Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee Osteoarthritis: A Prospective Routine Care Study.

Caroline Guillibert,Denis Arniaud,Jeremy Magalon,Roch Giorgi,Georges El Ghobeira,Caroline Charpin,Marie Raffray,Annie Benmenni,Francois-Xavier Dehaut

doi:10.3390/ijms20061327

Abstract

Background: Evidence is growing regarding the ability of platelet-rich plasma (PRP) injections to enhance functional capacity and alleviate pain in knee osteoarthritis (OA). However, heterogeneity in common practice regarding PRP preparation and biological content makes the initiation of this activity in a hospital complex. The aim of this study was to document the efficacy of a single PRP injection to treat knee OA and validate a routine care procedure. Methods: Fifty-seven patients with symptomatic knee OA received a single injection of large volume of very pure PRP. They were assessed at baseline and after one, three and six months, by measuring Knee Injury and Osteoarthritis Score (KOOS), Observed Pain after a 50-foot walk test and Visual Analog Scale (VAS) assessments. Magnetic Resonance Imaging (MRI) analysis was performed at baseline and six months after the procedure. The objective was to recover 50% of responders three months after the procedure using OMERACT-OARSI criteria. Results: A single administration of high volume pure PRP provided significant clinical benefit for 84.2% of the responders, three months after the procedure. The KOOS total score significantly increased from 43.5 ± 14.3 to 66.4 ± 21.7 six months after the procedure (p < 0.001). Pain also significantly decreased from 37.5 ± 25.1 to 12.9 ± 20.9 (p < 0.001). No difference was observed on MRI parameters. Conclusion: A single injection of large volume of very pure PRP is associated with significant functional improvement and pain relief, allowing initiation of daily PRP injection within our hospital.

Highlights

Osteoarthritis (OA) of the knee is a progressive joint disease involving the intra-articular (IA) tibiofemoral and patellofemoral cartilage and all surrounding IA and periarticular structures [1]
Single administration of high volume of autologous pure platelet-rich plasma (PRP) provided significant clinical benefit to more than 80% of responders at three months according to OMERACT-OARSI definition, in patients presenting knee OA in stage 2 or 3 according Kellgren–Laurence scale
The therapeutic schema was different as the 10 randomized clinical trial (RCT) selected in that meta-analysis included multiple PRP injections whereas one of the originality of our study was to perform a single large volume PRP injection

Summary

Introduction

Osteoarthritis (OA) of the knee is a progressive joint disease involving the intra-articular (IA) tibiofemoral and patellofemoral cartilage and all surrounding IA and periarticular structures [1]. The American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines provide evidence against HA viscosupplementation injections in patients with symptomatic knee OA [8]. This situation has led to the emergence of cell-based therapy options called orthobiologics. They were assessed at baseline and after one, three and six months, by measuring Knee Injury and Osteoarthritis Score (KOOS), Observed Pain after a 50-foot walk test and Visual Analog Scale (VAS) assessments. Results: A single administration of high volume pure PRP provided significant clinical benefit for 84.2% of the responders, three months after the procedure. Conclusion: A single injection of large volume of very pure PRP is associated with significant functional improvement and pain relief, allowing initiation of daily PRP injection within our hospital

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Conclusion