Intra-articular PRP Injections Research Articles

Comparison of the effectiveness of temporomandibular joint osteoarthritis treatment with corticosteroids, hyaluronic acid, and platelet-rich plasma mono-therapy

The prevalence of temporomandibular joint (TMJ) osteoarthritis is 18–85 % of all TMJ dysfunctional conditions. Most patients are elderly, especially women. Today, intra-articular injections are often used for treatment, so it is necessary to study the effectiveness of drug administration on the course of the disease. The number of studies on the effectiveness of certain drugs most commonly used to treat TMJ osteoarthritis is limited, that does not allow correct treatment planning in each individual case. Aim: to evaluate the effectiveness of TMJ osteoarthritis treatment with monotherapy with hyaluronic acid, corticosteroids, and platelet-rich plasma. Materials and methods. We included 90 patients who received intra-articular injections. Patients were randomly divided into 3 groups: group I, which received platelet-rich plasma (PRP, n = 30), group II, which received hyaluronic acid (HA, n = 30), group III, which received corticosteroids (CS, n = 30). To objectively evaluate the effectiveness of TMJ osteoarthritis treatment with monotherapy of hyaluronic acid, corticosteroids and platelet-rich plasma, the following indicators were used: filling in the visual analogue pain scale, maximum mouth opening (mm) and cortical plate density of the articular head of the mandible according to the Hounsfield scale using CBCT. Results. PRP therapy demonstrated the highest efficacy in the form of monotherapy for all study parameters (p < 0.05). The fastest pain reduction was achieved with the use of corticosteroids (p < 0.05). In general, during the treatment period, the reduction of pain according to the visual analogue scale in group I was 85.71 %. In patients of group II (HA) and group III (CS) – by 71.42 %. Maximum mouth opening after treatment in group I increased by 24.32 %, in group II – by 15.79 %, in group III – by 18.92 %. The density of the articular head according to the Hounsfield scale after treatment in group I increased by 12.56 %, in group II – by 6.97 %, in group III – by 4.87 %. Conclusions. All of the studied drugs demonstrated a positive effect on the treatment of TMJ osteoarthritis, but monotherapy with intra-articular PRP injections demonstrated the highest effectiveness according to the studied parameters (p < 0.05).

Efficacy of Platelet-Rich Plasma Versus Hyaluronic Acid in Symptomatic Knee Osteoarthritis

Background: Osteoarthritis (OA) is one of the most common forms of arthritis and leading causes of disability. Intra-articular injection of PRP or steroid may provide benefit for patients suffering from osteoarthritis of knees, preventing, and delaying the need of a larger operative measures as many of the senile patients suffering from OA knee are quite hesitant to undergo any operative measure for the same. Materials and Methods: This was prospective type of study, with randomised selection of the patients for the assessment of outcome of treatment of symptomatic knee osteoarthritis with intra articular injections of PRP or hyaluronic acid. This study was carried out in the department of orthopaedics at our institute. In this study both injections given superolaterally weekly for 3 weeks. Study conducted over 2 years, a total of 50 patients suffering from OA knee were included in the study depending upon inclusion criteria. These patients were randomly selected for injection in a sequential manner i.e., case number 1,3,5,7 and so on sequentially were given injection HA. Case number 2,4,6,8 and so on sequentially were given injection PRP. Patients were evaluated prospectively at enrolment and at 6 weeks, 3 and 6-months follow-up with WOMAC and KSS scores. Results: PRP seems to be more efficient as compared to HA in salvaging knee in osteoarthritis. It can work as a salvaging agent in mild to moderate osteoarthritis of knee. HA injection has been found to be effective only in short term cases. Conclusion: The clinical results of this study show that both these non-surgical modalities (intraarticular injections of PRP or HA) are useful for the treatment of osteoarthritis of knee. Treatment with PRP shows significantly better outcome compared with HA group; with respect to WOMAC and KSS scores.

