Abstract

(1) Background: The emergence of injectable “biologic” medication creates a new approach to treat osteoarthritis (OA). Among them, the use of intra-articular injection of PRP became widespread despite the absence of consensus regarding its optimal composition. The aim of this study was to retrospectively correlate an extensive biological characterization of injected PRP to the clinical responses of patients presenting knee OA. (2) Methods: This retrospective study included 75 patients with knee OA. Cartilage lesions were assessed using magnetic resonance imaging and the International Cartilage Regeneration Society (ICRS) classification. PRP extensive biological characterization was performed and patients’ subjective symptoms were recorded before injection and 3 and 6 months after injection using the Knee injury and Osteoarthritis Outcome Score (KOOS). Responders were defined by an improvement of 10 points on KOOS. (3) Results: At 6 months, 63.0% of the patients were responders. Impairment was characterized by a significantly higher proportion of patients with three compartments altered at baseline MRI and receiving a significantly higher dose of platelets compared to responders. (4) Conclusions: Single injection of pure PRP resulted in significant clinical improvement in the management of knee OA. Both baseline MRI and PRP biological features may be predictive factors of the clinical response, highlighting that a better understanding of action mechanism of PRP is still required.

Highlights

  • Radiographic evaluation revealed that majority of the patients had a grade II (22 patients; 29.0%) or III (38 patients; 51.5%) Knee osteoarthritis (KOA) according to Kellgren and Lawrence (KL) scale whereas 5 (6.5%) and 10 (13.0%) patients presented a grade I or IV, respectively

  • This study differs from the current one on several points: (i) the responder’s definition was based on Knee injury and Osteoarthritis Outcome Score (KOOS) score but using the OMERACT OARSI criteria

  • This aspect is of importance as knee injection should take into account of the articular capacity of the knee in order to favor a better distribution of platelet-rich plasma (PRP) throughout the joint

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Summary

Introduction

Osteoarthritis (OA) is a degenerative joint pathology of the cartilage This highly prevalent multifactorial musculoskeletal disorder represents a substantial burden for the health-care system [1]. A combination of non-pharmacological approaches such as dietary supplements, muscle strengthening exercises and pharmacological therapies (including analgesics, non-steroid anti-inflammatory (NSAI) drugs and corticosteroid or hyaluronic acid (HA) injections) is prescribed [5]. This provides only temporary benefits and could be associated with side effects for corticosteroids especially a decrease cartilage volume, systemic effects (hyperglycemia, warmth, flushing of the skin) and risk of subsequent infections [6,7]

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