Role of biologics – Platelet-rich plasma in treatment of moderate osteoarthritis of the knee

Abstract

Background: Osteoarthritis is a degenerative disease of the joints which involves cartilage. Osteoarthitis of the knees is the most common joint disease. It is a chronic progressive degenerative disease. It affects 30% of the people having an age more than 50 years. Various studies have shown that osteoarthritis leads to a major burden on the economy of many developing countries. The basis for biologics such as platelet-rich plasma (PRP) therapy in osteoarthritis of knees is the stimulation of the natural healing and regeneration due to the presence of large number of platelet-derived growth factors directly at the site of treatment. There is a lack of clarity regarding the number and frequency of injections for proper effectiveness as well as the ideal treatment for different stages of In our study, we have tried to analyze PRP as a treatment modality in osteoarthritis of the knee. Materials and Methods: Thirty patients of osteoarthritis of bilateral knees and who fulfilled inclusion criteria and were managed with two sessions of intra-articular PRP infiltration 3 months apart between the duration May 2018 and May 2020 were included in our study. Maximum follow-up was done for 8 months. Functional assessment was done with the help of the Western Ontario and McMaster Universities (WOMAC) score and Visual Analogue Scale (VAS) score. Results: The mean age group of the patients in our study was 53.9 years. Out of 30 patients, 13 (43.333%) were males and 17 (56.666%) were females. Out of 30 patients, 9 patients (30%) had Grade I osteoarthritis of knees according to Kelgren-Lawrence grading, while 16 (53.333%) had Grade II and 5 (16.666%) had Grade III osteoarthritis, i.e., majority of the patients had Grade II osteoarthritis. The mean ± 2 standard deviation WOMAC scores before intervention, at 1-month follow-up, 3-month follow–up, and 8-month follow-up are 49.833 ± 5.854, 40.103 ± 8.08, 30.033 ± 6.976, and 19.666 ± 4.26, respectively. The mean VAS scores before intervention, at 1-month follow-up, 3-month follow–up, and 8-month follow-up are 4.4, 3.2, 2.9, and 2.5, respectively. There were no major complications in our study. The complication rate of our study was 6.6667%, i.e., only two patients had complications. Out of 30 patients, 24 (80%) were satisfied with this treatment modality, 3 (10%) were partially satisfied, and 3 (10%) were not satisfied. Discussion: Even though the results and observations of our study are comparable with other studies on this subject, there are some limitations in our study like short duration of follow-up, lack of radiological modalities for judging functional outcome, and small sample size. Conclusion: Multiple (2) intra-articular PRP injections are a new modality in the treatment of early osteoarthritis. In our study, symptomatic and functional improvement was seen in cases of bilateral early osteoarthritis. This technique is cost-friendly and has very low complications rates. Hence, this modality can be used in the treatment of early osteoarthritis as an alternative to other established modalities.