Abstract

INTRA-ARTICULAR INJECTION OF PLATELET RICH PLASMA IN KNEE OSTEOARTHRITIS CLINICAL EVALUATION

*Gamal Salaheldin Elmorsy, M.D.

Abstract

Objective: A prospective study with a total of 20 patients with Grade 1or 2 osteoarthritis (Kellgren and Lawrence). All patients was treatedusing intra-articular applications of autologous PRP Clinical outcomewas evaluated using IKDC and WOMAC, before treatment and at 6weeks, 3 months and 6 months after treatment The visual analog scalefor pain and overall satisfaction with the procedure. The aim of thisstudy was planned to evaluate intra articular injection of PRP onprimary knee osteoarthritis which were refractory to conservativeTreatment.Methods: This study is carried out on 20 patients sufferingfrom primaryknee osteoarthritis grade1, grade2. This study was doneduring theperiod from August 2011 to September 2012 with follow upperiodranged from 6 months to 12 months with average follow up period 9months.Therewere 14 female and 6 male patients. Their age rangebetween 35 and 55 years with average 44years. While bilateral footaffection was in 7 patients in whom the more complaining sidewasinjected. The period of complaint before operation varied between 1-5 years with average2.3years.All patients were treated by intra articular injection of PRPafter failure ofconservative treatment for at least three months. Thepost injection follow up period was ninemonths. This short termfollow up had no statistically significant effect on the final Outcome.Results: The clinical results were classified on subjective base and weregraded as Excellentin seven patients (35%), Good in eight patients (40%), Fair in two patients (10%) and poor inthree patients (15%).The excellent and good results were considered as satisfactory, andtheunsatisfactory included the fair and the poor results. Thus, satisfactory results were found in15 patients (75%), and theunsatisfactory ones were found in 5 patients (25%).The averageage was 44 years. The highest incidence ofsatisfactory results was in the age group (below 40years); whileresults were close in the other age groups. Age had statisticallysignificant effecton the results. The study included 14 female and 6 male patients. Malepatients gave better results than female. A satisfactory result infemale was 71.4 % while in male it was 83.3%. Sex had nostatistically significant effect on the results. The period of complaint before operation varies between 1-5years withaverage 2.3 years. Period of complaint had statisticallysignificant effect on results. The best result was (satisfactory 100%)in patients complaining for less than three years while the worst wasin patients complaining for more than five years (unsatisfactoryin60%).There were 13 patients with unilateral complaint and 7patients with bilateral knee osteoarthritis. Best results were inunilateral cases (84.6% satisfactory) while in bilateral cases only57.1% showed satisfactory results. Laterality had significant effect onresults. The results of this study were discussed and compared with other studies.Conclusion: The preliminary short-term results of this study areencouraging and indicate that treatment with autologous PRP intraarticularinjections is safe, and may be useful for the treatment of early degenerative articular pathology of the knee, aiming to reducepain and improve knee function and quality of life. However, randomized controlled studies will be needed to confirm the realpotential and to evaluate the durability of this procedure, to betteridentify indication criteria and to improve application modalities. Further studies evaluating this new technique for treating cartilage degenerative pathology are in progress.

Keywords: Knee Osteoarthritis, Intra-articular injection of Platelet Rich Plasma.