Efficacy of Platelets Rich Plasma in the Management of Osteoarthritis Knee Joint Data from a Tertiary Care Hospital
DOI:
https://doi.org/10.35845/abms.2024.2.340Keywords:
Platelets rich plasma, osteoarthritis knees, visual analogue scale , WOMACAbstract
Objective: To evaluate the efficacy of intra-articular injection of platelet-rich plasma in the management of grade 1 & 2 osteoarthritis of knee joints
Methodology: This retrospective study was conducted at Khyber Teaching Hospital Peshawar, Pakistan, using clinical records of patients aged 40 to 70 years diagnosed with grade 1 and 2 knee osteoarthritis. These patients were treated with autologous intra-articular PRP injections between March 2022 and March 2024. The study included 206 patients with only type 1 and 2 osteoarthritis knee joints. No analgesic medications were used after the first month post-injection. VAS and WOMAC scores, before PRP treatment and at 3 months post-treatment were compared. Paired t-test and P value were calculated using Microsoft Excel software version 2007.
Results: The study included 206 patients with grade 1 and 2 knee osteoarthritis treated with intra-articular PRP injections. Female patients were 54.36% and male patients were 45.64%. The mean age of the patients was 58.69±9 years. Most of the knees (65%) had grade II osteoarthritic while 35% of knees had grade I osteoarthritic changes. The pre-PRP injection scores were as follows: VAS score 6.75±0.9, WOMAC pain score 15.97±0.9, WOMAC stiffness score 5.29±1.1 and WOMAC Function score 58.9±6.6. The post-PRP injection scores in 3rd month were: VAS score 2.77±1.19, WOMAC pain score 8.80±1.87, WOMAC stiffness score 2.47±1.17 while WOMAC function score 22.93±5.38. No complications were observed.
Conclusion: Three intra-articular PRP injections administered at one-month intervals in patients with grade 1 and 2 osteoarthritis of the knee joint resulted in a significant decrease in knee joint pain and improvement in knee joint functions, as assessed by WOMAC criteria. A limitation of our study is the lack of long-term follow-up, which prevents the evaluation of the sustained efficacy of PRP in osteoarthritis of the knee.
References
Charlier E, Deroyer C, Ciregia F, Malaise O, Neuville S, Plener Z, Malaise M, de Seny D. Chondrocyte dedifferentiation and osteoarthritis (OA). Biochem Pharmacol. 2019;165:49-65.
Messina OD, Vidal Wilman M, Vidal Neira LF. Nutrition, osteoarthritis and cartilage metabolism. Aging clinical and experimental research. 2019;31:807-13.
Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16(4):494-502.
Barbour KE. Prevalence of doctor-diagnosed arthritis at state and county levels—United States, 2014. MMWR. Morbidity and mortality weekly report. 2016;65.
Hunter DJ, March L, Chew M. Osteoarthritis in 2020 and beyond: a Lancet Commission. The Lancet. 2020;396(10264):1711-2.
Deyle GD, Allen CS, Allison SC, Gill NW, Hando BR, Petersen EJ, Dusenberry DI, Rhon DI. Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. New England Journal of Medicine. 2020;382(15):1420-9.
Paskins Z, Bromley K, Lewis M, Hughes G, Hughes E, Hennings S, Cherrington A, Hall A, Holden MA, Stevenson K, Menon A. Clinical effectiveness of one ultrasound guided intra-articular corticosteroid and local anaesthetic injection in addition to advice and education for hip osteoarthritis (HIT trial): single blind, parallel group, three arm, randomised controlled trial. bmj. 2022;377.
Verma R, Kumar S, Garg P, Verma YK. Platelet-rich plasma: a comparative and economical therapy for wound healing and tissue regeneration. Cell and Tissue Banking. 2023;24(2):285-306.
Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee osteoarthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. The American journal of sports medicine. 2016;44(4):884-91.
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. The American journal of sports medicine. 2009;37(11):2259-72.
Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports medicine. 2009;39:345-54.
