IMPROVING FUNCTION IN KNEE OSTEOARTHRITIS WITH PLATELET-RICH PLASMA THERAPY: A FUNCTIONAL OUTCOME EVALUATION

PASUPULETI ARCHANA BABU; A. CHANDRA SEKHAR; S. SUJIN

doi:10.22159/ijpps.2023v15i6.48005

Authors

PASUPULETI ARCHANA BABU Government General Hospital. Budhwarpet Road, Kurnool-518002, Andhra Pradesh, India
A. CHANDRA SEKHAR Kurnool Medical College, Bharath Petroleum, Near, Bhudawarapet, Kisan Ghat Road, Kurnool-518002, Andhra Pradesh, India
S. SUJIN Kurnool Medical College, Bharath Petroleum, Near, Bhudawarapet, Kisan Ghat Road, Kurnool-518002, Andhra Pradesh, India

DOI:

https://doi.org/10.22159/ijpps.2023v15i6.48005

Keywords:

Platelet-rich plasma, Osteoarthritis, WOMAC score

Abstract

Objective: Osteoarthritis is a chronic and degenerative disease that commonly affects the knee joint. The effectiveness of using PRP injections in the knee joint for managing osteoarthritis symptoms, which include pain, disability, deformity, and reduced quality of life, is being studied.

Methods: This is a two-year prospective study conducted between January 2019 and December 2020 at the Government General Hospital in Kurnool. The study focused on the management of osteoarthritis knee in 60 patients who received 3 ml autologous intra-articular platelet-rich plasma injections, with their pain, joint stiffness, and joint mobility being evaluated using the WOMAC score. The majority of participants were middle-aged women with grade KL 2 and 3 osteoarthritis knee.

Results: The study included 60 cases with KL grade II (28 cases) and grade III (32 cases) of knee osteoarthritis. The pretreatment WOMAC score for KL grade II was 56.11±6.36, which showed significant improvement to 50.76±7.6 (p=0.000) at 2 w, 50.76±7.6 (p=0.001) at one month, 26.97±3.47 (p=0.001) at 3 mo, and 22.11±2.99 (p=0.001) at 6-month follow-up. Similarly, for KL grade III, the pretreatment WOMAC score was 59.21±5.63, which improved significantly to55.76±7.6 (p=0.000) at 2 w, 48.79±5.42 (p=0.001) at one month, 36.46±4.36 (p=0.001) at 3 mo, and 32.12±2.66 (p=0.001) at 6-month follow-up.

Conclusion: PRP injection is a safe and cost-effective alternative for treating knee osteoarthritis, leading to pain relief and an enhanced quality of life, especially in the initial stages. Not only does PRP provide immediate relief, but it also results in gradual improvements over time. Overall, PRP is a viable option for individuals seeking alternative treatments for knee osteoarthritis.

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References

Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012 Jun;64(6):1697-707. doi: 10.1002/art.34453. PMID 22392533, PMCID PMC3366018.

Felson DT. Clinical practice. Osteoarthritis of the knee. N Engl J Med. 2006 Feb 23;354(8):841-8. doi: 10.1056/NEJMcp051726. Erratum in: N Engl J Med. 2006 Jun 8;354(8):841-8. doi: 10.1056/NEJMcp051726, PMID 16495396.

Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013 Sep;21(9):571-6. doi: 10.5435/JAAOS-21-09-571, PMID 23996988.

Beitzel K, McCarthy MB, Russell RP, Apostolakos J, Cote MP, Mazzocca AD. Learning about PRP using cell-based models. Muscles Ligaments Tendons J. 2014 May 8;4(1):38-45, PMID 24932446, PMCID PMC4049649.

Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)-development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96. doi: 10.2519/jospt.1998.28.2.88, PMID 9699158.

Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. J Cutan Aesthet Surg. 2014 Oct-Dec;7(4):189-97. doi: 10.4103/0974-2077.150734, PMID 25722595, PMCID PMC4338460.

Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res. 2016 Aug;474(8):1886-93. doi: 10.1007/s11999-016-4732-4. PMID 26872913, PMCID PMC4925407.

Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2003 Aug;11(8):551-60. doi: 10.1016/s1063-4584(03)00089-x, PMID 12880577.