Efficacy of intra-articular platelet -rich plasma in osteoarthritis knee

: Knee osteoarthritis is prevalent globally among the aged adults with an ageing and increasingly obese population. It is also the second leading cause of disability and a heavy economic and social burden. The aim of this study is to analyse the efficacy of intra articular PRP injections in knee osteoarthritis. : This study is a prospective randomised controlled trial with duration of 6 months upon a sample size of 50 people with a diagnosis of Knee Osteoarthritis in which 2 injections of PRP were given 4 weeks apart and its result was analysed at 3 months and compared with initial pre-administration levels.: In a study with 50 participants (50% males, mean age 59.02 years), intra-articular PRP injections showed significant improvement in WOMAC scores for pain (75.5% to 41.1%), stiffness (84.5% to 57.5%), and physical function (46.2% to 78.2%) at 3 months. No side effects were reported. Visual Analog scale indicated a notable decrease in pain (7.44 to 4.8).: In conclusion, the administration of PRP injections showed substantial decrease in pain and other associated symptoms and an increase in physical function.

Comparative efficacy of platelet-rich plasma and dextrose prolotherapy for stifle joint arthritis in a rabbit model

This study aimed to investigate the efficacy of PRP and dextrose PRL in stifle joint arthritis in rabbits.Sixteen healthy adult male rabbits were allocated into groups A (n=8) and B (n=8). After induction of arthritis in all experimental animals, the animals of group A were treated with intra-articular injection of PRP, while the animals of group B were treated with dextrose PRL. Pain scoring was evaluated by the Simple Descriptive Pain scale at 0d, 6d, 13d, and 19d, while radiographic scoring was examined by Kellgren and Lawrence grading system at pre-induction, post-induction, and post-treatment. The hematological parameters, including PLT, HB, WBC, PCV, RBC, monocytes, and lymphocytes, were assessed in blood samples at 0d, 6d, 13d, and 19d. We observed that Pain scoring showed a significantly lower (P<0.05) value in group A than in group B at 13d and 19d. Radiographic scoring was significantly lower (P<0.05) in group A than the group B during post-treatment. However, during the pre- and post-monoiodoacetate (MIA) induction, there was no significant difference (P>0.05) in radiographic scoring between both groups. The PLT concentration was increased, and monocyte was decreased in the group A animals than the group B animals at 13d and 19d (P<0.05), while WBC, RBC, PCV, HB, and lymphocyte concentration showed no significant difference (P>0.05) between both groups. In conclusion, the application of PRP is an effective method for treating stifle joint arthritis compared to the dextrose PRL in the rabbit model.

Assessment of Pain and Functional Outcome between Intra-Articular Corticosteroids and Platelet Rich Plasma (Prp) in Treatment of Knee Osteoarthritis: A Prospective Observational Cohort Study

Background-Osteoarthritis is the most prevalent type of arthritis, which significantly impacts the patient’s mobility and quality of life. Although pharmacological treatments like corticosteroids can provide immediate pain relief and enhance mobility and quality of life for osteoarthritis patients, their long-term effectiveness is limited. Material and Method- Forty patients affected by symptomatic radiologically confirmed knee osteoarthritis (Kellgren Lawrence grades II–III) were enrolled in this study. In the study, 30 patients were assigned to the PRP group and received a 5 mL intra-articular injection of PRP, while another 30 patients were randomized to the corticosteroid group and received an intra-articular injection of triamcinolone acetonide (2 mL of 40 mg/mL) and lidocaine (3 mL of 2%). The VAS, IKDC, and WOMAC scales were used to evaluate pain and function of the target knee at baseline, 1.5 months, and 3 months after treatment.

Retracted: Intra-Articular Injection of PRP in the Treatment of Knee Osteoarthritis Using Big Data.

[This retracts the article DOI: 10.1155/2021/4504155.].

