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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 October;62(5):331-6
Platelet rich plasma in osteoarthritis
Gobbi A., Malchira S., Karnatzikos G.
OASI Bioresearch Foundation, NPO, Milan, Italy
AIM: The aim of this study was to determine the efficacy of platelet rich plasma (PRP) treatment in active patients with symptomatic pre-arthritic knees and to compare the two groups of patients with or without previous operative intervention.
METHODS:We prospectively followed up 80 patients with symptomatic prearthritic knees (mean age 47.7 years) for a minimum follow-up of 12 months. All patients were treated with two intra-articular injections (one monthly) with autologous PRP. Forty patients (S1 group) underwent a previous operative intervention for cartilage lesions whereas 40 patients (S2 group) did not undergo any previous operative intervention. We divided our patients according to previous operative intervention into S1a (cartilage shaving) and S1b (microfracture) subgroups. KOOS, VAS, Tegner, IKDC and MARX scores were collected at pre-treatment evaluation and at 6 and 12 months following treatment. Non-parametric analysis was performed with the Wilcoxon rank test to compare the variations of the scores from pretreatment to 6 and 12 months; non-parametric Mann-Whitney U test was performed to analyse difference in improvement between the S1 and S2 group, S1a and S1b subgroups and between males and females. All reported P-values were two tailed, with an alpha level of 0.05 indicating significance.
RESULTS:Patients in both groups showed significant improvement in all the scores at final follow up (P<0.005) and returned to previous activities. There was significant difference in improvement between S1 and S2 group in VAS score, which showed higher reduction in S1 group, in KOOS (Sport) from pre-treatment to 6 month follow up and in KOOS (QOL) from 6 to 12 month follow-up scores, which showed higher improvement in S2 group. There was no significant difference in improvement between S1a and S1b subgroups as well as between males and females.
CONCLUSION:This study shows that PRP treatment is effective both in operated and non-operated pre-arthritic knees and can act as a preventive agent of OA, by diminishing pain and improving symptoms and quality of life.