Efficacy of Genicular Nerve Radiofrequency Ablation Versus Intra-Articular Platelet Rich Plasma in Chronic Knee Osteoarthritis: A Single-Blind Randomized Clinical Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.127-134 ◽

2021 ◽

pp. 127-134

Keyword(s):

Clinical Trial ◽

Knee Osteoarthritis ◽

Visual Analog Scale ◽

Platelet Rich Plasma ◽

Pulsed Radiofrequency ◽

Analog Scale ◽

P Values ◽

Plasma Injection ◽

Index Of Severity ◽

Single Blind

BACKGROUND: Chronic knee osteoarthritis is a common problem with increasing of the aging population. Pulsed radiofrequency and intraarticular platelet rich plasma injection are well evidenced beneficial modalities for pain alleviation in such groups of patients. OBJECTIVE: The primary goal in this study was to compare the 2 modalities regarding pain alleviation evaluated by visual analog scale. The secondary goal focused upon the change of the Index of Severity for Osteoarthritis of the Knee by Lequesne. STUDY DESIGN: Single-blind randomized interventional clinical trial. SETTING: University hospitals. METHODS: Two hundred patients with chronic knee osteoarthritis were equally and randomly distributed into 2 groups. Group PRF received pulsed radiofrequency, whereas the group PRP received intraarticular platelet-rich plasma. The visual analog scale and index of severity of osteoarthritis were evaluated before intervention, after one week (for visual analog scale only), then after 3, 6, and 12 months. RESULTS: Visual analog scale was significantly lower in the PRF group compared to the PRP group at 6 and 12 months with P-values of 0.01 and 0.04, respectively. Regarding to the postinterventional index of severity of osteoarthritis, it was significantly lower in the PRF group than the PRP group with P-values of 0.001 at 3, 6, and 12 months follow-up. LIMITATIONS: Physical and analgesic therapy were not included in data collection, and there was no control group. CONCLUSION: Pulsed radiofrequency of the genicular nerves can be considered superior to knee intraarticular platelet-rich plasma injection for sustained pain relief and the lower severity index in patients with chronic knee osteoarthritis. KEY WORDS: Pulsed radio frequency, platelet-rich plasma, chronic knee osteoarthritis, chronic pain

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Clinical comparison of platelet-rich plasma injection and daily celecoxib administration in the treatment of early knee osteoarthritis: A randomized clinical trial

Journal of Applied Biomedicine ◽

10.32725/jab.2020.012 ◽

2020 ◽

Vol 18 (2-3 double issue) ◽

pp. 41-45

Author(s):

Rubén Reyes-Sosa ◽

Agustin Lugo-Radillo ◽

Lizzet Cruz-Santiago ◽

Celia Rubí García-Cruz ◽

Oliver Mendoza-Cano

Keyword(s):

Clinical Trial ◽

Knee Osteoarthritis ◽

Randomized Clinical Trial ◽

Platelet Rich Plasma ◽

Clinical Comparison ◽

Plasma Injection

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Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association with Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis. A Randomized Double-Blind Controlled Clinical Trial as Compared with Hyaluronic Acid.

Schmerz Nachrichten ◽

10.1007/s44180-021-0003-1 ◽

2021 ◽

Vol 21 (3) ◽

pp. 5-5

Keyword(s):

Clinical Trial ◽

Hyaluronic Acid ◽

Growth Factors ◽

Knee Osteoarthritis ◽

Clinical Efficacy ◽

Platelet Rich Plasma ◽

Controlled Clinical Trial ◽

Double Blind ◽

Plasma Injection

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Randomized Clinical Trial Evaluating Transdermal Ibuprofen for Moderate to Severe Knee Osteoarthritis

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/e749 ◽

2013 ◽

Vol 6;16 (6;11) ◽

pp. E749-E762

Author(s):

Dr. Gyula Varadi

Keyword(s):

Clinical Trial ◽

Knee Osteoarthritis ◽

Visual Analog Scale ◽

Statistical Significance ◽

Academic Medical Center ◽

Osteoarthritis Of The Knee ◽

Clinical Effects ◽

Phase 2 ◽

Analog Scale ◽

Clinical Endpoints

Background: Osteoarthritis is a common condition, typically treated with orally administered analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Chronic administration of NSAIDs, serotoninnorepinephrine reuptake inhibitors (SNRIs, i.e., duloxetine), and opioid medications (i.e., tramadole) is regularly associated with multiple, serious side effects, in part due to the route of administration. Transdermal delivery of NSAIDs, such as ibuprofen, represents a potentially alternative treatment for this inflammatory pain condition with a better therapeutic profile. Objective: Investigate the safety and efficacy of a novel transdermal ibuprofen formulation (VALE®- ibuprofen) containing 10% ibuprofen, compared to a placebo in a randomized, double-blinded clinical trial, for clinical improvement in patients with moderate to severe painful osteoarthritis of the knee. Study Design: A randomized, placebo-controlled, double blind, multi-center Phase 2 clinical trial. Setting: An academic medical center, and private rheumatology and interventional pain management practices in Massachusetts and in Switzerland. Methods: The Phase 2 clinical study included patients with primary osteoarthritis in a single knee joint with a progression level of moderate to severe based in part on a grade II or III designation according to the Kellgren and Lawrence classification system. Patients received the corresponding, randomly assigned study formulation (VALE-ibuprofen or placebo) for application to the target knee at a dose of 2.0 grams of drug product (200 mg ibuprofen) twice daily for 14 days. The evaluation of the efficacy of the treatments utilized the widely accepted methods of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Visual Analog Scale (VAS) scores for the patients. Results: The results indicate that the transdermal VALE-ibuprofen formulation was very well tolerated from a safety perspective during the 2-week trial and also produced significant, positive clinical improvements superior to the placebo in all clinical endpoints tested. In particular, the WOMACTotal and WOMACPhysical Functioning, for the VALE-ibuprofen, were superior compared to the placebo (P = 0.0283 and P = 0.0201, respectively). Other clinical endpoints including the WOMACPain, WOMACStiffness, and VASResting scores were superior to those obtained from the placebo group, trending towards statistical significance compared to placebo (P = 0.0811, 0.1103, and 0.0785, respectively). Based on the Patient and Physician Global Impression of Change survey, patient satisfaction slightly improved across both groups; however, no statistical significance was detectable as compared to the baseline. Limitations: The sample size of 64 subjects in the final data analysis and the lack of including an orally administered drug group are limitations of this study. Conclusions: The use of transdermal VALE-ibuprofen has beneficial clinical effects on the pain levels experienced in some patients with moderate to severe osteoarthritis of the knee as measured by the WOMAC Osteoarthritis Indices for stiffness, pain, physical function, and total. Visual Analog Scales (VAS) tests, VASMotion and VASWeight-bearing, again while appeared superior to placebo, were not statistically different from placebo. Clinical Trial Registration: NCT01496326 Key words: Ibuprofen, transdermal treatment, VALE-ibuprofen, knee osteoarthritis, Visual Analog Scale, WOMAC score

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