Assessment of Pain and Functional Outcome between Intra-Articular Corticosteroids and Platelet Rich Plasma (Prp) in Treatment of Knee Osteoarthritis: A Prospective Observational Cohort Study

Background-Osteoarthritis is the most prevalent type of arthritis, which significantly impacts the patient’s mobility and quality of life. Although pharmacological treatments like corticosteroids can provide immediate pain relief and enhance mobility and quality of life for osteoarthritis patients, their long-term effectiveness is limited. Material and Method- Forty patients affected by symptomatic radiologically confirmed knee osteoarthritis (Kellgren Lawrence grades II–III) were enrolled in this study. In the study, 30 patients were assigned to the PRP group and received a 5 mL intra-articular injection of PRP, while another 30 patients were randomized to the corticosteroid group and received an intra-articular injection of triamcinolone acetonide (2 mL of 40 mg/mL) and lidocaine (3 mL of 2%). The VAS, IKDC, and WOMAC scales were used to evaluate pain and function of the target knee at baseline, 1.5 months, and 3 months after treatment.

Assessment of Pain and Functional Outcome between Intra-Articular Corticosteroids and Platelet Rich Plasma (Prp) in Treatment of Knee Osteoarthritis: A Prospective Observational Cohort Study

Background-Osteoarthritis is the most prevalent type of arthritis, which significantly impacts the patient’s mobility and quality of life. Although pharmacological treatments like corticosteroids can provide immediate pain relief and enhance mobility and quality of life for osteoarthritis patients, their long-term effectiveness is limited. Material and Method- Forty patients affected by symptomatic radiologically confirmed knee osteoarthritis (Kellgren Lawrence grades II–III) were enrolled in this study. In the study, 30 patients were assigned to the PRP group and received a 5 mL intra-articular injection of PRP, while another 30 patients were randomized to the corticosteroid group and received an intra-articular injection of triamcinolone acetonide (2 mL of 40 mg/mL) and lidocaine (3 mL of 2%). The VAS, IKDC, and WOMAC scales were used to evaluate pain and function of the target knee at baseline, 1.5 months, and 3 months after treatment

Intra-articular platelet-rich plasma injection versus hydrocortisone with local anesthetic injections for temporo mandibular disorders.

Disorders of temporomandibular joint (TMDs) are characterised by a variety of symptoms, including discomfort in the orofacial region, muscle tenderness, restricted jaw motion and noise at the joint. Additional neurological symptoms such as headaches, vertigo, heaviness, and altered vision may also coexist with TMDs. Because prostaglandin production is a critical mediator of inflammatory reaction and is inhibited by corticosteroids, they have anti-inflammatory effects. Platelet rich plasma popularly considered as PRP is a concentration of platelets and related growth factors that may have therapeutic effects by attracting, promoting, and differentiating cells as well as redesigning tissue. 64 joints totaling 40 individuals with temporomandibular joint problems were split into two categories (Category A and Category B). PRP was applied to category A's (36 joints of 20 patients) joints, while Group B's joints received hydrocortisone combined with local anaesthetic (28 joints of 20 patients). Patients were evaluated for tenderness, , maximum inter incisal opening (MIO) and clicking sound at TMJ prior to and following treatment at intervals of one week, one month and 6 months of the first week and third month. When there was comparison of outcomes in study participants receiving injections of platelet rich plasma and study participants receiving injections of hydrocortisone with local anesthetic then it was found that although both type of study participants got reduction in pain, increased opening of mouth and reduction in clicking sound however the difference between two groups was not significant statistically. There was no statistically significant difference between injections of platelet rich plasma and hydrocortisone with local anesthetic solution regarding outcomes in disorders of temporomandibular joint, however the results were slightly better in study participants receiving platelet rich plasma injections. This study demonstrated that while treating patients with TMJ issues, local anaesthesia combined with hydrocortisone as well as intra-articular injection of PRP help in reduction in pain, increase mouth opening, and minimize joint sound. Additionally, it was discovered that intra-articular injection of PRP was more successful in treating patients in this trial than local anaesthetic combined with hydrocortisone.

