The Effect of Platelet Rich Plasma Frequency On Early Stage Knee Osteoarthritis

Yıl 2020, , 13 - 19, 21.04.2020

Aziz Atik

https://doi.org/10.33713/egetbd.674135

Öz

ABSTRACT
Introduction: Platelet rich plasma (PRP) revealed quite satisfying results for early knee osteoarthritis (OA) especially in younger ages by decreasing pain and improving function and quality of life. However, what becomes the ideal dose and how often it should be performed, the effectiveness of intra-articular PRP application in different stages of OA are the main topics discussed. There are few studies in the literature comparing the efficacy of PRP with the administration dose. The primary aim of this study was to compare the efficacy of different doses of PRP in primary knee OA and to determine the ideal treatment modality.
Material and methods: 174 patients who met the criteria were evaluated retrospectively between January 2016 and April 2017. The patients were divided into 3 groups according to doses. Western Ontario and McMaster University Arthritis Index (WOMAC) scores, International Knee Documentation Committee (IKDC) scores and 100 mm Visual Analogue Scale (100 mm VAS) scores were evaluated before treatment, 6 months and 12 months after treatment. Satisfaction status and treatment-related complications were examined at 12 months after treatment.
Results: At the end of the follow-up, a significant improvement was observed in all three groups compared to the pre-treatment values. (p <0.05). Significant improvement was observed in pain scores (p <0.001) and functional scores (p <0.001) in all three injection groups. No significant difference was observed between twice or thrice applications (p >0.05). The clinical and functional results of one application was significantly lower than the other groups (p <0.05).
Conclusion: We think that single dose therapy is less sufficient in effect, thus the appropriate method of treatment is at least 2 doses of PRP.

Anahtar Kelimeler

platelet rich plasma, PRP, Knee, osteoarthritis, dose, frequency

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Yazar katkılarından dolayı Dr. Ahmet Safa TARGAL’a teşekkür eder. The author would like to thank to Dr. Ahmet Safa TARGAL for his support.

Plateletten Zengin Plazma Uygulama Sıklığının Erken Evre Diz Osteoartriti Üzerine Etkisi

Öz

ÖZET
Giriş: Plateletten zengin plazma (PRP) erken evre diz osteoartritinde (OA), özellikle genç hastalarda ağrıyı azaltıp fonksiyonu arttırarak iyi sonuçlar sağlamaktadır. Ancak ideal dozun ne olduğu ve kaç kere yapılması gerektiği, farklı OA evrelerindeki etkinliği tartışılagelen konulardır. Literatürde uygulama sıklığı ile PRP etkinliğini karşılaştıran az sayıda çalışma vardır. Bu çalışmanın amacı, primer diz OA hastalarında PRP uygulama sıklığının etkinliğini kıyaslamaktır.
Materyal ve Metod: Ocak 2016 ile Nisan 2017 arasında kriterlere uygun 174 hasta geriye dönük olarak incelendi. Hastalar uygulama doz sayılarına göre 3 gruba bölündü. Tedaviden önce ve tedaviden sonraki 6. ve 12. aylarda Western Ontario and McMaster University Arthritis Index (WOMAC) skorları, International Knee Documentation Committee (IKDC) skorları ve 100 mm Visual Analogue Scale (100 mm VAS) skorları ölçüldü. Hastaların memnuniyet durumu ve tedaviye bağlı komplikasyonlar 12. ayda değerlendirildi.
Bulgular: Takip sonunda her 3 grupta tedavi öncesi değerlere göre iyileşme görüldü (p<0,05). Ağrı skorlarında (p<0,001) ve fonksiyonel skorlarda (p<0,001) her 3 grupta da önemli gelişme vardı. Tedavi öncesi ve sonrası değerlendirildiğinde iki ve üç doz uygulana gruplar arasında istatistiksel anlamlı bir fark yoktu (p>0,05). Tek doz grubunun klinik ve fonksiyonel sonuçları diğer iki gruptan kötüydü (p<0,05).
Sonuç: Tek doz PRP uygulamasının yeterli etkinliği sağlamadığı, bu sebeple tedavide uygun metodun en az 2 doz PRP uylaması olduğu kanaatindeyiz.

