Official publication of Rawalpindi Medical University
Comparison of Intra-articular Platelet Rich Plasma versus Corticosteroid Injections for the Treatment of Moderate Knee Osteoarthritis

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Keywords

Corticosteroids, intra-articular injections, knee osteoarthritis, knee pain, osteoarthritis, platelet rich plasma, prednisolone acetate.

How to Cite

1.
Napar AR, Solangi NA, Shahni MA, Ghumro H, Jumani NA, Hussain A. Comparison of Intra-articular Platelet Rich Plasma versus Corticosteroid Injections for the Treatment of Moderate Knee Osteoarthritis. JRMC [Internet]. 2023 Apr. 1 [cited 2024 Jun. 14];27(1). Available from: http://www.journalrmc.com/index.php/JRMC/article/view/2016

Abstract

Objective:  To compare the efficacy of intra-articular injections of prednisolone acetate and platelet rich plasma in cases of moderate knee osteoarthritis.

Study design: Prospective comparative study.

Place and Duration of study: Department of Orthopedic Surgery, Khairpur Medical College, Khairpur Mirs, from January 2021 till December 2021

Methodology: A total of 100 patients were selected for the study and were randomly divided into two equal groups. Group C patients received intra-articular corticosteroid injection along with local anesthetic (Prednisolone acetate 40 mg + 3 ml of 0.5% bupivacaine) under ultrasound guidance. Group P patients received 3 injections of PRP, each of 8 ml volume given at one week’s interval. Patients with signs of hemodynamic compromise, sepsis, past history of any intra-articular injection in the same joint were also excluded from the study. Follow up of patients was carried out at 1, 3 and 6 months. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scale was used to assess the patients prior to injection and then at each follow up. WOMAC scale consists of three subsets i-e pain, stiffness and physical function.

Results: Demographic data was comparable between both groups. Pre-injection WOMAC score in group C and P was 71.54±12.18 and 75.20±8.58 respectively (p-value=0.086); after one month of injections, it was 34.20±10.48 and 35.38±6.31 respectively (p-value=0.580). After 3 months of injection, it was 33.20±8.13 and 31.10±5.50 respectively (p-value=0.195). After 6 months of injection, it was 35.32±10.41 and 32.10±6.63 respectively (p-value=0.68).

Conclusion: It is concluded in our study that intra-articular injections of prednisolone acetate and PRP are equally effective in patients of moderate knee osteoarthritis.

 

https://doi.org/10.37939/jrmc.v27i1.2016

References

Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis. JAMA. 2021; 325(6):568. doi:10.1001/jama.2020.22171.

Verges J, Vitaloni M, Bibas M, Sciortino R, Quintero M, Monfort J, et al. Global OA management begins with quality of life assessment in knee oa patients: A systematic review. Osteoarthritis and Cartilage. 2019; 27(1):S229-S230. doi:10.1016/j.joca.2019.02.358.

Sharma L. Knee osteoarthritis is highly prevalent among older adults. Treatments include exercise, weight management, training in self-efficacy and pain-coping skills, and medications (commonly topical or oral NSAIDs, the latter often with a proton-pump inhibitor). N Engl J Med 2021; 384(1):51-59. DOI: 10.1056/NEJMcp1903768.

Mora JC, Przkora R, Cruz-Almeida Y. Knee osteoarthritis: Pathophysiology and current treatment modalities. Journal of Pain Research. 2018;11(1):2189-2196. doi:10.2147/jpr.s154002.

Benis S, Vanhove W, Van Tongel A, Hollevoet N. Non-traumatic primary and secondary osteoarthritis of the distal radioulnar joint. Journal of Hand Surgery (European Volume). 2019; 44(9):951-956. doi:10.1177/1753193419867843.

Kohn MD., Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clinical Orthopaedics & Related Research, 2016; 474(8):1886-1893. doi:10.1007/s11999-016-4732-4.

Jordan KM, Sawyer SP, Coakley HE, Smith C, Cooper NK, Arden. The use of conventional and complementary treatments for knee osteoarthritis in the community. Rheumatology. 2004; 43(3):381–384. https://doi.org/10.1093/rheumatology/keh045.

Jones IA, Togashi R, Wilson ML, et al. Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol. 2010; 15(1):77–90. https://doi.org/10.1038/s41584-018-0123-4.

McLarnon M, Heron N. Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: Systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2021; 22(1):1-13. doi:10.1186/s12891-021-04308-3.

Carlos J. Meheux PC. McCulloch DM. Lintner KE, Varner JD, Joshua DH. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2016; 32(3):495-505. https://doi.org/10.1016/j.arthro.2015.08.005.

Western Ontario and McMaster Universities osteooarthritis index [Internet]. [cited 2022Aug25]. Available from: https://www.princetonhcs.org/-/media/files/forms/princeton-rehabilitation/womac.pdf.

Moskowitz RW. The burden of osteoarthritis: clinical and quality-of-life issues. Am J Manag Care. 2009;15(8 Suppl):S223-9.

Elksniņš-Finogejevs A, Vidal L, Peredistijs A. Intra-articular platelet-rich plasma vs corticosteroids in the treatment of moderate knee osteoarthritis: A single-center prospective randomized controlled study with a 1-year follow up. Journal of Orthopaedic Surgery and Research. 2020; 15(1):1-10. doi:10.1186/s13018-020-01753-z.

Chen P, Huang L, Ma Y, Zhang D, Zhang X, Zhou J, et al. Intra-articular platelet-rich plasma injection for knee osteoarthritis: A summary of meta-analyses. Journal of Orthopaedic Surgery and Research. 2019; 14(1):1-11. doi:10.1186/s13018-019-1363-y.

Roos EM, Klässbo M, Lohmander LS. WOMAC osteoarthritis index: Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Scandinavian Journal of Rheumatology. 1999; 28(4):210-215. doi:10.1080/03009749950155562.

Huang Y, Liu X, Xu X, Liu J. Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis : A prospective randomized controlled study: A prospective randomized controlled study. Orthopade [Internet]. 2019; 48(3):239–47.: doi.org/10.1007/s00132-018-03659-5.

Forogh B, Mianehsaz E, Shoaee S, Ahadi T, Raissi GR, Sajadi S et al. Effect of Single Injection of Platelet-rich Plasma in Comparison with Corticosteroid on Knee Osteoarthritis: Double-blind Randomized Clinical Trial. J Sports Med and Phys Fitness. 2015; 56(7-8):901-908.

Migliorini F, Driessen A, Quack V, Sippel N, Cooper B, Mansy YE, et al. Comparison between intra-articular infiltrations of placebo, steroids, hyaluronic and PRP for knee osteoarthritis: a Bayesian network meta-analysis. Arch Orthop Trauma Surg. 2021;141(9):1473–90. doi.org/10.1007/s00402-020-03551-y.

Sohail A, Zaid A, Feroz S, Saeed M, Naseer S, Sultan, M. COMPARISON OF PAIN RELIEF EFFICACY OF PLATELET-RICH PLASMA VERSUS CORTICOSTEROIDS IN KNEE OSTEOARTHRITIS. PAFMJ. 2021; 71(5):1764-68. https://doi.org/10.51253/pafmj.v71i5.4135.

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Copyright (c) 2023 Abdul Rasheed Napar, Naveed Ahmed Solangi, Mehtab Shahni, Hafeezullah Ghumro, Naveed Ahmed Jumani, Aftab Hussain