Abstract

Introduction/objectivesIntra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane® (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA.MethodFifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up.ResultsMean age was 55.8 ± 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p < 0.05). There were no statistically significant differences between the groups in terms of first week pain relief (p > 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group’s rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group.ConclusionAs a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group.Key Points• The short-term effects of intra-articular HA, peptide, and PRP injections were compared in knee osteoarthritis.• HA, peptide, and PRP injections may be useful in pain relief and functional improvement in knee osteoarthritis.

Highlights

  • Knee osteoarthritis (OA) is the most common cause of chronic arthritis and is associated with severe pain, disability, loss of function, and adverse effects on quality of life [1,2,3]

  • Alpha granules consist of various growth factors (GFs) that can effectively promote articular cartilage repair, such as plateletderived GF (PGDF), transforming GF (TGF-β), plateletderived epidermal GF, vascular endothelial GF, insulin-like GF-1, fibroblastic GF, and epidermal GF

  • Patients were selected from 120 patients who admitted to the outpatient clinic of a hospital with symptomatic knee osteoarthritis between January 2018 and June 2018

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Summary

Introduction

Knee osteoarthritis (OA) is the most common cause of chronic arthritis and is associated with severe pain, disability, loss of function, and adverse effects on quality of life [1,2,3]. There are conflicting results about intra-articular hyaluronic acid (HA) injections [10, 11]. Intra-articular PRP injections are widely used all over the world [4, 7,8,9,10,11,12,13]. PRP content contains more than 1500 active proteins, including alpha and dense granules. These platelet-derived mediators have anti-inflammatory, proinflammatory, anabolic, and catabolic effects [4, 7,8,9,10,11,12,13]. Dense granules contain regenerative molecules for damaged tissues, such as adenosine diphosphate, adenosine triphosphate, calcium, histamine, serotonin, and dopamine [12,13,14]

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