time points using repeated measures ANOVA or paired t-test. Comparison between different groups of treatment has been performed using mixed ANOVA.Results: The main finding is that, although the two treatments have been both effective, PRP+HA determined significantly better functional status, pain and mobility, measured with KSS.Discussion: We observed a significant effect of the two formulations in exam in all the outcomes in analysis: both treatments were effective in improving pain, knee functional status and symptoms, and the benefits persisted after 3 and 12 months from the infiltrative therapy. Nevertheless, patients who received PRP+HA injections presented higher knee mobility and better function (measured by KSS score) after one year.Conclusions: This work compares clinical outcomes of L-PRP and PRP+HA treatment in patients with KO. Our results encourage the use of one of the two treatments in patients with mild to moderate KO. When possible, we suggest to the use of PRP+HA formulation, because it may determine better results in improving knee function and mobility.

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

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

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

scholarly journals Changes in Knee Joint Space Width in Treatment with a New Hyaluronic-Based Hydrogel

2017 ◽  
Vol 63 (3) ◽  
pp. 125-128
Author(s):  
Octav Marius Russu ◽  
Andrei Marian Feier ◽  
Tudor Sorin Pop ◽  
Marcela Todoran ◽  
István Gergely
Keyword(s):  
Hyaluronic Acid ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Narrowing ◽  
Joint Space Width ◽  
Joint Space ◽  
One Year ◽  
A Minor ◽  
Space Width

AbstractObjective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis.Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart.Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237).Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

The Role of Intra-articular Hyaluronic Acid in Symptomatic Osteoarthritis of the Knee

PM&R ◽  
2015 ◽  
Vol 7 (9) ◽  
pp. 995-1001 ◽  
Author(s):  
Thiru M. Annaswamy ◽  
Erika V. Gosai ◽  
David S. Jevsevar ◽  
Jaspal Ricky Singh
Keyword(s):  
Hyaluronic Acid ◽  
Osteoarthritis Of The Knee

scholarly journals Efficacy and safety of platelet rich plasma in primary osteoarthritis of the knee joint

2020 ◽  
Vol 6 (3) ◽  
pp. 720-723
Author(s):  
Dr. Atul Rai Sharma ◽  
Harkirat Thind ◽  
Ravish Grag ◽  
Gurmeen Garg
Keyword(s):  
Knee Joint ◽  
Platelet Rich Plasma ◽  
Osteoarthritis Of The Knee ◽  
Efficacy And Safety ◽  
Primary Osteoarthritis

scholarly journals Biomechnical Aspects of the Occurrence and Development of Osteoarthrosis of the Knee Joint

2020 ◽  
Vol 1 (51) ◽  
pp. 20-23
Author(s):  
Arman Abdurazakov ◽  
◽  
Vladimir Nechaev ◽  
Keyword(s):  
Knee Joint ◽  
Clinical Studies ◽  
Osteoarthritis Of The Knee ◽  
Published Data ◽  
Foot Orthoses ◽  
Medial Part

This article is devoted to the study of the biomechanics of the occurrence and development of osteoarthrosis of the knee joint. Based on published data and our own clinical studies, data are presented on the role of varus torque in the development and progression of osteoatrosis of the knee joint. To reduce the load on the medial part of the knee joint, the use of foot orthoses is recommended, which relieve the medial part and reduce the progression of osteoarthritis of the knee joint

scholarly journals Role of platelet-rich plasma in early osteoarthritis of knee joint: Experience from a tertiary care center in Pakistan

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901985395 ◽  
Author(s):  
Nusrat Rasheed ◽  
Kamran Hafeez ◽  
Itat Hussain Zaidi ◽  
Raza Askari ◽  
Naseem Rasheed ◽  
...  
Keyword(s):  
Knee Joint ◽  
Platelet Rich Plasma ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Early Osteoarthritis ◽  
Osteoarthritis Of Knee ◽  
Joint Experience

Quality of prospective controlled randomized trials regarding platelet-rich plasma injection for osteoarthritis of the knee

2021 ◽  
Author(s):  
Andrew G. Chan ◽  
Jeffrey D. Hoffmann ◽  
John J. Pisquiy ◽  
Philip J. Belmont ◽  
John C. Dunn
Keyword(s):  
Randomized Trials ◽  
Platelet Rich Plasma ◽  
Osteoarthritis Of The Knee ◽  
Plasma Injection

The Role of Drug-coated Balloons in Infrapopliteal Intervention

2012 ◽  
Vol 9 (2) ◽  
pp. 112-114
Author(s):  
Gary M Ansel ◽  
Peter A Schneider
Keyword(s):  
Endovascular Therapy ◽  
Metal Stents ◽  
Below The Knee ◽  
Straight Line ◽  
Improved Outcomes ◽  
Line Flow ◽  
Drug Eluting ◽  
One Year

The goal of infrapopliteal endovascular therapy is the re-establishment of straight-line flow to the foot with adequate perfusion of tissue. This treatment should be the first method in properly selected patients to relieve ischemic rest pain, heal ulcers and prevent limb loss, improving quality of life. Percutaneous angioplasty (PTA) continues to be the cornerstone of infrapopliteal therapy. Metal stents are reserved for suboptimal PTA. Although data are accumulating that may eventually guide the use of alternative devices such as lasers, excisional, and rotational atherectomy, drug-eluting stents or drug-coated balloons, we currently lack adequate evidence demonstrating improved outcomes. Endovascular therapy has expanded to include patients with severe co-morbidities such as renal failure and complex occlusive disease. Despite advances in below-the-knee (BTK) angioplasty balloons and a focus on angioplasty technique, current PTA results demonstrate one-year restenosis rates up to 80 %, depending on lesion complexity. Drug-coated balloons have demonstrated superior patency in the superficial femoral artery and it is yet to be determined if this technology can achieve improved patency and the clinical outcomes in the infrapopliteal region.

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