Clinical outcome and risk factor predictive for failure of autologous PRP injections for low-to-moderate knee osteoarthritis.

To report the 5-year clinical efficacy of PRP intra articular injections in knee osteoarthritis (OA) and to investigate the risk factors predictive for treatment failure and poor clinical outcome. We retrospectively evaluated 118 patients treated for low to moderate knee OA demonstrated by X-Ray and magnetic resonance imaging (MRI) with autologous PRP injection from 2014 to 2018 with a mean 51.1 ± 14.8 (range 29 to 89) months follow-up. All the patients were evaluated with Lysholm and WOMAC score. The role of Kellgren Lawrence (KL) grade, patello-femoral (PF) degeneration, age, body mass index (BMI), relevant comorbilities, smoking status, gender, previous surgery or conservative measures were analyzed with univariate and multivariate analysis. There was a significant improvement of all outcome measures at final follow-up and high satisfaction rate (79.7%). The overall failure rate was of 15.3% after a mean of 57.7 ± 15.1 (range 33 to 85) months. The BMI and the KL grade were identified as significant independent risk factor related to failure of autologous PRP injection. Patients under 60 reported significantly higher Tegner activity scale (p = 0.032) at final follow-up. Patients with KL grade 3 and patients with PF MRI-KL grade 3 had significantly lower Lysholm scores (p = 0.026 and p = 0.042 respectively) at final assessment. Younger patients with lower BMI and lower grade of radiographic OA had significantly longer therapeutic benefit (p < 0.05). Intra articular PRP injections led to a significant clinical improvement in middle-aged adults with a low to moderate knee OA. BMI and high KL grade have been identified as significant risk factors predictive for failure at mid-term follow-up.

A Retrospective Analysis of Characteristic Features of Responders and Impaired Patients to a Single Injection of Pure Platelet-Rich Plasma in Knee Osteoarthritis.

(1) Background: The emergence of injectable “biologic” medication creates a new approach to treat osteoarthritis (OA). Among them, the use of intra-articular injection of PRP became widespread despite the absence of consensus regarding its optimal composition. The aim of this study was to retrospectively correlate an extensive biological characterization of injected PRP to the clinical responses of patients presenting knee OA. (2) Methods: This retrospective study included 75 patients with knee OA. Cartilage lesions were assessed using magnetic resonance imaging and the International Cartilage Regeneration Society (ICRS) classification. PRP extensive biological characterization was performed and patients’ subjective symptoms were recorded before injection and 3 and 6 months after injection using the Knee injury and Osteoarthritis Outcome Score (KOOS). Responders were defined by an improvement of 10 points on KOOS. (3) Results: At 6 months, 63.0% of the patients were responders. Impairment was characterized by a significantly higher proportion of patients with three compartments altered at baseline MRI and receiving a significantly higher dose of platelets compared to responders. (4) Conclusions: Single injection of pure PRP resulted in significant clinical improvement in the management of knee OA. Both baseline MRI and PRP biological features may be predictive factors of the clinical response, highlighting that a better understanding of action mechanism of PRP is still required.

The application of platelet-rich plasma in the treatment of knee osteoarthritis: A literature review

