EFFECTS OF PLATELET-RICH PLASMA AND OZONE THERAPY ON PAIN AND QUALITY OF LIFE IN KNEE OSTEOARTHRITIS: A RETROSPECTIVE TRIAL

Öz

Objective: There are many methods for treating knee osteoarthritis (KOA). However, especially among conservative treatments, intra articular injection methods have not been shown to be superior to each other. In our study, we compared the effects of ozone therapy and platelet-rich plasma on pain and functionality. Material and Methods: This retrospective clinical study included patients aged 30-70 years who received ozone and Platelet-Rich Plasma (PRP) for the treatment of knee osteoarthritis. Both groups received 3 sessions of ultrasound-guided intra-articular injection. The demographic characteristics of the patients, such as age and gender, were recorded. Pain was assessed with a numerical rating scale (NRS) before and 3 months after treatment, functionality with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quality of life with the Short Form-12 (SF-12). Results: The mean age of the 54 patients included in the study was 58.53±8.25 years. No significant difference was found between the two groups in terms of age, gender, pre-treatment NRS, WOMAC, and SF-12 values. There were significant differences in the NRS, WOMAC, and SF-12 values in both ozone and PRP groups after treatment compared to before treatment. However, this difference was not found to be significant between the groups. Conclusion: Both PRP and ozone therapy are effective short term treatments for KOA. There is no evidence that one is more effective than the other.

Anahtar Kelimeler

• Knee osteoarthritis
• ozone
• pain
• platelet-rich plasma
• quality of life

DİZ OSTEOARTRİTİNDE TROMBOSİTTEN ZENGİN PLAZMA VE OZON TEDAVİSİNİN AĞRI VE YAŞAM KALİTESİ ÜZERİNE ETKİLERİ: RETROSPEKTİF ÇALIŞMA

Öz

Amaç: Diz osteoartritinin (DOA) tedavisi için birçok yöntem vardır. Ancak özellikle konservatif tedaviler arasında eklem içi enjeksiyon yöntemlerinin birbirlerine üstünlüğü gösterilememiştir. Çalışma mızda, ozon tedavisi ve trombositten zengin plazmanın ağrı ve fonksiyonellik üzerindeki etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Bu retrospektif klinik çalışmaya diz osteoartriti tedavisi için ozon ve trombositten zengin plazma (PRP) alan 30-70 yaş arası hastalar dahil edildi. Her iki gruba da 3 seans ultrason eşliğinde eklem içi enjeksiyon uygulandı. Hastaların yaş ve cinsiyet gibi demografik özellikleri kaydedildi. Ağrı tedaviden önce ve 3 ay sonra sayısal derecelendirme ölçeği (NRS) ile, işlevsellik Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC) ile ve yaşam kalitesi Kısa Form-12 (SF-12) ile değerlendirildi. Bulgular: Çalışmaya dahil edilen 54 hastanın yaş ortalaması 58,53±8,25 yıl idi. İki grup arasında yaş, cinsiyet, tedavi öncesi NRS, WOMAC ve SF-12 değerleri açısından anlamlı bir fark bulunmadı. Hem ozon hem de PRP gruplarında tedavi sonrası NRS, WOMAC ve SF-12 değerlerinde tedavi öncesine göre anlamlı farklılıklar var dı. Ancak bu fark gruplar arasında anlamlı bulunmamıştır. Sonuç: Hem PRP hem de ozon tedavisi DOA için etkili kısa süreli tedavilerdir. Birinin diğerinden daha etkili olduğuna dair bir kanıt saptanmamıştır.

Anahtar Kelimeler

• Diz osteoartriti
• ozon
• ağrı
• trombositten zen gin plazma
• yaşam kalitesi

Kaynakça

1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet 2019;393(10182):1745-59. [CrossRef] google scholar
2. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58(1):26-35. [CrossRef] google scholar
3. Raeissadat SA, Ghazi Hosseini P, Bahrami MH, Salman Roghani R, Fathi M, Gharooee Ahangar A, et al. The comparison effects of intra-articular injection of platelet rich plasma (PRP), plasma Rich in growth factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial. BMC Musculoskelet Disord 2021;22(1):134. [CrossRef] google scholar
4. Blaga FN, Nutiu AS, Lupsa AO, Ghiurau NA, Vlad SV, Ghitea TC. Exploring Platelet-rich plasma therapy for knee osteoarthritis: An in-depth analysis. J Funct Biomater 2024;15(8):221. [CrossRef] google scholar
5. Lin X, Zhi F, Lan Q, Deng W, Hou X, Wan Q. Comparing the efficacy of different intra-articular injections for knee osteoarthritis: A network analysis. Medicine (Baltimore) 2022;101(31):e29655. [CrossRef] google scholar
6. 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(3):495-505. [CrossRef] google scholar
7. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019;27(11):1578-89. [CrossRef] google scholar
8. Rahimzadeh P, Imani F, Azad Ehyaei D, Faiz SHR. Efficacy of oxygen-ozone therapy and platelet-rich plasma for the treatment of knee osteoarthritis: A meta-analysis and systematic review. Anesth Pain Med 2022;12(4):e127121. [CrossRef] google scholar

9. Arias-Vázquez PI, Tovilla-Zárate CA, Hernández-Díaz Y, González-Castro TB, Juárez-Rojop IE, López-Narváez ML, et al. Short-Term Therapeutic Effects of ozone in the management of pain in knee osteoarthritis: A metaanalysis. PM R 2019;11(8):879-87. [CrossRef] google scholar
10. Bensa A, Sangiorgio A, Boffa A, Salerno M, Moraca G, Filardo G. Corticosteroid injections for knee osteoarthritis offer clinical benefits similar to hyaluronic acid and lower than platelet-rich plasma: a systematic review and metaanalysis. EFORT Open Rev 2024;9(9):883-95. [CrossRef] google scholar
11. Khuba S, Khetan D, Kumar S, Garg KK, Gautam S, Mishra P. Role of platelet rich plasma in management of early knee osteoarthritis pain: A retrospective observational study. Interv Pain Med 2023;2(4):100297. [CrossRef] google scholar
12. Kikuchi N, Yoshioka T, Arai N, Sugaya H, Hyodo K, Taniguchi Y, et al. A Retrospective analysis of clinical outcome and predictive factors for responders with knee osteoarthritis to a single injection of leukocyte-poor platelet-rich plasma. J Clin Med 2021;10(21):5121. [CrossRef] google scholar
13. Berrigan W, Tao F, Kopcow J, Park AL, Allen I, Tahir P, et al. The effect of platelet dose on outcomes after platelet rich plasma injections for musculoskeletal conditions: A systematic review and meta-analysis. Curr Rev Musculoskelet Med 2024. 2024/09/27. doi: 10.1007/s12178-024-09922-x. [CrossRef] google scholar
14. Lino VTS, Marinho DS, Rodrigues NCP, Andrade CAF. Efficacy and safety of ozone therapy for knee osteoarthritis: an umbrella review of systematic reviews. Front Physiol 2024;15:1348028. [CrossRef] google scholar
15. Dernek B, Kesiktas FN. Efficacy of combined ozone and platelet-rich-plasma treatment versus platelet-rich-plasma treatment alone in early stage knee osteoarthritis. J Back Musculoskelet Rehabil 2019;32(2):305-11. [CrossRef] google scholar