Clinical results of PRP application for Gonartrosis; Comparison of one or two week interval application achievements PRP Application in the Treatment of Gonarthrosis
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Abstract
Objective: Intra-articular platelet-rich plasma PRP (platelet-rich plasma) treatment can be applied at an early stage of Gonarthrosis in addition to medical treatment. There is no consensus in the literature regarding the dose interval of PRP. Our aim in this study is to compare the short-term clinical results of three doses of PRP administered at one and two-week intervals in the treatment of early-stage Gonarthrosis.
Material and Methods: Three doses of PRP were applied to one knee of the patients at intervals of one week and to the other knee at intervals of two weeks. All patients were clinically evaluated with McMaster Universities Arthritis Index (WOMAC) and Visual Analogue Scale (VAS) before the PRP application and at the 1st, 3rd and 6th months after the application.
Results: The mean age of 61 (40 female, 21 male) patients included in this study was 56.75 years and the mean BMI (Body Mass Index) was determined as 25.45±3.15 kg/m2. In the clinical evaluation at the end of the 1st, 3rd, and 6th months after PRP, there was no significant difference between the one-week interval and two-week application. However, it was observed that PRP application provided statistically significant improvement in WOMAC and VAS scores in both applications (p<0.05).
Conclusion: According to the findings we obtained in our study, it has been determined that there was no difference between applying three doses of PRP at one- or two-weeks intervals.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2022-02-08
Published 2022-02-19
References
O'Neill TW, Felson DT. Mechanisms of Osteoarthritis (OA) Pain. Curr Osteoporos Rep. 2018;16:611-16. DOI: https://doi.org/10.1007/s11914-018-0477-1
Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011;131:311-17. DOI: https://doi.org/10.1007/s00402-010-1167-3
Murray I, Benke M, Mandelbaum B. Management of knee articular cartilage injuries in athletes: chondro protection, chondro facilitation, and resurfacing. Knee Surg Sports Traumatol Arthrosc. 2015;24:1617–26. DOI: https://doi.org/10.1007/s00167-015-3509-8
Kellgren JH, Lawrence J. The epidemiology of chronic rheumatism. In: Atlas of Standard Radiographs of Arthritis, Volume II. Oxford, UK: Black wellScientific; 1963.
Cole BJ, Karas V, Hussey K, Pilz K, Fortier LA. Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis. Am J Sports Med. 2017;45:339-46.
Wang P, Yang L, Li H, et al. Effects of whole-body vibration training with quadriceps strengthening exercise on function in gand gait parameters in patients with medial compartment knee osteoarthritis: a randomised controlled preliminary study. Physiotherapy. 2016;102:86–92. DOI: https://doi.org/10.1016/j.physio.2015.03.3720
Paoloni J, De Vos RJ, Hamilton B, Murrell GA, Orchard J. Platelet-rich plasma treatment for ligament and tendon injuries. Clin J Sport Med 2011;21:37-45. DOI: https://doi.org/10.1097/JSM.0b013e31820758c7
Dório M, Pereira RMR, Luz AGB, Deveza LA, de Oliveira RM, Fuller R. Efficacy of platelet-rich plasma and plasma for symptomatic treatment of knee osteoarthritis: a double-blinded placebo-controlled randomized clinical trial. BMC Musculoskelet Disord. 2021 24;22:822. DOI: https://doi.org/10.1186/s12891-021-04706-7
Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2030;41:356-64. DOI: https://doi.org/10.1177/0363546512471299
Zhang W, Robertson J, Jones A, Dieppe P, Doherty M. The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials. Ann Rheum Dis. 2008;67:1716–23. DOI: https://doi.org/10.1136/ard.2008.092015
Huang PH, Wang CJ, Chou WY, Wang JW, Ko JY. Short-term clinical results of intra-articular PRP injections for early osteoarthritis of the knee. Int J Surg. 2017;42:117-22. DOI: https://doi.org/10.1016/j.ijsu.2017.04.067
Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. 2000;43:1905-15. DOI: https://doi.org/10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-P
Petersson IF, Boegård T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren& Lawrence systems for the tibio femoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis. 1997;56:493-96. DOI: https://doi.org/10.1136/ard.56.8.493
Tavassoli M, Janmohammadi N, Hosseini A, Khafri S, Esmaeilnejad-Ganji SM. Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial. World J Orthop. 2019;10:310-26. DOI: https://doi.org/10.5312/wjo.v10.i9.310
Smith PA. Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial. Am J Sports Med. 2016;44:884-91. DOI: https://doi.org/10.1177/0363546515624678
Cole BJ, Karas V, Hussey K, Merkow DB, Pilz K, Fortier LA. Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical out comes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 2017;45:339-46. DOI: https://doi.org/10.1177/0363546516665809
Chouhan DK, Dhillon MS, Patel S, Bansal T, Bhatia A, Kanwat H. Multiple Platelet-Rich Plasma Injections Versus Single Platelet-Rich Plasma Injection in Early Osteoarthritis of the Knee: An Experimental Study in a Guinea Pig Model of Early Knee Osteoarthritis. Am J Sports Med. 2019;47:2300-2307. DOI: https://doi.org/10.1177/0363546519856605
Cole BJ, Karas V, Fortier LA. Hyaluronic Acid Versus Platelet-rich Plasma: Response. Am J Sports Med. 2017;45:NP21-NP22. DOI: https://doi.org/10.1177/0363546517703364
Campbell KA, Saltzman BM, Mascarenhas R, et al. Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses. Arthroscopy. 2015;31:2213-21. DOI: https://doi.org/10.1016/j.arthro.2015.03.041
Taniguchi Y, Yoshioka T, Kanamori A, Aoto K, Sugaya H, Yamazaki M. Intra-articular platelet-rich plasma (PRP) injections for treating knee pain associated with osteoarthritis of the knee in the Japanese population: a phase I and II a clinical trial. Nagoya J MedSci. 2018 ;80:39-51.
Gobbi A, Lad D, Karnatzikos G. Theeffects of repeated intra-articular PRP injections on clinical outcomes of early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23:2170-77. DOI: https://doi.org/10.1007/s00167-014-2987-4
Shahid M, Kundra R. Platelet-rich plasma (PRP) for knee disorders. EFORT Open Rev. 2017;2:28-34. DOI: https://doi.org/10.1302/2058-5241.2.160004
Almasry SM, Soliman HM, El-Tarhouny SA, Algaidi SA, Ragab EM. Platelet rich plasma enhances the immunohistochemical expression of platelet derived growth factor and vascular endothelial growth factor in the synovium of the meniscectomized rat models of osteoarthritis. Ann Anat. 2015;197:38-49 DOI: https://doi.org/10.1016/j.aanat.2014.10.006
Kazemi D, Fakhrjou A. Leukocyte and Platelet Rich Plasma (L-PRP) Versus Leukocyte and Platelet Rich Fibrin (L-PRF) For Articular Cartilage Repair of the Knee: A Comparative Evaluation in an Animal Model. Iran Red Crescent Med J. 2015;17:e19594. DOI: https://doi.org/10.5812/ircmj.19594
Liu J, Song W, Yuan T, Xu Z, Jia W, Zhang C. A comparison between platelet-rich plasma (PRP) and hyaluronate acid on the healing of cartilage defects. PLoS One. 2014;9:e97293. DOI: https://doi.org/10.1371/journal.pone.0097293
Dhillon MS, Patel S, Bansal T. Improvising PRP for use in osteoarthritis knee- upcoming trends and futuristic view. J Clin Orthop Trauma. 2019;10:32-35. DOI: https://doi.org/10.1016/j.jcot.2018.10.005
Cook CS, Smith PA. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee. Curr Rev Musculoskelet Med. 2018;11:583-92. DOI: https://doi.org/10.1007/s12178-018-9524-x
Filardo G, Kon E, Buda R, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:528e535. DOI: https://doi.org/10.1007/s00167-010-1238-6
Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2017;12:16. DOI: https://doi.org/10.1186/s13018-017-0521-3
Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2016 ;32:495-505. DOI: https://doi.org/10.1016/j.arthro.2015.08.005