Diz osteoartritinde PRP’nin kronik ağrı üzerine kısa dönem etkinliği
Amaç: Diz osteoartritinde (OA) kıkırdak rejenerasyonu sağlamaya yönelik büyüme faktörlerinin salınımını artıran platelet rich plasma (PRP) uygulamaları ile diz ağrılarında iyileşme sağlanmaya çalışılmaktadır. Biz de bu nedenle diz OA’da PRP’nin kronik ağrı üzerine kısa dönem etkinliğini ölçmeyi amaçladık. Gereç ve Yöntem: Kellgren – Lawrence (K-L) sınıflamasına göre grade 2-4 arası diz OA olan kronik diz ağrılı 69 hasta çalışmaya alındı. 3 hafta aralıklarla uygulanan 3 doz intraartiküler PRP enjeksiyonunu tamamlayan 42 hastanın 60 diz eklemi ile çalışma tamamlandı. Hastaların ağrıları 0. gün, 3., 6., ve 12. haftalarda istirahat ve aktivite visual analog scala (VAS) ile değerlendirildi. Bulgular: 37’si kadın 42 hastanın ortalama yaşı ve vücut kitle indeksi sırasıyla (ort±standart sapma (SS)) 60.52±10.41 ve 28.5±9.71 idi. Toplam 18 hasta bilateral diz olup, 60 diz ekleminin 39’u ise K-L grade 3-4 osteoartritti. Hastaların 0. gün ve 12. hafta ortalama istirahat ve aktivite VAS skorlarında; (sırasıyla (ort±SS), 5.13±2.70, 7.68±1.83 ve 2.60±2.05, 3.75±2.12, p
The short-term effect of PRP on chronic pain in knee osteoarthritis
Objectives: The administration of platelet-rich plasma (PRP), which increases the release of growth factors targeting cartilageregeneration, is used in an effort to relieve pain in knee osteoarthritis (OA). This study measured the short-term efficacy of PRPon chronic pain in patients with OA of the knee.Methods: Patients with chronic knee pain and grade 2-4 knee OA based on the Kellgren-Lawrence (K-L) classification were enrolledin the study. A total of 60 knee joints of 42 patients who completed 3 doses of intraarticular PRP injections administeredat intervals of 3 weeks were analyzed. The patients’ pain was evaluated using a resting and activity visual analog scale (VAS)on day 0, and at week 3, 6, and 12.Results: Of the 42 patients, 37 were female. The mean age and body mass index was 60.52±10.41 years and 28.5±9.71 kg/m2. A total of 18 patients had bilateral knee involvement, and 39 of the 60 knee joints were classified as K-L grade 3-4 OA. Asignificant improvement was observed in the mean resting and activity VAS scores at day 0 and week 12 (p
___
- Kavadar G, Demircioglu DT, Celik MY, Emre TY. Effectiveness
of platelet-rich plasma in the treatment of moderate
knee osteoarthritis: a randomized prospective study. J
Phys Ther Sci 2015;27(12):3863–7. [CrossRef]
- Mangone G, Orioli A, Pinna A, Pasquetti P. Infiltrative treatment
with Platelet Rich Plasma (PRP) in gonarthrosis. Clin
Cases Miner Bone Metab 2014;11(1):67–72. [CrossRef]
- Kim G, Kim E. Anti-inflammation effects of low intensity laser
therapy on monosodium iodoacetate-induced osteoarthritis
in rats. J Phys Ther Sci 2013;25:173–75. [CrossRef]
- Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen
WS. Comparative effectiveness of platelet-rich plasma injections
for treating knee joint cartilage degenerative pathology:
a systematic review and meta-analysis. Arch Phys
Med Rehabil 2014;95(3):562–75. [CrossRef]
- Cole BJ, Karas V, Hussey K, Pilz K, Fortier LA. Hyaluronic Acid
Versus Platelet-Rich Plasma: A Prospective, Double-BlindRandomized
Controlled Trial Comparing Clinical Outcomes
and Effects on Intra-articular Biology for the Treatment of
Knee Osteoarthritis. Am J Sports Med 2017;45(2):339–46.
- Arroll B, Goodyear-Smith F. Corticosteroid injections
for osteoarthritis of the knee: meta-analysis. BMJ
2004;328(7444):869. [CrossRef]
- Jevsevar DS, Brown GA, Jones DL, Matzkin EG, Manner
PA, Mooar P, et al. The American Academy of Orthopaedic
Surgeons evidence-based guideline on: treatment of osteoarthritis
of the knee, 2nd edition. J Bone Joint Surg Am
2013;95(20):1885–6. [CrossRef]
- Hashemi M, Jalili P, Mennati S, Koosha A, Rohanifar R, Madadi
F, et al. The Effects of Prolotherapy With Hypertonic Dextrose
Versus Prolozone (Intraarticular Ozone) in Patients
With Knee Osteoarthritis. Anesth Pain Med 2015;5:e27585.
- Karan A, Müslümanoğlu L, Durmuş B, Ketenci A, Aydın R, Akı
S, et al. Intraraticular Na-hyaluronate (Ortovisc) injection in
knee osteoarthritis: comparison of different injection techniques
and short term efficacy. Agri 2000;12(4):31–5.
- Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect
of platelet-rich plasma on pain and physical function in the
treatment of knee osteoarthritis: systematic review and
meta-analysis of randomized controlled trials. J Orthop
Surg Res 2017;12(1):16. [CrossRef]
- Cugat R, Cuscó X, Seijas R, Álvarez P, Steinbacher G, Ares
O, et al. Biologic enhancement of cartilage repair: the role
of platelet-rich plasma and other commercially available
growth factors. Arthroscopy 2015;31(4):777–83. [CrossRef]
- Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-rich
plasma as a treatment for patellar tendinopathy: a double-blind,
randomized controlled trial. Am J Sports Med
2014;42(3):610–8. [CrossRef]
- Smyth NA, Murawski CD, Fortier LA, Cole BJ, Kennedy
JG. Platelet-rich plasma in the pathologic processes of
cartilage: review of basic science evidence. Arthroscopy
2013;29(8):1399–409. [CrossRef]
- Hsu WK, Mishra A, Rodeo SR, Fu F, Terry MA, Randelli P, et
al. Platelet-rich plasma in orthopaedic applications: evidence-based
recommendations for treatment. J Am Acad
Orthop Surg 2013;21(12):739–48. [CrossRef]
- Xie X, Zhang C, Tuan RS. Biology of platelet-rich plasma
and its clinical application in cartilage repair. Arthritis Res
Ther 2014;16(1):204. [CrossRef]
- Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green
SE. Quality and consistency of clinical practice guidelines
for diagnosis and management of osteoarthritis of the hip
and knee: a descriptive overview of published guidelines.
Med J Aust 2008;189(7):394–9.
- Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A.
Arthroscopic validation of radiographic grading scales of
osteoarthritis of the tibiofemoral joint. AJR Am J Roentgenol
2006;187(3):794–9. [CrossRef]
- Dixon JS, Bird HA. Reproducibility along a 10 cm vertical visual
analogue scale. Ann Rheum Dis 1981;40(1):87–9. [CrossRef]
- Interventional procedure overview of platelet-rich plasma
injections for osteoarthritis of the knee. NICE Interventional
Procedure Guidance. Available at: https://www.nice.org.
uk/guidance/ipg637/chapter/2-The-condition-currenttreatments-and-procedure.
Accessed April 08, 2019.
- Marx RE. Platelet-rich plasma (PRP): what is PRP and what is
not PRP? Implant Dent 2001;10(4):225–8. [CrossRef]
- Everts PA , Brown Mahoney C, Hoffmann JJ, Schönberger
JP, Box HA, van Zundert A, et al. Platelet-rich plasma preparation
using three devices: implications for platelet activation
and platelet growth factor release. Growth Factors
2006;24(3):165–71. [CrossRef]
- Lana JF, Weglein A, Sampson SE, Vicente EF, Huber SC,
Souza CV, et al. Randomized controlled trial comparing hyaluronic
acid, platelet-rich plasma and the combination of
both in the treatment of mild and moderate osteoarthritis
of the knee. J Stem Cells Regen Med 2016;12(2):69–78.
- Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M,
Timoncini A, et al. Platelet-rich plasma intra-articular injection
versus hyaluronic acid viscosupplementation as treatments
for cartilage pathology: from early degeneration to
osteoarthritis. Arthroscopy 2011;27(11):1490–501. [CrossRef]
- Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment
with platelet-rich plasma is more effective than placebo
for knee osteoarthritis: a prospective, double-blind,
randomized trial. Am J Sports Med 2013;41(2):356–64.
- Vaquerizo V, Plasencia MÁ, Arribas I, Seijas R, Padilla S,
Orive G, et al. Comparison of intra-articular injections of
plasma rich in growth factors (PRGF-Endoret) versus Durolane
hyaluronic acid in the treatment of patients with
symptomatic osteoarthritis: a randomized controlled trial.
Arthroscopy 2013;29(10):1635–43. [CrossRef]
- Marmotti A, Rossi R, Castoldi F, Roveda E, Michielon G,
Peretti GM. PRP and articular cartilage: a clinical update.
Biomed Res Int 2015;2015:542502. [CrossRef]
- Calis HT, Sutbeyaz ST, Guler E, Halici C, Sayan H, Koc A, et
al. Efficacy of intra-articular autologous platelet rich plasma
application in knee osteoarthritis. Arch Rheumatol
2015;30:198–205. [CrossRef]
- Castillo TN, Pouliot MA, Kim HJ, Dragoo JL. Comparison of
growth factor and platelet concentration from commercial
platelet-rich plasma separation systems. Am J Sports Med
2011;39(2):266–71. [CrossRef]
- Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML,
Cenacchi A, et al. Platelet-rich plasma vs hyaluronic acid
to treat knee degenerative pathology: study design and
preliminary results of a randomized controlled trial. BMC
Musculoskelet Disord 2012;13:229. [CrossRef]
- Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi
A, et al. Platelet-rich plasma intra-articular knee injections
for the treatment of degenerative cartilage lesions
and osteoarthritis. Knee Surg Sports Traumatol Arthrosc
2011;19(4):528–35. [CrossRef]