BackgroundPrimary knee osteoarthritis remains a difficult-to-control degenerative disease. With the rise in average life expectancy and the incidence of obesity, osteoarthritis has brought an increasing economic and physical burden on people. This article summarizes the latest understanding of platelet-rich plasma in the treatment of knee osteoarthritis, and reviews the economic issues of PRP. MethodsThe literatures in Pubmed, Embase, Cochrane library, Web-science and other databases were searched, and literature inclusion and exclusion criteria were formulated. According to the Cochrane systematic reviewer's manual, the included literatures were grouped, and qualitative descriptions and quantitative meta-analysis were performed. Continuous statistical methods were used to compare the effects and adverse effects of PRP before and after treatment, as well as between PRP and other conservative treatments. ResultsA total of 12 randomized controlled trials were included in this study. A total of 959 KOA patients (1070 knees) were enrolled and followed for 3–12 months. PRP total knee scores were significantly better than baseline at 1, 2, 3, 6 and 12 months after treatment (1 month: SMD = 0.60, P < 0.01; 2 months: SMD = 0.98, P < 0.01; 3 months: SMD = 1.16, P < 0.01; 6 months: SMD = 1.49, P < 0.01; 12 months: SMD = 1.47, P < 0.01). In terms of adverse reactions, PRP did not increase the risk of adverse events compared with HA (OR = 0.96, P = 0.85). ConclusionsCompared with many other treatment methods, intra-articular injection of PRP has been proven to be safe and effective to improve the quality of life of patients with KOA.

Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up.

Objective: PRP is produced by centrifugation of whole blood containing highly concentrated platelets, associated growth factors, and other bioactive agents which has been shown to provide some symptomatic relief in early knee osteoarthritis (OA). The principal objective of our study was to evaluate the effectiveness and safety of standardized intra-articular injection of autologous PRP in early osteoarthritis knee. Methods: A total of 98 eligible symptomatic patients received two injections of standardized PRP 3 weeks apart. Clinical outcomes were evaluated using the VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, 6 months, and 1 year after treatment. Secondary objectives were safety (side effects), and the effect of PRP on the different grades of knee degeneration. Results: There was a statistically significant improvement in mean VAS and WOMAC scores at 6 weeks, 3 months, 6 months, and slight loss of improvement at 1 year follow-up. There was also a correlation between the degree of degeneration and improvement in the mean scores. The decrease in mean pain score is more in grades 1 and 2 (early OA) than in grade 3. The intraarticular injection is safe, with no major complications. Conclusion: PRP is a safe and effective biological regenerative therapy for early OA Knees. It provides a significant clinical improvement in patients with some loss of improvement with time. More studies will be needed to confirm our findings.

Is platelet-rich plasma effective for the treatment of knee osteoarthritis? A systematic review and meta-analysis of level 1 and 2 randomized controlled trials.

The purpose of this study was to perform a systematic review and meta-analysis comparing intra-articular knee injection of PRP and hyaluronic acid and investigate clinical outcomes and pain at both 6 and 12months. A systematic review of Medline, Embase, Scopus, and Google Scholar was performed in the English and German literature reporting on intra-articular knee injections for knee osteoarthritis. All level 1 and 2 studies with a minimum of 6-month follow-up in patients with knee osteoarthritis from 2010 to 2019 were included. Clinical outcome was assessed by WOMAC and IKDC scores and pain by VAS and WOMAC pain scores. Subgroup analysis for autologous platelet-rich plasma (ACP) was performed. Publication bias and risk of bias were assessed using the Cochrane Collaboration's tools. The GRADE system was used to assess the quality of the body of evidence. Heterogeneity was assessed using χ2 and I2 statistics. Twelve studies (1,248 cases; 636 PRP, 612 HA) met the eligibility criteria. The pooled estimate demonstrated non-significant differences between PRP and HA for clinical outcomes at 6months (p = 0.069) and at 12months (p = 0.188). However, the pooled estimate for pain did demonstrate significant differences in favour of PRP at 6months (p = 0.001) and 12months (p = 0.001). For the ACP subgroup (249 cases), the pooled estimate for these studies demonstrated significant differences in favour of PRP (p < 0.0001) at 6months. The results of this systematic review and meta-analysis suggest that PRP is superior to HA for symptomatic knee pain at 6 and 12months. ACP appears to be clearly superior over HA for pain at both 6 and 12months. There were no advantages of PRP over HA for clinical outcomes at both 6 and 12months. Level 2; systematic review and meta-analysis.

