FUNCTIONAL OUTCOME IN EARLY OSTEOARTHRITIS OF KNEE WITH TWO DOSES OF PLATELET RICH PLASMA OUR EXPERIENCE.

Abstract

Background: Osteoarthritis (OA) is a degenerative disorder of synovial joints in which there is gradual softening and disintegration of articular cartilage accompanied by the new growth of cartilage and bone at the joint margins(Osteophytes), cyst formation and sclerosis in the subchondral bone, mild synovitis, and capsular brosis. It differs from simple wear and tears in that it is asymmetrically distributed, often localized to only one part of a joint i.e., weight bearing, and often associated with abnormal loading rather than frictional wear. It is a dynamic phenomenon and shows features of both destruction and repair. Cartilage softening and disintegration are accompanied from the very outset by hyperactive new bone formation, osteophyte formation and remodeling. Osteoarthritis is an age-related phenomenon, and it affects more than 80% of people greater than 55 years of age. Body mass index (BMI) plays a vital role in osteoarthritis in weight-bearing joints. People with obese or overweight were approximately 4.6 times more likely to have knee OA than normalweight individuals. In addition people with metabolic and endocrine disorders are also more prone for osteoarthritis at an early age. Methods: Sixty patients suffering from grade1and 2 osteoarthritis knee joint who attended the outpatient department of orthopaedics, King George hospital, Visakhapatnam between November 2018 to October 2020 were included in the study. Informed and written consent was taken from the patients. General physical examination was done. Neurovascular status of both lower limbs was also examined. X-ray of both knee joints in antero-posterior and lateral views were taken in standing position. Routine pre-injection WOMAC and VAS score were recorded. Under aseptic conditions, two platelet-rich plasma (PRP) injections were injected into the knee joint at four weeks interval. Functional status of the knee was evaluated using WOMAC and VAS score at one, three and six week's interval. This study is a anlyticl comparative study. Results: There is a signicant difference in the VAS score and WOMAC score before giving an injection and after giving an injection, in patients with grade 1 and grade 2 osteoarthritis. The visual analogue score showed a mean of 7.16 at pre-injection period, which decreased to 5.95 at 1st week and 4.81 at 3rd week and 4.06 at six weeks follow up. Conclusion: In the present study the effectiveness of two aliquots of PRP injection was evaluated. Although studies including more than 2 PRP injections and more advanced stages of osteoarthritis were compared, the time frame was xed to 6 weeks. The functional outcome of the patient was better after 2nd dose of PRP. The present study concluded that two doses of PRP injection decreases the joint pain, alleviates the symptoms and enhances the activity of daily living and quality of life in short term duration.