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

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.

scholarly journals Single Platelet-Rich Plasma Injection for Early Stage of Osteoarthritis of the Knee

Joints ◽  
2017 ◽  
Vol 05 (01) ◽  
pp. 002-006 ◽  
Author(s):  
Liborio Martini ◽  
Alessio Via ◽  
Chiara Fossati ◽  
Filippo Randelli ◽  
Pietro Randelli ◽  
...  
Keyword(s):  
Early Stage ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Womac Score ◽  
Rank Test ◽  
Osteoarthritis Of The Knee ◽  
Low Grade ◽  
Level Of Evidence ◽  
Knee Oa

Purpose The purpose of this study was to determine the safety efficacy and outcomes of platelet-rich plasma (PRP) intra-articular injections for early stages of knee osteoarthritis (OA). Methods Twenty-five patients affected by grade I and II knee primary OA according to the Kellgren–Lawrence scale received a single intra-articular PRP injection. Patients were prospectively evaluated for 6 months. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee injury and Osteoarthritis Outcome Score (KOOS) scoring scales were used to evaluate clinical outcomes. Wilcoxon signed rank test was used to evaluate significance of improvement of WOMAC, KOOS, and VAS scores. Results Twenty-one patients completed 6-months follow-up. The median WOMAC score improved from 29.1 points (range: 17.4–60.4; standard deviation [SD] = 13.0) at baseline to 42.41 (range: 24.3–71.2; SD = 12.5) at final follow-up. Improvements in median KOOS and VAS score have been also found, from 37.49 points and 64.2 mm before injection to 59.71 points and 42.8 mm, respectively. All these improvements were statistically significant (p < 0.05). No adverse reactions have been observed. Conclusion Treating knee OA with PRP injection is safe. A single dose of PRP seems to be effective in managing pain and improving quality of life in patients with low-grade knee OA. Level of Evidence Level IV, therapeutic case series.

scholarly journals T2 mapping evaluation of changes in cartilage matrix after PRP and HA injection therapy in knee osteoarthritis: a prospective, randomized, double blind, placebo controlled study

2020 ◽  
Author(s):  
Matjaz Vogrin ◽  
Jakob Naranda ◽  
Mario Gorenjak ◽  
Tomaz Bajec ◽  
Domen Mongus ◽  
...  
Keyword(s):  
Placebo Group ◽  
Knee Osteoarthritis ◽  
Pain Score ◽  
T2 Mapping ◽  
Womac Score ◽  
Controlled Study ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Knee Oa

Abstract BackgroundIn this study we focused on evaluating the effect of intra-articular platelet-rich plasma (PRP) and hyaluronic acid (HA) on the qualitative and quantitative properties of the articular cartilage in patients with knee osteoarthritis (OA).MethodsWe evaluated 264 patients undergoing treatment of moderate knee OA. Patients aged between 40 and 70 years were included with articular K-L stage ≤ 2. Patients were randomized into three groups and treated with three doses of intra-articular PRP, HA, or placebo injection. Patients were evaluated clinically and by using T2 mapping.ResultsBoth PRP (619.05 ± 243 ms; p = 2.7 × 10− 5) and HA (637.12 ± 273 ms; p = 1.×10− 4) group showed statistically significant lower post-application T2 relaxation times in comparison to the placebo group (859.80 ± 406 ms).Cartilage thickness increased significantly after PRP (2.41±0.87 vs. 2.58±0.97 mm, p=0.033) and HA (2.28±0.81 vs. 2.80±1.00 mm, p=1.8×10) applications. There was a significant decrease in WOMAC pain score by 30% (p=0,001) and the overall WOMAC score by 27 p=1.9×10-4%) in PRP group. The decrease in WOMAC pain score and the overall WOMAC score in the placebo group was similar to the results observed in the PRP group. In the HA group a significant decrease in WOMAC pain score by 14% (p=0,005) was observed only at the first follow-up, whereas no difference was observed at the second follow-up. ConclusionsT2 mapping of cartilage tissue may aid to monitor its properties after the intra-articular therapies in knee OA. However, there is a discrepancy between clinical findings and the results of T2 mapping, suggesting questionable grounds for applying intra-articular therapy.