A comparative study of functional outcome of osteoarthritis knee post intraarticular injection of PRP and corticosteroid with minimum six months of follow-up

A comparative study of functional outcome of osteoarthritis knee post intraarticular injection of PRP and corticosteroid with minimum six months of follow-up

Intra-articular and extra-articular platelet-rich plasma injections for knee osteoarthritis: A 26-week, single-arm, pilot feasibility study

AimPlatelet Rich Plasma (PRP) is an emerging therapy for knee osteoarthritis (KOA). Studies have evaluated the effectiveness of intra-articular PRP, which ignores extra-articular tissue dysfunction and may provide incomplete treatment of KOA. The study aimed to pilot test a leukocyte-rich (mononuclear cells) PRP injection protocol for primary KOA, which consisted of single intra-articular injection and extra-articular injections on the medial coronary and medial collateral ligaments. MethodsA prospective 26-week single-arm uncontrolled feasibility pilot study. Patients (N = 12) with primary KOA as defined by the American Rheumatology Association, with moderate to severe medial knee pain which failed conservative management, were recruited in a university primary care clinic and received a single session of PRP injection in week 1. The primary outcome was the feasibility of the protocol at 26 weeks as defined by rates of recruitment, compliance, retention, dropout, side effects or adverse events; and treatment satisfaction. Secondary outcomes included the Western Ontario McMaster University Osteoarthritis Index, the Intermittent and Constant Osteoarthritis Pain total and subscales, objective physical function tests and EuroQol-5D. ResultsTwelve of 40 potential patients were recruited in 3 months period (recruitment rate 30%, x2 = 3.33, P = 0.068). All participants adhered to the protocol and completed the follow up assessment with no dropouts (dropout rate 0%, X2= 2.67, P = 0.103). Satisfaction was high; no related adverse events were reported. Most secondary outcomes showed statistically significant improvement. ConclusionsConcomitant intra-articular and extra-articular PRP injections were feasible and produced preliminary favourable outcomes.

Platelet-rich plasma for the improvement in shoulder function in rotator cuff disorders

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Among causes of shoulder pain, rotator cuff disorders are very common. The exact pathogenesis of rotator cuff tears is not clearly understood. To improve outcomes, the relatively new technique of injection of PRP is under investigation. Purpose of this study is to clinically evaluate the efficacy of new treatment of PRP injection in shoulder pain due to rotator cuff pathology.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective, observational study, on patients with shoulder pain diagnosed as rotator cuff disorders admitted in Department of Orthopaedics, RIMS, Ranchi during one year time interval (from 10th October 2016 to 09th October 2017) in the age ranging from 41 to 80 years with a mean age of 57.90 years was conducted. 20 Patients were selected for the study. Initial pre-injection score of patient taken on constant shoulder score and noted. Patient underwent intra-articular injection of PRP in shoulder joint through posterior approach under local anaesthesia. Patients were followed up at 1&lt;sup&gt;st&lt;/sup&gt; post-injection day, 1 month, 3 months and 6 months after the injection.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Results were analysed according to constant shoulder score. In partial tear 5 (41.67%) have excellent, 6 (50%) have good and 1 (8.33%) has fair outcome on 6 months follow up and in full tear all 8 (100%) patients have poor outcome and none of the patients developed any complication.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A&lt;strong&gt; &lt;/strong&gt;single injection of PRP resulted in a safe, significant, sustained improvement in pain and functional outcomes for patients with refractory partial rotator cuff tear (RCT). &lt;p&gt; &lt;/p&gt;

Therapeutic efficacy of intra-articular injection of platelet–rich plasma and ozone therapy in patients with primary knee osteoarthritis