Hsu WK, Mishra A, Rodeo SR, Fu F, Terry MA, Randelli P. Platelet-rich plasma in orthopaedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2013 Dec;21(12):739-48. doi: 10.5435/ JAAOS-21-12-739, PMID 24292930.

Buckwalter JA, Mankin HJ, Grodzinsky AJ. Articular cartilage and osteoarthritis. Instr Course Lect. 2005;54:465-80. PMID 15952258.

Pearle AD, Warren RF, Rodeo SA. Basic science of articular cartilage and osteoarthritis. Clin Sports Med. 2005 Jan;24(1):1-12. doi: 10.1016/j.csm.2004.08.007. PMID 15636773.

Goldring MB, Otero M, Plumb DA, Dragomir C, Favero M, El Hachem K. Roles of inflammatory and anabolic cytokines in cartilage metabolism: signals and multiple effectors converge upon MMP-13 regulation in osteoarthritis. Eur Cell Mater. 2011 Feb 24;21:202-20. doi: 10.22203/ecm.v021a16. PMID 21351054, PMCID PMC3937960.

Everts PA, Knape JT, Weibrich G, Schönberger JP, Hoffmann J, Overdevest EP. Platelet-rich plasma and platelet gel: a review. J Extra Corpor Technol. 2006 Jun;38(2):174-87. PMID 16921694, PMCID PMC4680757.

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004 Apr;62(4):489-96. doi: 10.1016/j.joms.2003.12.003. PMID 15085519.

Goldring MB. The role of the chondrocyte in osteoarthritis. Arthritis Rheum. 2000 Sep;43(9):1916-26. doi: 10.1002/1529-0131(200009)43:9<1916::AID-ANR2>3.0.CO;2-I, PMID 11014341.

Akeda K, An HS, Okuma M, Attawia M, Miyamoto K, Thonar EJ. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage. 2006 Dec;14(12):1272-80. doi: 10.1016/j.joca.2006.05.008. PMID 16820306.

Frazer A, Bunning RA, Thavarajah M, Seid JM, Russell RG. Studies on type II collagen and aggrecan production in human articular chondrocytes in vitro and effects of transforming growth factor-beta and interleukin-1beta. Osteoarthritis Cartilage. 1994 Dec;2(4):235-45. doi: 10.1016/s1063-4584(05)80075-5, PMID 11550708.

Pujol JP, Chadjichristos C, Legendre F, Bauge C, Beauchef G, Andriamanalijaona R. Interleukin-1 and transforming growth factor-beta 1 as crucial factors in osteoarthritic cartilage metabolism. Connect Tissue Res. 2008;49(3):293-7. doi: 10.1080/03008200802148355, PMID 18661363.

Schmidt MB, Chen EH, Lynch SE. A review of the effects of insulin-like growth factor and platelet-derived growth factor on in vivo cartilage healing and repair. Osteoarthritis Cartilage. 2006 May;14(5):403-12. doi: 10.1016/j.joca.2005.10.011. PMID 16413799.

Martin JA, Buckwalter JA. The role of chondrocyte-matrix interactions in maintaining and repairing articular cartilage. Biorheology. 2000;37(1-2):129-40. PMID 10912185.

Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Zamanabadi MN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clin Interv Aging. 2018 Jan 4;13:73-9. doi: 10.2147/CIA.S147757. PMID 29379278, PMCID PMC5757490.

Vamshi R, Bheemisetty V, Bollabathini R, Mahadevuni V. A prospective study of intra-articular injections of platelet rich plasma in early osteoarthritis knee joint. Int J Res Orthop. 2018 Jan;4(1):133-40. doi: 10.18203/issn.2455-4510.IntJResOrthop20175661.

Uslu Guvendi E, Askin A, Guvendi G, Koçyigit H. Comparison of efficiency between corticosteroid and platelet rich plasma injection therapies in patients with knee osteoarthritis. Arch Rheumatol. 2018;33(3):273-81. doi: 10.5606/ArchRheumatol.2018.6608, PMID 30632533, PMCID PMC6328223.

Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012 Nov 23;13:229. doi: 10.1186/1471-2474-13-229, PMID 23176112, PMCID PMC3532098.

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 Mar;32(3):495-505. doi: 10.1016/j.arthro.2015.08.005. PMID 26432430.