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 Platelet-rich plasma injection is more effective than hyaluronic acid in the treatment of knee osteoarthritis

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0024
Author(s):  
Esteban Holguin
Keyword(s):  
Hyaluronic Acid ◽  
Platelet Rich Plasma ◽  
Low Cost ◽  
Study Groups ◽  
Womac Score ◽  
Pain Scale ◽  
Control Group ◽  
Osteoarthritis Of The Knee ◽  
Clear Result

Objectives: To determine and compare the effects of autologous platelet rich plasma (PRP) and hyaluronic acid (HA) for the treatment of osteoarthritis of the knee. Methods: This prospective study included 150 patients affected by severe osteoarthritis of the knee. Gonarthrosis was graded using the Kellgren-Lawrence and Albhack radiographic classification scale. 150 patients were randomized into 2 study groups .In the PRP group (n=55) three intraarticular injection were applied andthe control group (n=55) received 3 intra-articular injections of high molecular weight HA. An unblinded physician performed infiltration once a week for 3 weeks into the knee affected by clinically relevant gonarthrosis (in both groups). All patients were evaluated with the Western Ontario and McMaster (WOMAC) score and visual pain scale before the infiltration and at 3, 6, and 12 months after the first injection. Results: No severe adverse events was observed. Statistically significant better results in the WOMAC score and visual pain scale was determined in PRP group than HA group at 3 months and 6 months follow up. The cost of the application for the PRP group was lower than that of the HA group.At 12 months' of follow-up, PRP and HA treatments offered similar results. Conclusion: The results of this study have shown the application of autologousPRP to be a safe, effective and low-cost method for treating OA tan HA. However, further studies are required for a more clear result

scholarly journals Comparing efficacy of intraarticular single crosslinked Hyaluronan (HYAJOINT Plus) and platelet-rich plasma (PRP) versus PRP alone for treating knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shu-Fen Sun ◽  
Guan-Chyun Lin ◽  
Chien-Wei Hsu ◽  
Huey-Shyan Lin ◽  
I.-H.siu Liou ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Pain Reduction ◽  
Womac Pain ◽  
Knee Oa ◽  
Lequesne Index ◽  
Injection Group ◽  
The One

AbstractIntraarticular hyaluronan or platelet-rich plasma (PRP) is widely used in the treatment of knee osteoarthritis (OA). The efficacy of combined hyaluronan with PRP remained inconclusive. This study aimed to investigate the efficacy of combined a single crosslinked hyaluronan (HYAJOINT Plus) and a single PRP versus a single PRP in patients with knee OA. In a prospective randomized-controlled trial, 85 patients with knee OA (Kellgren-Lawrence 2) were randomized to receive a single intraarticular injection of HYAJOINT Plus (3 ml, 20 mg/ml) followed by 3 ml PRP (the combined-injection group, N = 43) or a single injection of 3 ml PRP (the one-injection group, N = 42). The primary outcome was the change from baseline in the visual analog scale (VAS) pain (0–00 mm) at 6 months. Secondary outcomes included The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Likert Scale), Lequesne index, single leg stance test (SLS), use of rescue analgesics and patient satisfaction at 1, 3 and 6 months. Seventy-eight patients were available for the intention-to-treat analysis at 6 months. Both groups improved significantly in VAS pain, WOMAC, Lequesne index and SLS at each follow-up visit (p < 0.001). Patients receiving a single PRP experienced significantly greater improvements in VAS pain than patients receiving combined injections at 1-month follow-up (adjusted mean difference: − 5.6; p = 0.017). There were no significant between-group differences in several of the second outcomes at each follow-up visit, except the WOMAC-pain and WOMAC-stiffness scores favoring the one-injection group at 1 month (p = 0.025 and p = 0.011). However, at 6-month follow-up, the combined-injection group achieved significantly better VAS pain reduction (p = 0.020). No serious adverse events occurred following injections. In conclusion, either combined injections of HYAJOINT Plus and PRP or a single PRP alone was safe and effective for 6 months in patients with Kellgren-Lawrence 2 knee OA. Combined injections of HYAJOINT Plus and PRP achieved better VAS pain reduction than a single PRP at 6 months. The results indicating a long term benefit effect of a combination of HYAJOINT Plus and PRP in a particular subset of patients with moderate knee OA need to be replicated in larger trials.ClinicalTrials.gov number NCT04315103.

scholarly journals Combination of platelet-rich plasma and hyaluronic acid in the treatment of moderate and severe osteoarthritis of the knee joint

2020 ◽  
Vol 28 (4) ◽  
pp. 31-35
Author(s):  
Muthanna Abdul Razaq ◽  
Anmar Ahmed Qasim ◽  
Thamer Mohammed Assim ◽  
Ramzi Ramzi
Keyword(s):  
Hyaluronic Acid ◽  
Physical Function ◽  
Effect Size ◽  
Platelet Rich Plasma ◽  
Womac Score ◽  
Osteoarthritis Of The Knee ◽  
Knee Oa ◽  
Womac Index ◽  
Symptomatic Knee ◽  
Mean Differences

