Abstract
Background: Osteoarthritis (OA) is the most prevalent etiology for arthritis. Knee OA clinical symptoms and signs have direct impact on social interactions, mental functioning, sleep quality and various aspects of patients’ lives. The applications of biologic managing agents such as PRP in musculoskeletal disorders are growing considerably.
Aim: To investigate and compare gender differences in response to platelets rich plasma intra articular injections in cases having knee osteoarthritis.
Methodology: The research clinical trial recruited 44 elderly participants aged sixty years and above with mild to moderate knee osteoarthritis according to Kellgren-Lawrence Grading Scale system. The studied sample have been categorized into two equal matched age research groups: Research Group A:22 male patients 60 years old and above with knee osteoarthritis. Research Group B:22 female patients 60 years old and above with knee osteoarthritis.
Results: Significant improvement in pain scores among all grades of knee OA, the best improvement achieved at 6 months follow up. Rate of improvement in pain Scores at 6 and 12 months follow up was almost equal between the 3 grades of OA with no statistically significant difference.
Conclusions and Recommendations: Intra-articular injection of PRP in knee OA may be a valid alternative treatment for knee osteoarthritis. Intra-articular infiltration of autologous PRP under the conditions described in this study seems to be a safe, effective treatment for knee OA and does not require hospitalization or surgery.
Keywords: platelets rich plasma, knee osteoarthritis, elderly.
References
- Anitua E, Prado R, Padilla S, et al. (2016). Platelet-rich plasma therapy: another appealing technology for regenerative medicine? Regen Med. Jun; 11(4):355-7.
- Duymus TM, Mutlu S, Dernek B, et al., (2017). Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc. Feb; 25(2):485-492.
- Castell M V, Pas S, Otero A, et al (2015). Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on Osteoarthritis (EPOSA); BMC Musculoskelet Disord. 16: 351-359.
- Chang KV, Hung CY, Aliwarga F, et al., (2014). Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic review and meta-analysis. Arch Phys Med Rehabil. Mar; 95(3):562-75.
- Cole B.J., Karas V, Hussey K., et al., (2016). Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-Articular Biology for the Treatment of Knee Osteoarthritis Am J Sports Med Oct 21: 45 (2), 339-346.
- Forogh B, Mianehsaz E, Shoaee S, et al. (2016). Effect of single injection of platelet-rich plasma in comparison with corticosteroid on knee osteoarthritis: a double-blind randomized clinical trial. J Sports Med Phys Fitness.; 56(7-8):901-8.
- Freitag J, Bates D, Boyd R, et al (2016). Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy – a review. BMC Musculoskeletal Disorders. 17, 230. doi:10.1186/s12891-016-1085-9
- Boswell SG, Schnabel LV, Mohammed HO, et al. (2014). Increasing platelet concentrations in leukocyte-reduced platelet-rich plasma decrease collagen gene synthesis in tendons. Am J Sports Med. 42(1):42–9.
- Boyan, B. D., Tosi, L. L., Coutts, R. D., et al. (2013). Addressing the gaps: sex differences in osteoarthritis of the knee. Biology of Sex Differences, 4, 4.
- Braun HJ, Kim HJ, Chu CR, et al. (2014). The effect of platelet-rich plasma formulations and blood products on human synoviocytes: implications for intra-articular injury and therapy. Am J Sports Med. 42(5):1204–10
- Davis VL, Abukabda AB, Radio NM, et al. (2014). Platelet-rich preparations to improve healing. Part I: workable options for every size practice. J Oral Implantol; 40(4):500–10.
- Cooper, C., Rannou, F., Richette, P., et al. (2017). Use of Intra-Articular Hyaluronic Acid in the Management of Knee Osteoarthritis in Clinical Practice. Arthritis Care & Research. Accepted Author Manuscript. doi:10.1002/acr.23204
- Dold AP, Zywiel MG, Taylor DW et al, (2014).Theodoropoulos J. Platelet-rich plasma in the management of articular cartilage pathology: a systematic review. Clin J Sport Med. 24:31-43
- Musumeci G, Szychlinska MA and Mobasheri A (2015). Age related degeneration of articular cartilage in the pathogenesis of osteoarthritis: molecular markers of senescent chondrocytes. Histol Histopathol 30: 1-12.
- Çalış HT, Sutbeyaz ST, Guler E, et al. (2015). Efficacy of intra-articular autologous platelet rich plasma application in knee osteoarthritis. Arch Rheumatol. 30: 198–205
- Castañeda S, Roman-Blas JA, Largo R, et al, (2014). Osteoarthritis: a progressive disease with changing phenotypes. Rheumatology (Oxford). Jan; 53(1):1-3.
- Guo Y, Yu H, Yuan L, et al; (2016). Treatment of knee osteoarthritis with platelet-rich plasma plus hyaluronic acid in comparison with platelet-rich plasma only. Int J Clin Exp Med; 9(6):12085-12090
- Hassan AS, El-Shafey AM,. Ahmed HS, et al., (2015). Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis. The Egyptian Rheumatologist 37(3): 119–124.
- Lana J F S D, Vicente E F, Weglein A, et al, (2016). Platelet Rich Plasma in Musculoskeletal Practice, Platelet-Rich Plasma in Pain Medicine. Springer-Verlag, London. Chapter 2; pp 30- 62.
- Filardo G, Di Matteo B, Di Martino A, et al., (2015). Platelet-Rich Plasma Intra-Articular Knee Injections Show No Superiority Versus Viscosupplementation: A Randomized Controlled Trial. Am J Sports Med.; 43(7):1575-82
- Filardo G, Kon E, Roffi A, et al, (2015). Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRPfor joint degeneration. Knee Surg Sports Traumatol Arthrosc. 23(9):2459–2474.
- Hunter D (2014). Atlas of Osteoarthritis; Epidemiology of osteoarthritis, Springer Healthcare, London, UK. Chapter 6; pp 83:99.
- Iaccarino MA and Borg-Stein J (2016). Platelet Rich Plasma in Musculoskeletal Practice. Platelet-Rich Plasma in Knee Osteoarthritis in the Athlete. Chapter 6, pp 123-146.
- Joshi Jubert N., Rodríguez, L., Reverté-Vinaixa, M. M., et al. (2017). Platelet-Rich Plasma Injections for Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-Blinded Clinical Trial. Orthopaedic Journal of Sports Medicine, 5(2), 2325967116689386.
- Kavadar G, Demircioglu DT., Celik MY., ET AL., (2015). Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. J Phys Ther Sci. Dec; 27(12): 3863–3867.
- Kawano M M, Araújo I L, Castro M C, et al. (2015). Assessment of quality of life in patients with knee osteoarthritis. Acta OrtopedicaBrasileira, 23(6), 307–310.
Corresponding Author
Maram Maher Monier
Department of Geriatrics and Gerontology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.89
