Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) versus Hyaluronic Acid (A one-year randomized clinical trial)

Raeissadat, Seyed Ahmad; Rayegani, Seyed Mansoor; Hassanabadi, Hossein; Fathi, Mohammad; Ghorbani, Elham; Babaee, Marzieh; Azma, Kamran

doi:10.4137/cmamd.s17894

Cited by 252 publications

(289 citation statements)

References 29 publications

Supporting

Mentioning

268

Contrasting

Unclassified

Order By: Relevance

“…Patients were randomly divided into two groups and once-weekly, double-blind trials were conducted in Xi'an Jiangtong University College of Medicine. A detailed description of the inclusion/exclusion criteria, allocation method and other details can be found in previously published studies (20,21). A total of 8 ml blood was harvested from the cubital vein and centrifuged for 5 min at 1,500 x g. Patients with knee osteoarthritis received PRP (2, 4, 8, 10, 12 or 14 ml) treatment through intralesional injections and a placebo was used as a control.…”

Section: Methodsmentioning

confidence: 99%

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Huang

Sha²,

Yang

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

Abstract. Knee osteoarthritis is a degenerative disease that may develop due ageing, obesity, strain, congenital abnormal joints, joint deformity or trauma. It is caused by many factors, such as degradation of articular cartilage injury, joint edge and subchondral bone hyperplasia of reactivity. Platelet-rich plasma (PRP) is an autologous blood sample that contains highly concentrated platelets and multiple cell growth factors. PRP promotes synovial cell proliferation and differentiation and may recover cartilage morphology. In the present study, the clinical efficacy of PRP was investigated in patients with knee osteoarthritis aged between 18 and 30 years in a phase-III clinical study. Following an 8-week baseline, patients with knee osteoarthritis were randomized into once-weekly, double-blind treatment with PRP (2-14 ml) or placebo groups. The results indicated that patients with osteoarthritis treated with PRP had modulated plasma concentrations of inflammatory factors and pro-angiogenic factors compared with the placebo group. Treatment responses were assessed by median percent reduction in inflammatory and pro-angiogenic factors and these improved with PRP treatment compared with the placebo. Clinical data indicated that PRP alleviated knee osteoarthritis and reduced humoral and cellular immune responses that led to beneficial effects on histological parameters. Inflammation was significantly alleviated in patients receiving PRP compared with the placebo group. The most common treatment-emergent adverse events in the presence of PRP were hypertension and proteinuria. In conclusion, treatment with PRP for patients with knee osteoarthritis presented beneficial effects in alleviating joint inflammation, cartilage destruction and bone damage, and repairing joint tissue. These results suggested that PRP may be a potential therapeutic agent for knee osteoarthritis.

show abstract

Section: Methodsmentioning

confidence: 99%

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Huang

Sha²,

Yang

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…Nine RCTs were included in the results, 15,16,[21][22][23][33][34][35]38 3 of which were double blinded ( Table 2). Hyaluronic acid was used for the control groups in 7 RCTs, saline was used in 1 study, and an exercise program was used in another.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

“…The rate of response to PRGF was significantly higher than the rate of response to HA for all scores including pain, stiffness, and function on the WOMAC, Lequesne index, and OMERACT-OARSI responders at 24 and 48 weeks. In the most recent RCT, 15 Raeissadat et al compared 2 intraarticular injections of PRP (Rooyagen Kit) to 3 injections of Hyalgan HA for patients with knee OA. The PRP group included 87 patients and the HA group 73 patients.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

et al. 2016

View full text Add to dashboard Cite

Objective: To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects. Design: Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis." Results: The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies. Conclusion: Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

show abstract

“…In turn, it can be predicted that the synovial fluid is rich in polyP. As a therapeutical consequence, platelet-rich plasma which has been injected into knees of osteoarthritis patients, was found to be superior compared to an application of HA (Raeissadat et al, 2015). Whereas HA, acting as a potential joint lubricant, has been proposed to ameliorate the pathophysiological symptoms of osteoarthritis by acting through CD44 receptors at the chondrocyte surface (Akmal et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Artificial cartilage bio-matrix formed of hyaluronic acid and Mg2+-polyphosphate

Wang¹,

Ackermann²,

Tolba³

et al. 2016

eCM

View full text Add to dashboard Cite

Here we show that inorganic polyphosphate (polyP), a polyanionic metabolic regulator consisting of multiple phosphate residues linked by energy-rich phosphoanhydride bonds, is present in the synovial fluid. In a biomimetic approach, to enhance cartilage synthesis and regeneration, we prepared amorphous polyP microparticles with Mg 2+ as counterions. The particles were characterised by X-ray diffraction (XRD), energy-dispersive X-ray (EDX) and Fourier transformed infrared spectroscopic (FTIR) analyses. Similar particles were obtained after addition of Mg 2+ ions to a solution containing hyaluronic acid, as a major component of the synovial fluid, and soluble NapolyP. The viscous paste-like material formed, composed of globular microparticles with diameter of 400 nm, strongly promoted the adhesion of chondrocytes and caused a significant upregulation of the expression of the genes encoding collagen type 3A1, as a marker for chondrocyte differentiation, and SOX9, a transcription factor that regulates chondrocyte differentiation and proliferation. The expression level of the collagen type 3A1 gene was also enhanced by exposure of chondrocytes to synovial fluid that was found to contain polyP with a size of about 80 phosphate residues. This stimulatory effect was abolished after pre-incubation of the synovial fluid with the polyP degrading alkaline phosphatase. We propose a strategy for treatment of joint dysfunctions caused by osteoarthritis based on the application of amorphous Mg 2+ -polyP microparticles that prevent calcium crystal formation in the synovial fluid using scavenging Ca -polyP to hyaluronic acid at the cartilage surface.

show abstract

Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) versus Hyaluronic Acid (A one-year randomized clinical trial)

Cited by 252 publications

References 29 publications

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

Artificial cartilage bio-matrix formed of hyaluronic acid and Mg2+-polyphosphate

Contact Info

Product

Resources

About