The study aimed to determine the effectiveness of monthly intra-articular injection of combination of PRP and hyaluronic acid in improvement of outcome of knee OA. It was conducted as open clinical trial on a convenient sample of 17 patients with unilateral or bilateral symptomatic knee OA in rheumatology and orthopedic clinics at Al-Jumhoori Teaching Hospital in Mosul, Iraq during 1st of Jan to 30th Jun, 2018. The patients received intra-articular injection of combination of plate rich plasma (PRP) and hyaluronic acid (HA) monthly for three months. The outcome assessment was carried out 4 weeks after the last injection using WOMAC index. The results revealed that WOMAC index subscales was reduced significantly (p <0.001) after treatment by followings mean differences: 3.88 in pain (95% CI: 3.18-4.58); 1.29 in stiffness (95% CI: 0.85-1.73); 9.29 in physical function (95% CI: 6.70-11.88); and 14.47 in total score (95% CI: 11.20-17.73). The intervention effect size were as follows: 1.23 in pain; 1.49 in stiffness; 1.11 in physical function, and 1.20 in total WOMAC score. Overall, effect size of combination of PRP and HA intra-articular injection is classified as large effect size (> 0.8) in improving outcome of knee OA. A combination of PRP and HA has large synergistic effect size in improving outcome of moderate and severe OA of knee.

scholarly journals Effect of Dextrose Prolotherapy, Platelet Rich Plasma and Autologous Conditioned Serum on Knee Osteoarthritis: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Alireza Pishgahi ◽  
Rozita Abolhasan ◽  
Seyed Kazem Shakouri ◽  
Mohammad Sadegh Soltani-Zangbar ◽  
Shahla Dareshiri ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trial ◽  
Platelet Rich Plasma ◽  
Womac Score ◽  
Knee Function ◽  
Post Intervention ◽  
Knee Oa ◽  
Autologous Conditioned Serum ◽  
And Function

Knee osteoarthritis (OA) is one of the common degenerative articular disorders that are related to decreased quality of life. Currently, novel biologic therapeutic approaches are introduced in the literature for OA management. In this study, the clinical efficiency of Dextrose prolotherapy, platelet-rich plasma (PRP) and autologous conditioned serum (ACS) injection on the level of pain and function in Knee OA were compared. A randomized clinical trial was directed on 92 knee OA patients. Patients were randomly divided into three groups: 30 were received dextrose prolotherapy once in a week for three weeks, 30 received autologous PRP for two times with seven days interval, and in the remaining 32 patients 2ml of ACS were injected two times every seven days. Study participants were measured through the Western Ontario and McMaster Universities (WOMAC) score, the visual analogue scale (VAS), at baseline, 1 and 6 months post-intervention. Both ACS and PRP treated patients showed improvement in pain intensity and knee function during 1 and 6 months pursue; however, this progress was more significant in the ACS group. Dextrose prolotherapy showed no substantial changes in pain and function of the affected knee in treated patients. Treatment of Knee OA with ACS and PRP injections are associated with pain reduction and knee function improvement. Not only, ACS therapy is more effective than that of PRP, but also due to its less variability in processing and less reported side effects, it could be considered as a safe and effective non-surgical alternative for OA management.  

Does Intra-Articular Injection of Platelet-Rich Plasma Have an Effect on Cartilage Thickness in Patients with Primary Knee Osteoarthritis?

2021 ◽  
Vol 17 ◽  
Author(s):  
Noha M Abdel Baki ◽  
Zeinab O. Nawito ◽  
Nehal M. S. Abdelsalam ◽  
Dina Sabry ◽  
Hossam Elashmawy ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Womac Score ◽  
Cartilage Thickness ◽  
Condylar Cartilage ◽  
Knee Oa ◽  
Group I ◽  
Grading Scale ◽  
Inflammatory Drugs ◽  
Group Ii

Objectives: To determine the effect of intra-articular injection of platelet-rich plasma (PRP) in patients with primary knee osteoarthritis (OA) by clinical evaluation and ultrasonographic (US) assessment of cartilage thickness. Patients and Methods: A total of 100 patients with mild to severe primary knee OA using the Kellgren-Lawrence (K-L) grading scale were included and divided into two groups. Group I included 50 patients who were given two intra-articular knee injections of PRP, 1 week apart; Group II included 50 patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and chondroprotective drugs. Functional assessment of all OA patients done using the basal WOMAC score, at 2 and 6 months.US assessment of femoral condylar cartilage thickness was conducted basally and at 6 months. Results: Improvement of WOMAC score was observed at 2 and 6 months in Group I following PRP injection compared to Group II (p values < 0.001), The improvement of WOMAC in Group I occurred in all severity degrees of OA (p < 0.001). Moreover, a significant increase in cartilage thickness at the intercondylar area (ICA) at 6 months relative to baseline assessment by US in Group I (p = 0.041) was found. Conclusion: Treatment with PRP injections can reduce pain and improve knee function in patients with various degrees of articular degeneration. Further studies are needed to clarify the anabolic effect of PRP on the articular cartilage.