Anahtar Kelimeler

plateletten zengin plazma, PRP, diz, osteoartrit, doz, sıklık

Proje Numarası

yok

Kaynakça

• 1. Curl, W.W., et al., Cartilage injuries: A review of 31,516 knee arthroscopies. Arthroscopy, 1997 DOI: 10.1016/S0749-8063(97)90124-9
• 2. Widuchowski, W., J. Widuchowski, and T. Trzaska, Articular cartilage defects: Study of 25,124 knee arthroscopies. Knee, 2007 DOI: 10.1016/j.knee.2007.02.001
• 3. Woolf, A.D. and B. Pfleger, Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 2003 Pubmed ID: 14710506
• 4. Altman, R., et al., Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis and rheumatism, 1986 doi:10.1002/art.1780290816
• 5. Wesseling, J., et al., CHECK (Cohort Hip and Cohort Knee): similarities and differences with the Osteoarthritis Initiative. Annals of the rheumatic diseases, 2009. 68(9): p. 1413-1419 doi:10.1136/ard.2008.096164
• 6. Clegg, D.O., et al., Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine, 2006. 354(8): p. 795-808
• 7. Zhang, W., et al., OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage, 2008 DOI: 10.1016/j.joca.2007.12.013
• 8. El-Refaie, W.M., et al., Novel self-assembled, gel-core hyaluosomes for non-invasive management of osteoarthritis: in-vitro optimization, ex-vivo and in-vivo permeation. Pharmaceutical research, 2015. 32(9): p. 2901-2911 doi:10.1007/s11095-015-1672-8
• 9. Wang, F. and X. He, Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta-analysis. Experimental and Therapeutic Medicine, 2015 DOI: 10.3892/etm.2014.2131
• 10. Strand, V., et al., Safety and efficacy of US-approved viscosupplements for knee osteoarthritis: A systematic review and meta-analysis of randomized, saline-controlled trials. Journal of Pain Research, 2015 DOI: 10.2147/JPR.S83076
• 11. Mladenovic, Z., et al., Potential Role of Hyaluronic Acid on Bone in Osteoarthritis: Matrix Metalloproteinases, Aggrecanases, and RANKL Expression are Partially Prevented by Hyaluronic Acid in Interleukin 1-stimulated Osteoblasts. The Journal of Rheumatology, 2014 DOI: 10.3899/jrheum.130378
• 12. Kon, E., et al., Platelet-rich plasma: Intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surgery, Sports Traumatology, Arthroscopy, 2010 DOI: 10.1007/s00167-009-0940-8
• 13. Spaková, T., et al., Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. American Journal of Physical Medicine and Rehabilitation, 2012 DOI: 10.1097/PHM.0b013e3182aab72
• 14. Sánchez, M., et al., A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy - Journal of Arthroscopic and Related Surgery, 2012 DOI: 10.1016/j.arthro.2012.05.011
• 15. T, M. and F. L, Temporal growth factor release from platelet-rich plasma, trehalose lyophilized platelets, and bone marrow aspirate and their effect on tendon and ligament gene expression. Journal of Orthopaedic Research, 2009 doi: 10.1002/jor.20853
• 16. Xie, X., et al., Comparative evaluation of MSCs from bone marrow and adipose tissue seeded in PRP-derived scaffold for cartilage regeneration. Biomaterials, 2012 DOI: 10.1016/j.biomaterials.2012.06.058
• 17. Saito, M., et al. Intraarticular administration of platelet-rich plasma with biodegradable gelatin hydrogel microspheres prevents osteoarthritis progression in the rabbit knee. Pubmed ID: 19473558
• 18. Jang, S.-J., J.-D. Kim, and S.-S. Cha, Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. European Journal of Orthopaedic Surgery & Traumatology, 2013. 23(5): p. 573-580 DOI: 10.1007/s00590-012-1037-5
• 19. Halpern, B., et al., Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clinical Journal of Sport Medicine, 2013. 23(3): p. 238-239
• 20. Cerza, F., et al., Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. American Journal of Sports Medicine, 2012 DOI: 10.1177/0363546512461902
• 21. Patel, S., et al., Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: A prospective, double-blind, randomized trial. 2013 DOI: 10.1177/0363546512471299
• 22. Görmeli, G., et al., Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 2017 DOI: 10.1007/s00167-015-3705-6
• 23. Huang, P.H., et al., Short-term clinical results of intra-articular PRP injections for early osteoarthritis of the knee. International Journal of Surgery, 2017 DOI: 10.1016/j.ijsu.2017.04.067