Abstract
Purpose: The purpose of this study was to estimate the effect of platelet-rich plasma (PRP) augmentation in microfractures of chondral lesions in elderly individuals. Methods: 29 patients with knee osteoarthritis were enrolled in the single-blinded randomized study. The study group consisted of 16 patients and 13 were in the control group. All surgeries were performed in the same manner. The PRP injection was made in a dry arthroscopy directly over the microfractures. The evaluation was performed preoperatively on the 6th, 12th, and 24th week following the surgery. WOMAC and Lysholm questionnaires were utilized. Results: Microfracturation showed WOMAC improvement in the PRP group (p = 0.0012) and in the control group (p = 0.0042). No statistically significant differences between the two groups (p = 0.698) have been found. Clinical improvement was noted in the first six weeks after which the effect lasted. In addition, Lysholm score showed no significant differences at the end of the follow-up between both groups (p = 0.941). Conclusions: Arthroscopic microfracture improves motor function and reduces pain in patients over 50 years old. PRP augmentation of the procedure is safe, and can accelerate and prolong the therapeutic effect of treatment. Excellent effects of the procedure are observed in the first six weeks, after which the improvement lasts.
Highlights
Osteoarthritis [OA] is a complex process, in which degenerative changes appearing in articular cartilage [AC], subchondral bone, or synovial membrane can lead to joint failure [1]
The cohort consisted of patients from the outpatient clinic of District Hospital in Leczna (Kranystawska 52 St. 21-010 Łeczna, Poland) who had persistent pain in knee joints with early osteoarthritic changes estimated in Kellgren-Lawrence 1–2
Based on the assumptions that administration of platelet-rich plasma (PRP) improves the mechanical and histological properties of the cartilage covering the defect, the study reported in this work set out to investigate the clinical effect of PRP augmentation of arthroscopic microfractures in elderly population
Summary
Osteoarthritis [OA] is a complex process, in which degenerative changes appearing in articular cartilage [AC], subchondral bone, or synovial membrane can lead to joint failure [1]. Hyaline cartilage is the main component of every synovial joint; due to its function and structure, it has a very limited capacity for healing [2]. Once the cartilage is damaged, the joint is predisposed to rapid osteoarthritis changes, which lead to irreversible joint failure [2]. OA is mainly considered as a disease of older people, as over one-third of the population over 65 years old present OA in at least one joint [3]; factors such as obesity, sports, genetic factors, work, previous injuries or socio-economic status can influence osteoarthritic changes in the joint [4,5] in younger populations.
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