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Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
A tertiary care interventional study on autologous platelet-rich plasma regenerative therapy for Grade III knee
Vinu Rajendran1, Debasish Gupta1, Meethu Muraleedharan1
1Department of Transfusion Medicine, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Background:
Platelet-rich plasma (PRP) therapy is widely used in regenerative medicine, with proven efficacy in mild-to-moderate knee osteoarthritis (OA). However, its role in advanced OA (Kellgren-Lawrence Grade III) remains uncertain.
Objective:
The objective of the study was to evaluate the effectiveness of PRP therapy in reducing pain and improving function in patients with Grade III bilateral knee OA.
Methods:
A prospective interventional study was conducted on 29 patients with Grade III bilateral knee OA. Each patient received four intra-articular PRP injections per knee (7-8 ml; 2-3 × concentration) at 4-5-week intervals. PRP was prepared using MARSPILL criteria: Non-activated, leukocyte-rich, double-spin, in a closed system, and administered within 60 min of preparation. The PRP preparation process was supervised by the transfusion medicine department. Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were recorded at baseline and at 3, 6, and 12 months posttreatment, along with monitoring for adverse events.
Results:
Mean WOMAC total scores improved significantly from 58.28 ± 7.7 at baseline to 27.48 ± 9.9, 26.31 ± 6.9, and 29.59 ± 7.3 at 3, 6, and 12 months, respectively (all P < 0.001). Significant improvements were also observed in the pain and functional difficulty subscales. No major adverse effects were reported.
Conclusion:
Four sessions of standardized PRP therapy significantly reduced pain and improved function in patients with bilateral Grade III knee OA for up to 1 year. This therapy may serve as a temporizing measure before definitive surgical intervention.
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