AB0877 Effectiveness of Intra-Articular Injection of Platelet-Rich Plasma on Clinical Improvement of Patients with Knee Osteoarthritis

Abstract

BackgroundPlatelet-rich plasma (PRP), an autologous source of growth factors, can stimulate stem cells and chondrocytes within synovial joints to enhance cartilage regeneration of patients with osteoarthritis (OA).1ObjectivesTo evaluate the effectiveness of intra-articular injection of PRP on clinical improvement of patients with knee OA.MethodsDuring March to December 2013 patients who visited the Rheumatolgy Clinic in Imam Reza Hospital, Mashhad, Iran, with diagnosis of knee OA were interviewed and examined. Patients aged between 45 and 75 years with grade 2 and 3 knee OA according to Kellgren and Lawrence grading scale and without any history of intra-articular injection of hyaluronic acid in the last 6 months before the visit to the clinic were included. Patients with secondary OA, major psychologic disorders, connective tissue disorder, any chronic debilitating disease requiring constant treatment (e.g. malignancies) being under constant treatment with antithrombotic medications and history of allergy to biologic products were excluded. All patients received single injection of 2 mL autologous PRP after signing informed consent. The patients were evaluated prior to injection (baseline) as well as in 3 follow-up visits (1, 3 and 6 months post-injection) according to the following parameters: Persian version of Knee injury and Osteoarthritis Outcome Score (KOOS),2 numerical rating scale (NRS) for subjective measurement of pain, walking time to produce pain and number of stairs to climb to produce pain. Mean differences of parameters among the 4 visits were analyzed using repeated measures ANOVA.ResultsFourteen patients (92.9% women) with mean age of 51.6±7.9 years were studied. By the effect of the treatment, from baseline visit (pre-injection) to 4th visit (6th month post-injection), mean scores of the KOOS subscales significantly improved for pain (42.2±19.9 to 54.2±19.2, p=0.004), activity of daily living (ADL) (43.1±19.3 to 55.6±19.9, p=0.001) and quality of life (QOL) (21.1±18.5 to 32.1±20.7, p=0.04). However, subscales of symptoms as well as sports and recreational activities had no significant change over the 4 visits (Figure 1). Besides, from baseline visit to 4th visit, pain on NRS decreased significantly from 6.1±2.9 to 3.8±1.7 (p=0.02), number of stairs to climb to produce pain significantly increased from 5.1±3.7 to 12.0±6.8 (p=0.04), and the walking time (minute) to induce pain increased from 20.7±15.6 to 38.8±21.0 (p=0.03). No notable adverse events occurred during the 6-month observation.ConclusionsThe intra-articular injection of PRP was clinically effective in knee OA in terms of improvement of pain, ADL, QOL and physical function during 6 months of follow-up. However, long-term follow-up is needed to determine if the clinical response is durable.ReferencesKon E, Buda R, Filardo G, et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc. 2010;18:472-9.Salavati M, Mazaheri M, Negahban H, et al....

Safety and Effectiveness of a Novel Liposomal Intra-Articular Lubricant in Symptomatic Knee Osteoarthritis: A First in Human Study

“…The current study effectiveness results are comparable with the recently published results by several RCTs reporting clinical results in patients with knee OA treated with IA injections. A recent study by Jalal Jivan S et al compared the effectiveness of IA injection of platelet-rich plasma (PRP) with HA (as one of the standard treatments) on mild to moderate knee OA (13). They found that in the majority of visits (especially 6 and 12 month), the extent of improvement in scores of KOOS subscales was signi cantly higher in the PRP recipients, compared to that in the HA recipients.…”

Allogenic Platelet-Rich Plasma for Treating Cartilage Injury: A Systematic Review of the Evidence on the Basic Sciences for Potential Future Applications

“…Autologous PRP has always been the choice of treatment as it is inherently biocompatible, safe and free from the risk of acquiring microbial and viral transmissible infections [Lacci and Dardik, 2010;Li and Li, 2013]. Several published phase I/II clinical trials have firmly demonstrated the superiority of autologous PRP in comparison to using hyaluronic acid [Cole et al, 2017;Jubert et al, 2017;Raeissadat et al, 2017;Glynn et al, 2018;Taniguchi et al, 2018;Di Martino et al, 2019;Jalali et al, 2021;Nie et al, 2021]. A single injection of autologous PRP into class I obese older patients (with the mean age of 67 years) was reported to be useful in relieving pain in the late-stage knee OA.…”