scholarly journals Personal Perspectives on Enablers and Barriers to Accessing Care for Hip and Knee Osteoarthritis

2016 ◽  
Vol 96 (1) ◽  
pp. 26-36 ◽  
Author(s):  
Ilana N. Ackerman ◽  
Jenni A. Livingston ◽  
Richard H. Osborne
Keyword(s):  
Health Insurance ◽  
Knee Osteoarthritis ◽  
Joint Replacement ◽  
Private Health Insurance ◽  
Waiting Times ◽  
Perceived Barriers ◽  
Specialist Care ◽  
Joint Replacement Surgery ◽  
Knee Oa ◽  
Barriers And Enablers

Background Despite increasing demand for joint replacement surgery and other health services for hip and knee osteoarthritis (OA), barriers and enablers to individual access to care are not well understood. A comprehensive understanding of drivers at all levels is needed to inform efforts for improving access. Objective The aim of this study was to explore perceived barriers and enablers to receiving conservative (nonsurgical) and surgical treatment for hip and knee OA. Design This was a qualitative study using directed content analysis. Methods Semistructured telephone interviews were conducted, with 33 participants randomly sampled from an Australian population-based survey of hip and knee OA. Each interview covered factors contributing to receiving treatment for OA and perceived barriers to accessing care. Interview transcripts were coded and organized into themes. Results Key barriers to accessing care for OA included medical opinions about saving surgery for later and the appropriate age for joint replacement. Other common barriers included difficulty obtaining referrals or appointments, long waiting times, work-related issues, and limited availability of primary and specialist care in some areas. Several participants perceived a lack of effective treatment for OA. Private health insurance was the most frequently cited enabler and was perceived to support the costs of surgical and conservative treatments, including physical therapy, while facilitating faster access to surgery. Close proximity to services and assistance from medical professionals in arranging care also were considered enablers. Conclusions People with hip or knee OA experience substantial challenges in accessing treatment, and these challenges relate predominantly to health professionals, health systems, and financial factors. Private health insurance was the strongest perceived enabler to accessing care for OA.

scholarly journals Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michael McLarnon ◽  
Neil Heron
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Risk Of Bias ◽  
Post Intervention ◽  
Promising Alternative ◽  
Knee Oa ◽  
Sporting Activity ◽  
Symptomatic Management ◽  
Corticosteroid Injections

Abstract Background Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee osteoarthritis (OA), particularly in the UK. IA platelet-rich plasma (PRP) injections are a promising alternative, but no systematic reviews to date have compared them to the current standard of care, IA CS injections. We aim to investigate the effect of IA PRP injections versus IA corticosteroid injections for the symptomatic management of knee OA. Methods All published trials comparing IA PRP and CS injections for knee OA were included. MEDLINE, EMBASE, Scopus and Web of Science were searched through June 2020. Risk of bias was assessed using the Cochrane Risk of Bias tool. A random effects model was used to calculate standardized mean difference with 95% confidence interval in WOMAC/VAS score (or subscores), comparing IA PRP to CS injections across studies. Results Included were eight studies and 648 patients, 443 (68%) were female, mean age 59 years, with a mean BMI of 28.4. Overall, the studies were considered at low risk of bias. Compared with CS injections, PRP was significantly better in reducing OA symptoms (pain, stiffness, functionality) at 3, 6 and 9 months post-intervention (P < 0.01). The greatest effect was observed at 6 and 9 months (− 0.78 (− 1.34 to − 0.23) standard mean deviations (SMD) and − 1.63 (− 2.14 to − 1.12) SMD respectively). At 6 months, this equates to an additional reduction of 9.51 in WOMAC or 0.97 on the VAS pain scales. At 6 months PRP allowed greater return to sporting activities than CS, measured by the KOOS subscale for sporting activity, of magnitude 9.7 (− 0.45 to 19.85) (P = 0.06). Triple injections of PRP, generally separated by a week, were superior to single injections over 12 months follow-up (P < 0.01). Conclusions IA-PRP injections produce superior outcomes when compared with CS injections for symptomatic management of knee OA, including improved pain management, less joint stiffness and better participation in exercise/sporting activity at 12 months follow-up. Giving three IA-PRP, with injections separated by a week, appears more effective than 1 IA-PRP injection. Prospero trial registration number CRD42020181928.

Sign in / Sign up

Export Citation Format

Share Document