Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial

Görmeli, Gökay; Görmeli, Cemile Ayşe; Ataoğlu, Muhammet Baybars; Çolak, Cemil; Aslantürk, Okan; Ertem, Kadir

doi:10.1007/s00167-015-3705-6

Cited by 321 publications

(354 citation statements)

References 33 publications

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“…Indeed, at least from the owners’ HCPI score side, the results could be attributed to a placebo effect. However, a number of randomized, controlled trials demonstrated variable efficacy of the major treatments (HA, PRP, or NSAIDS) in both dogs and humans . Furthermore, we have additional unpublished data regarding the use of bone marrow‐derived MSCS in dogs affected by spontaneous OA where, despite good clinical results, extended culture time, the need for specialized facilities, and high‐costs make it more limited compared to MFAT.…”

Section: Discussionmentioning

confidence: 99%

Intra-Articular Administration of Autologous Micro-Fragmented Adipose Tissue in Dogs with Spontaneous Osteoarthritis: Safety, Feasibility, and Clinical Outcomes

Zeira

Scaccia

Pettinari

et al. 2018

Stem Cells Translational Medicine

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Similar to the disease affecting humans, osteoarthritis (OA) is a painful musculoskeletal condition affecting 20% of the adult canine population. Several solutions have been proposed, but the results achieved to date are far from being satisfactory. New approaches, such as intra‐articular delivery of cells (including mesenchymal stromal cells), have been proposed. Among the many sources, the adipose tissue is considered very promising. We evaluated the safety, feasibility, and efficacy of a single intra‐articular injection of autologous and micro‐fragmented adipose tissue (MFAT) in 130 dogs with spontaneous OA. MFAT was obtained using a minimally invasive technique in a closed system and injected in the intra‐ and/or peri‐articular space. Clinical outcomes were determined using orthopedic examination and owners’ scores for up to 6 months. In 78% of the dogs, improvement in the orthopedic score was registered 1 month after treatment and continued gradually up to 6 months when 88% of the dogs improved, 11% did not change, and 1% worsened compared with baseline. Considering the owners’ scores at 6 months, 92% of the dogs significantly improved, 6% improved only slightly, and 2% worsened compared with baseline. No local or systemic major adverse effects were recorded. The results of this study suggest that MFAT injection in dogs with OA is safe, feasible, and beneficial. The procedure is time sparing and cost‐effective. Post injection cytological investigation, together with the clinical evidence, suggests a long‐term pain control role of this treatment. The spontaneous OA dog model has a key role in developing successful treatments for translational medicine. stem cells translational medicine 2018;7:819–828

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Section: Discussionmentioning

confidence: 99%

Intra-Articular Administration of Autologous Micro-Fragmented Adipose Tissue in Dogs with Spontaneous Osteoarthritis: Safety, Feasibility, and Clinical Outcomes

Zeira

Scaccia

Pettinari

et al. 2018

Stem Cells Translational Medicine

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“…Although a previous study has reported the direct effects of various drugs and PRP on knee osteoarthritis, it is essential to investigate the overall role of PRP in affecting the entire joint cytokine homeostasis (37). PRP has a long half-life and therefore is beneficial for treatment of knee osteoarthritis as PRP may be expected to degrade slowly (32).…”

Section: Discussionmentioning

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

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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.

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“…Sin embargo, al llevar estas recomendaciones a la práctica clínica, debemos tener en cuenta que estos pueden generar eventos adversos potenciales que limitan su uso (7,8), principalmente en pacientes con patología cardiovascular, gastrointestinal, hepática y metabólica (8) y, por otro lado, la efectividad del acetaminofén para el manejo sintomático de la OA ha quedado cuestionada en un metanálisis reciente presentado por Bruno y cols. (9).…”

Section: Introductionunclassified

“…(9). Por su parte, los medicamentos tópicos (sin un efecto sistémico) juegan un papel importante y son ampliamente usados para el manejo a corto plazo, pero no son efectivos en OA severa (7). La capsaicina tópica tiene un nivel de evidencia tipo 1B con un número necesario a tratar (NNT) de 8 en su presentación al 0,025 % (10).…”

Section: Introductionunclassified

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Terapias intervencionistas para manejo de dolor en Osteoartrosis de rodilla sintomática

Orozco-Arango¹

2016

Rev. Soc. Esp. Dolor.

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Introduction: Osteoarthritis (OA) of knee is the most common type of OA. It is a multifactorial disorder where pain is the most important clinical feature. Analgesic treatment in knee OA usually begins with acetaminophen and NSAIDs. Nonsurgical interventional indicated on nonsurgical symptomatic knee OA unresponsive to analgesic and anti-inflammatory oral and topical treatment, as well as knee osteoarthritis in surgery, when surgery is contraindicated or inadvisable.Objectives: A critical review of the current evidence for the following therapies intraarticular (IA): corticosteroids, hyaluronic acid (HA), ozone, platelet-rich plasma (PRP), botulinum toxin and RF geniculate nerves.Methodology: A search and no systematic review of individual articles, systematic reviews, meta-analysis was performed.Results and conclusions: IA steroids are effective, especially in those with greater radiographic commitment, with a level of evidence 1B. The PRP and AH, are useful in patients with mild to moderate knee osteoarthritis but not in severe knee osteoarthritis, with a longer duration of effect for the PRP. In severe degrees of gonarthrosis (Grades III-IV), the most suitable therapy is the RF geniculate nerves. Botulinum toxin, is superior to IA steroids with adequate response in different degrees of arthrosis, even when other therapies have not achieved adequate response. All therapies have been revised effective pain relief in knee osteoarthritis. However, there is great controversy over the degree of recommendation

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Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial

Abstract: I.

Cited by 321 publications

References 33 publications

Intra-Articular Administration of Autologous Micro-Fragmented Adipose Tissue in Dogs with Spontaneous Osteoarthritis: Safety, Feasibility, and Clinical Outcomes

Intra-Articular Administration of Autologous Micro-Fragmented Adipose Tissue in Dogs with Spontaneous Osteoarthritis: Safety, Feasibility, and Clinical Outcomes

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

Terapias intervencionistas para manejo de dolor en Osteoartrosis de rodilla sintomática

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