BackgroundPlatelet-rich plasma (PRP) and ozone therapy have been proposed as therapeutically efficient agents for the management of pain in knee osteoarthritis (KOA). Aim of the workTo reveal the efficiency of intra-articular injection of PRP and ozone therapy in the treatment of patients with primary KOA compared to a basic rehabilitation program. Patients and methods60 patients with KOA were randomly classified into 3 groups (20 patients each); group I received intra-articular PRP injection, group II received ozone and group III performed a rehabilitation program. All patients were assessed by visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) and 6-min walk test at baseline and after 1 and 3 months. ResultsThe patients mean age was 55 ± 4.5 years and were 46 females: 14 males (F:M 29:3). The age and gender were comparable among the 3 groups. There was high significant difference between PRP and others 2 groups as regard VAS after 1 and 3 months treatment (p < 0.001) while there was insignificant difference between groups II and III after one month from treatment; but there was significant difference between them at three months. After treatment regarding WOMAC score there was a significant difference between studied groups after 1 and 3 months of treatment (p < 0.05) while there was an insignificant difference between groups regarding 6 min–walk test after 1 and 3 months. ConclusionThe use of autologous PRP is an efficient treatment of KOA and resulted in better outcomes than ozone therapy up to 3 months.

Does intraarticular PRP injection improve function, pain and quality of life in patients with OA of knee? Case control study of 50 patients

Knee osteoarthritis (OA) is a common debilitating chronic disease. Up to one in 5 people over the age of 45 suffer from knee OA and typical symptoms include significant pain, restricted mobility and difficulty to indulge in activities of daily living. Other than knee replacement, no other reliable treatment exists to manage symptomatic knee OA.Platelet Rich Plasma (PRP) is a form of Prolotherapy and is increasingly used to manage OA patients, although the evidence is largely anecdotal. We conducted a case-control study to assess efficacy of PRP comparing it for pain relief in OA Knee.We studied two groups of 25 patients each. One group of 25 patients was given therapeutic exercises and Acetaminophen for pain relief (control group). Second group of 25 patients (PRP group) was injected with two courses of intra-articular injection of Leucocyte rich PRP with interval of 6 weeks. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) was recorded pre-intervention, at six months & one year post-intervention in both the groups. Change scores were assessed for statistical significance.No compilations were noted in both groups and none of the cases needed further surgical intervention during the follow up period. Mean changes of total WOMAC, in PRP group showed significantly better improvement than control group (P<0.05) at all time intervals.This study showed that intra articular PRP knee injection combined with therapeutic exercise can be more effective in pain reduction and improvement of stiffness and quality of life, compared with therapeutic exercise alone.

INTRA ARTICULAR INJECTION OF HYALURONIC ACID ALONE IN COMPARISON WITH HYALURONIC ACID AND PRP IN THE TREATMENT OF INTERNAL DERANGEMENT OF TEMPOROMANDIBULAR JOINT

Objectives: This study aimed to compare the efficacy of intrarticular injection of HA alone versus HA and PRP in the treatment of internal derangement of the temporomandibular joint. Patients and Methods: Twenty patients were involved in our study, divided into two equal groups, group (1), treated with intraarticular injection of HA alone and group (2) treated with intraarticular injection of HA and PRP. All patients were diagnosed with internal derangement of the TMJ. The patients were evaluated clinically and radiographically preoperatively and postoperatively: clinically for evaluation of pain intensity, maximal mouth opening and lateral movements. Radiographically by panoramic and MRI images for detection of the condyle disc relationship and detection of any pathological changes. Postoperatively the patient’s clinical data including pain intensity, maximal mouth opening and the lateral movements were evaluated at one week and 2, 3 weeks and one month and 2,3 and 6 months. Radigraphically using MRI images to determine any changes in the TMJ after injection at 6 months. Results: Twenty patients, nineteen females and one male, their ages ranged from18-55 years with a mean of 29.5 years. The results of the clinical data including pain intensity, maximal mouth opening and lateral movements presented with significant improvements of all outcomes from preoperative to 6 months postoperatively for group (2) when compared with group (1). Radigraphically MRI after 6 months presented with no changes in the disc condyle relationship. Conclusion: Intraarticular injection of HA and PRP considered to be strongly effective and optional treatment of internal derangement of TMJ when compared to HA alone by controlling pain, improving mouth opening and the lateral movements for up to 6 months.