Engebretsen L, Steffen K, Alsousou J, Anitua E, Bachl N, Devilee R, Everts P, Hamilton B, Huard J, Jenoure P, Kelberine F. IOC consensus paper on the use of platelet-rich plasma in sports medicine. British journal of sports medicine. 2010;44(15):1072-81.
Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP?. Implant dentistry. 2001;10(4):225-8.
Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of intra-articular platelet-rich plasma injections in knee osteoarthritis: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2016;32(3):495-505.
Dai WL, Zhou AG, Zhang H, Zhang J. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2017;33(3):659-70.
Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. British journal of sports medicine. 2015;49(10):657-72.
Yaradilmis YU, Demirkale I, Tagral AS, Okkaoglu MC, Ates A, Altay M. Comparison of two platelet rich plasma formulations with viscosupplementation in treatment of moderate grade gonarthrosis: A prospective randomized controlled study. Journal of Orthopaedics. 2020;20:240-6.
Raeissadat SA, Ghorbani E, Sanei Taheri M, Soleimani R, Rayegani SM, Babaee M, Payami S. MRI changes after platelet rich plasma injection in knee osteoarthritis (randomized clinical trial). Journal of Pain Research. 2020:65-73.
Dixon JS, Bird HA. Reproducibility along a 10 cm vertical visual analogue scale. Annals of the rheumatic diseases. 1981;40(1):87-9.
McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2001;45(5):453-61.
Johnson D, Dhiman N, Badhal S, Wadhwa R. Effects of Intra-articular Platelet Rich Plasma on Cartilage Thickness, Clinical and Functional Outcomes in Knee Osteoarthritis. Cureus. 2023;14(12).
Chaudhry AA, Masood S, Butt SZ, Hameed SK, Ahmed U, Dar MM, Rafiq A, Dar UZ. Efficacy of Intra-articular injections of Platelet Rich Plasma (PRP) in Osteoarthritis Knee. Journal of Pakistan Orthopaedic Association. 2021;33(04):162-6.
Rai D, Singh J, Somashekharappa T, Singh A. Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up. SICOT-J. 2021;7.
Kavadar G, Demircioglu DT, Celik MY, Emre TY. Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. Journal of Physical Therapy Science. 2015;27(12):3863-7.
Guillibert C, Charpin C, Raffray M, Benmenni A, Dehaut FX, El Ghobeira G, Giorgi R, Magalon J, Arniaud D. Single injection of high volume of autologous pure PRP provides a significant improvement in knee osteoarthritis: a prospective routine care study. International journal of molecular sciences. 2019;20(6):1327.
Cole BJ, Karas V, Hussey K, Merkow DB, Pilz K, Fortier LA. Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. The American journal of sports medicine. 2017;45(2):339-46.
Migliorini F, Driessen A, Quack V, Sippel N, Cooper B, Mansy YE, Tingart M, Eschweiler J. Comparison between intra-articular infiltrations of placebo, steroids, hyaluronic and PRP for knee osteoarthritis: a Bayesian network meta-analysis. Archives of Orthopaedic and Trauma Surgery. 2021;141:1473-90.
Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. Journal of orthopaedic surgery and research. 2017;12:1-2.
Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clinical Journal of Sport Medicine. 2013;23(3):238-9.
Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: A prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-64.
Bottegoni C, Gigante A. Homologous Platelet-rich Plasma for the Treatment of Knee Osteoarthritis in Selected Elderly atients. In Orthopaedic Proceedings 2017 Jan 1 (Vol. 99, No. SUPP_2, pp. 101-101). Bone & Joint.
Rodríguez-Merchán EC. Intra-Articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Degree of Efficacy. Int J Mol Sci. 2022;23(3):1301.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Farmanullah Khan, Saeed Ahmad, Muhammad Tahir, Awal Hakeem
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Readers may “Share-copy and redistribute the material in any medium or format” and “Adapt-remix, transform, and build upon the material”. The readers must give appropriate credit to the source of the material and indicate if changes were made to the material. Readers may not use the material for commercial purpose. The readers may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
. 
