A Comparison between Platelet-Rich Plasma (PRP) and Hyaluronate Acid on the Healing of Cartilage Defects

Abstract

Platelet-rich plasma (PRP) has offered great promise for the treatment of cartilage degradation, and has been proved to have positive effects on the restoration of cartilage lesions. But no comparative work has been done between PRP and hyaluronate acid (HA) concerning their restoring effect on cartilage defect, especially by means of animal experiments and histologic assessments. The purpose of the study was to compare the therapeutic effects of P-PRP and HA on osteoarthritis in rabbit knees. Thirty rabbits were used to establish the animal models by creating a cartilage defect of 5 mm in diameter on the condyles of the femurs, and were randomly divided into three groups: the P-PRP group, HA group and the control group. Then each group was treated with P-PRP, HA or saline solution, respectively. Six and twelve weeks later the rabbits were sacrificed and the samples were collected. The platelet number, the concentrations of growth factors of P-PRP and whole blood, and the IL-1β concentration in the joint fluid were investigated, and the histological assessment of the cartilage were performed according to Mankin's scoring system. Micro-CT was also used to evaluate the restoration of subchondral bone. The platelet concentration in P-PRP is 6.8 fold of that in the whole blood. The IL-1β level in the P-PRP group was lower than in the HA group (p<0.01) and in the control group (p<0.01). The restoration of the defected cartilage as well as the subchondral bone was better in the P-PRP group than in the HA group or the control group (P<0.05). Our data showed that P-PRP is better than HA in promoting the restoration of the cartilage and alleviating the arthritis caused by cartilage damage.

The effect of intra-articular allogenic platelet rich plasma in Dunkin-Hartley guinea pig model of knee osteoarthritis

“…The clinical relevance of the synovial fluid COMP levels lies in the fact that higher concentration of synovial and serum COMP has been positively co-related with symptomatic OA 1,2,10,16 . Thus, indirectly, when we evaluate our equivocal histopathological results along with significant COMP level changes in PRP treated knees, our results could corroborate those of Kazemi et al 12 and Liu et al 19 indicating a beneficial effect of PRP on articular cartilage.…”

“…Saito et al 28 co-cultured adult rabbit chondrocytes in 3% PRP and showed increased in vitro chondrocyte GAG production. Liu et al 19 demonstrated improved cartilage and subchondral bone restoration via micro CT in a rabbit model after creating 5 mm defects in femoral condyles and treatment with 3 weekly PRP injections as compared to controls and hyaluronic acid treated groups. Kazemi et al 12 showed healing of surgically made chondral defects in PRP treated knees in a canine model.…”

“…In vivo studies demonstrating disease modifying effect of PRP are scarce. Kazemi et al 12 and Liu et al 19 have shown chondroprotective and anti-inflammatory effects of PRP on articular cartilage and synovium in in vivo canine and rabbit models of surgically induced OA. However, no studies have been done on a spontaneously occurring OA model such as the Dunkin Hartley guinea pigs wherein the progression and histological characteristics are comparable to human OA.…”

Platelet-Rich Plasma Inhibits Mechanically Induced Injury in Chondrocytes

“…However, few reports are available concerning the effect of PRP on acute cartilage injury. 13,14 Because the superficial layer of articular cartilage is typically subjected to high levels of cyclic shear and tensile stress during joint motion and because overloading observed in continual strenuous exercises results in a physiological imbalance, 15 an ideal in vitro model should involve a continuous mechanical load exerting injurious effects. A number of studies have investigated the effect of cyclic tensile strain (CTS) on chondrocytes.…”

Updated Animal Models in Orthopaedic Research

“…At week 12, the IL-1β level in the P-PRP group was lower than in the HA group (p < 0.01) and in the control group (p < 0.01). The restoration of the defected cartilage as well as the subchondral bone was better in the P-PRP group than in the HA group or the control group (P < 0.05) [ 34 ].…”