An Assessment of the effect of Platelet Rich Plasma in the Osteoarthritis of the Knee

Abstract

Introduction: Osteoarthritis (OA) is estimated to be the fourth leading cause of disability. With prevalence as high as 17 to 60.6%. With a 100% increase in prevalence of knee osteoarthritis since the mid-20th century. No specific cure for OA appears to exist. Most of the patients have no option but to undergo joint replacement surgery which again is an option not without risk and limitations. Therefore, there is need for a treatment option which could avoid or delay a joint replacement and make patient comfortable till surgery becomes an absolute indication. The available interventional therapies are visco-supplementation and PRP therapy which help in delaying the disease progression. This study was undertaken with the aim to assess the functional outcome of the therapeutic values of Platelet Rich Plasma (PRP) in knee osteoarthritis. Materials and Method: The present study was conducted in the Department of Orthopaedics, Rohilkhand Medical College, Bareilly. All the patients affected by a Unilateral or Bilateral knee osteoarthritis of all radiological grades (grade 1-4), attending the department from November 2016 to October 2017 were invited to participate in the study. It is a prospectivestudy of 50 cases. The patients were administered with 3 doses of intra-articular PRP and were followed up till 6 months post PRP therapy. The cases of knee OA were radiologically classified by the Kellegren Lawrence Grade. The functional outcome in the patients was assessed by the WOMAC, IKDC and VAS scores. Results: A significant change in WOMAC score was observed. The range of change in WOMAC score at 1 week to 6 months follow-up was 9.85% to 24.84%. Changes in WOMAC score at all the follow up visits were statistically significant (p<0.001).A subsequent decline in pre-treatment VAS score (Pain) was also observed at follow up visits at 1 week (1.15±0.69; 18.18%), 3 months (2.07±1.03; 32.63%) and 6 months (2.29±1.29; 36.14%). Conclusion: PRP is a very good alternative treatment modality in patients with knee OA from KL grade 1 to grade 3 to delay the progression of the disease and also it provided significant symptomatic improvement along with improvement in the functional outcome of the patients without any severe side-effects.