Effectiveness of Platelet Rich Plasma for the Management of Knee Osteoarthritis

Abstract

Aim: To determine impact of platelet rich plasma therapy for the management of knee osteoarthritis. Study design: Prospective double-blinded, add –on randomized, placebo-controlled trial Place and duration of study: Department of Orthopedics, Shaikh Zayed Hospital Lahore from 1st January 2019 to 30th June 2019 Methodology: Fifty volunteer participants fulfilling inclusion criteria were enrolled. One hundred knees of patients were randomly allocated into two groups. Knees were assigned either of the two groups. Platelet rich plasma group which was assigned to receive 5ml of platelet rich plasma and normal saline (NS) group which was assigned to receive 5ml of NS labeled as control group. All patients given 3 successive intra-articular injections of 5 mL of autologous platelet rich plasma or 5ml of normal saline was given at weekly intervals. Patients were blinded and subjected to a standardized injection protocol and the intensity of pain was assessed on visual analog scale (VAS) for pain. Results: The VAS scores decreased from 50.9±14.7 at baseline assessment to 43.6±16.2 at 1-month follow-up after completion of therapy for PRP group (p<0.0203). The improvement was maintained from the end of the therapy to 3 and 6 months’ follow-up, as measure of VAS score as 30.54±11.8 and 20.2±8.6 respectively (p<0.0001). In normal saline group, there was very slight decrease in VAS score from baseline i.e. 49.8±19.5 to 48±22.7, 44±16.6, and 42±21.7 at 1, 3 and 6 months interval. Conclusion: Platelet rich plasma therapy can provide effective pain control up to 6 months post injection in knee osteoarthritis. Key words: Platelet rich plasma (PRP), Knee osteoarthritis (OA), Pain score

Evaluating the Effectiveness of Intra-articular Platelet Rich Plasma Injections for the Treatment of Knee Osteoarthritis: A Systematic Review

“…Studies spanned different countries, with two articles each from India (18,26), Taiwan (27,28) and Australia (19,29). One article each was retrieved from the USA (30), Turkey (31), Pakistan (32), Brazil (33), Spain (34), and China (35).…”

“…VAS was the most used outcome in eight of these studies (18,26,29,(31)(32)(33)(34)(35). In total, the number of patients evaluated in the studies that we reviewed were 1859.…”

“…A total of eight studies reported the VAS Score (18,26,29,(31)(32)(33)(34)(35). The mean VAS score for the PRP groups decreased by 3.17, whereas a decrease of 0.92 is seen in the placebo groups.…”

Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

“…Treatment effects in response to IAI regimens are likely affected by the degree of cartilage degeneration. Numerus studies have conducted subgroup analyses stratified by KL grade to identify the efficacy of IAI agents in patients with KOA of varying severity, particularly PRP [ 53 , 84 , 90 , 125 , 126 , 127 , 128 ], HA [ 38 , 90 , 127 , 128 , 129 ], ACS [ 73 ], and MSCs [ 130 ]. These studies have obtained conclusive results indicating that patients who suffer minor cartilage loss or have a low KL grade generally respond well to such IAI agents compared with those that receive a placebo injection or comparative treatment, whereas those who experience more severe cartilage degeneration or have a high KL grade experience less improvement through treatment.…”

American Academy of Orthopaedic Surgeons Technology Overview Summary: Platelet-Rich Plasma (PRP) for Knee Osteoarthritis

“…The groups which received PRP showed improvement in patient-reported outcomes (PROs), including in all six high-quality studies that reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 9,12,16,22,32,36 and VAS pain scale scores. 9,12,22,23 No statistically significant improvement was reported for the moderate-quality study. 45 Regarding functional outcomes, PRP did not have any notable effect on cartilage thickness using ultrasonography evaluation 9 or knee strength.…”