Retrospective Analysis of Responders and Impaired Patients with Knee Osteoarthritis Treated with Two Consecutive Injections of Very Pure Platelet-Rich Plasma (PRP)

Abstract

Objectives: To assess the effectiveness of two consecutive intraarticular injections of PRP to treat knee osteoarthritis (KOA), discriminating between responders and impaired patients. Methods: This retrospective study included 73 consecutive patients who were referred for two intra-articular PRP injections (one week apart) for treating symptomatic moderate/severe KOA. Biological characterization of the PRP, including platelets, leukocytes and erythrocytes, was evaluated. Patient’s subjective symptoms were recorded before the treatment and 1 year after the second injection using pain VAS and WOMAC scores. Responders were defined by an improvement of 10 points on WOMAC. Results: At a 1-year follow up, we found 36 (49.3%) patients who fulfilled the criteria of responders, and 21 (28.8%) patients were impaired. A statistically and clinically significant global improvement of −29.2 ± 14.3 (p < 0.001) points in WOMAC score was observed 1 year after treatment in the responder group, with a higher response rate in patients with KL 2 (57.7%) compared to KL IV (28.6%). The percentage of patients with KL IV was higher in the impaired group (48.0%) compared to the responders (16.6%). As expected, the evaluation of the functionality of the knee in the impaired group indicates that it significantly worsened after one year from treatment (p = 0.027). However, the average pain score remained stable with no significant differences after 1 year (p = 0.843). No clinical complications or severe adverse events after the PRP injections were reported. Conclusion: The present study suggests that two intra-articular injections of 10 mL of very pure PRP provide pain and functional improvement in symptomatic KOA.

SAS-PRP Study: A Real-Life Satisfaction Assessment in Patients with Cartilage Lesions of the Knee Treated by Platelet-Rich Plasma

“…A total of 52% of the patients for whom we could gather the OMERACT-OARSI criteria were considered responders. This result is similar to the one obtained by Chopin et al [24] which was 46.5% at M7 and by Silvestre et al [34] which was 49%. Our study was limited by its low level of evidence.…”

“…These results need to be put into the perspective of the tiny population composing the different sub-groups and by the repetitions of analyses. However, these findings are consistent with previous studies [34,39]. A total of 52% of the patients for whom we could gather the OMERACT-OARSI criteria were considered responders.…”

“…The platelet increase factor largely depends on the centrifuge system [14,31,32]. Our increase factor was in the range exposed in the literature and is comparable to the ones obtained with the same centrifuge system [33][34][35]. Our PRP was classified as BBA according to the DEPA classification [15].…”

“…The production efficiency was 85% (rank B) and strictly depends on the device. The same production efficiency was declared by Silvestre et al [34] who used the same device. We obtained a better PRP classification than Guillibert et al who used the HighTissue PRP 20 device [33].…”