Effect of Platelet Rich Plasma Injection Effect on Knee Osteoarthritis in Elderly: Single Dose versus Double Dose Randomized Clinical Trial

Abstract

Objective: This study aims to evaluate the effect of platelet rich plasma (PRP) and compare between single and double dose regimens among patients diagnosed with osteoarthritis admitted to the orthopedic department of Al Qassimi Hospital Sharjah, United Arab Emirates.
 Methods: 200 patients were allocated into two groups in this randomized clinical trial. Patients were chosen to participate in this study after an informed consent. The trial took place at the Al Qassimi Hospital Sharjah, United Arab Emirates from July 2019 to July 2020. All patients had knee osteoarthritis, half of them received single dose PRP (group A) and the other half received double dose PRP (group B). All patients were adults and older than 18 years of age. Patients were followed up using Western Ontario and McMaster Universities Arthritis Index (WOMAC). The follow up was done prior to the administration of PRP, at 1 month, 3 month and 6 months after administration. Data was analyzed using SPSS program. Ethical approval was gained from the hospital as well as from patients.
 Results: The mean age of the patients was 48.5 ± 8.3 years. The study included 200 participants, among them, 60 were females and 140 were males. There was improvements in all parameters of WOMAC at 3 and 4 weeks following administration of PRP. The effect of PRP continued until 6 months of follow up with no differences between the two groups. Group A baseline WOMAC parameters (pain, stiffness, physical function and total score) mean score were 15.8, 6.24, 43.01 and 65.22 respectively. At the follow up, the mean scores were 4.73, 1.78, 13.88 and 19.56 respectively. This shows significant improvement. On the other hand, group B baseline mean scores were 16.31, 6.81, 40.89 and 64.77 respectively. At the final follow up of group B, the parameters mean scores were 4.40, 1.11, 13.64 and 20.27 respectively. Both groups were compared to each other and no benefit for the double dose over the single dose (P value, 0.66).
 Conclusion: Previous results suggests improvement in functionality in both groups of the trial. There was pain and stiffness relief among all patients. It is concluded that double dose has no additional effect to the single dose regimen.

The use of intra‐articular platelet rich plasma for the symptomatic management of osteoarthritis of the knee: a pilot study

“…found no difference in WOMAC scores between patients who received one versus three PRP injections, over a six month period. This is similarly reflected by a 2021 study that observed no additional benefit of a second injection administered two weeks after a first injection 24 . Therefore, there is no concrete number, or spacing, of PRP injections recommended in the symptomatic management of knee osteoarthritis.…”

“…This is similarly reflected by a 2021 study that observed no additional benefit of a second injection administered two weeks after a first injection. 24 Therefore, there is no concrete number, or spacing, of PRP injections recommended in the symptomatic management of knee osteoarthritis. Currently, in Australia, PRP injections are not covered by Medicare, resulting in high out of pocket costs for patients.…”