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Intra-articular injection of platelet - rich plasma and therapeutic exercise in knee osteoarthritis

Abstract

Context

There is no definite treatment strategy capable of decreasing destruction of cartilage and enhancing its healing. Intra-articular injection of platelet-rich plasma (PRP) provides a lot of growth factors that are capable of stimulating regeneration of cartilage and is supposed to be a future solution to patients with osteoarthritis (OA).

Aim

To detect the efficacy of intra-articular injection of PRP or therapeutic exercise (Ex) alone as well as a combination of both in the treatment of idiopathic knee OA.

Settings and design

A prospective randomized controlled clinical study was conducted.

Patients and methods

A total of 60 patients, 44 to 65 years of age, having idiopathic unilateral knee OA were included in the study and were divided into three groups: PRP group included 20 patients and were treated with intra-articular PRP injection, Ex group included 20 patients and were treated with only therapeutic Ex, and PRP and Ex group included 20 patients who were treated with both PRP intra-articular injection and therapeutic Ex. Evaluation of all patients was done by visual analogue scale, tenderness, range of motion, thigh circumference, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores at baseline and 1 and 6 months later. Objective evaluation was done through MRI of osteoarthritic knee at baseline and 6 months later.

Statistical analysis

Statistical analyses were performed using SPSS for windows, version 20.0.

Results

Baseline WOMAC score differences among the three groups were not statistically significant but were significant 6 months after treatment. In PRP and Ex groups, there was a significant improvement after treatment, whereas a highly significant improvement in PRP+Ex group. MRI grading differences among the three groups were not significant before or after treatment, with no improvement in all three groups after treatment.

Conclusion

A combination of intra-articular injection of PRP and therapeutic Ex resulted in significantly lesser visual analogue scale, WOMAC score, and joint tenderness compared with PRP or Ex alone.

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Correspondence to Eman A. R. Hafez.

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Badr, M.E.M., Hafez, E.A.R., El-Ghaweet, A.I. et al. Intra-articular injection of platelet - rich plasma and therapeutic exercise in knee osteoarthritis. Egypt Rheumatol Rehabil 46, 1–10 (2019). https://doi.org/10.4103/err.err_22_18

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Keywords

  • knee osteoarthritis
  • platelet-rich plasma
  • therapeutic exercise
  • Western Ontario and McMaster Universities Arthritis Index