Is Intra-articular Platelet-rich Plasma Injection Safe and Effective in Osteoarthritis Knee? A Prospective Study: A Case Series
Background: Osteoarthritis (OA) of the knee is the most common slowly progressive chronic degenerative joint disease, characterized by varying degrees of loss of joint cartilage with local inflammation, usually affecting the elderly population. If oral drugs are ineffective, intra-articular injectio...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2024-01-01
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| Series: | Journal of Orthopedics and Joint Surgery |
| Subjects: | |
| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1131 |
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| Summary: | Background: Osteoarthritis (OA) of the knee is the most common slowly progressive chronic degenerative joint disease, characterized by varying degrees of loss of joint cartilage with local inflammation, usually affecting the elderly population. If oral drugs are ineffective, intra-articular injections (corticosteroids, viscous supplements, and blood-derived products) can be offered as another nonoperative modality. The release of platelet-derived factors directly at the site of cartilage disease, particularly with interest to knee OA, may stimulate the natural regenerative signaling cascade and enhance tissue healing with further mediation of the anti-inflammatory response. Suppression of mediators, such as interleukin-1 interaction with nociceptors, brings inflammatory and analgesic effects.
Subjects and methods: This prospective study was conducted in our institution's outpatient orthopedics department from March 2022 to May 2023. In total, 30 patients of either sex, between 40 and 70 years of age, suffering from primary knee OA with Kellgren–Lawrence (KL) grades I, II, or III on standing anteroposterior and lateral knee radiographs, with symptoms for >3 months according to the American College of Rheumatology (ACR) clinical classification criteria and pain score of >4 cm on 10 cm visual analog scale (VAS) was included. We excluded patients below 40 and above 70 years of age with septic arthritis, grade IV OA according to KL grading, and systemic infections. Injected platelet-rich plasma (PRP) injection in the knee using an anterolateral approach. The patients were followed up for 6 weeks, 3 months, and 6 months using VAS, Western Ontario, and the McMaster University Osteoarthritis Index (WOMAC) scoring system. The data collected were subjected to data entry in Microsoft (MS) Excel. The data were analyzed using the Chi-squared test using the Statistical Package for the Social Sciences (SPSS) (SPSS Inc. IBM Chicago city, Illinois state, United States of America) version 20.0.
Results: We have excellent improvement in VAS score from the mean value of 7.5 ± 2 initially at preinjection to 4.5 ± 1.5 after 6 months follow-up and WOMAC score from 74.5 ± 8.5 initially at preinjection to 55.5 ± 10.5 after 6 months follow-up.
Conclusion: Based on our results, this minimally invasive PRP injection to the knee joint is a safe and effective treatment in mild to moderate OA. Since PRP injection is biologically considered to induce the growth of degenerated articular cartilage, it will be more effective in relatively young patients and lower degrees of cartilage degeneration. Since no complications were seen in this study, it is safe and effective to use PRP injection intra-articularly in grades I, II, and III OA of the knee joint.
Clinical significance: Identifying the patients early with grades I, II, and grade III OA knee and treating them with intra-articular PRP injection shall delay the progression and the need for future total knee replacement surgery. |
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| ISSN: | 2582-7863 |