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J Orthop Surg Res. 2019 May 24;14(1):153. doi: 10.1186/s13018-019-1203-0.

Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage.

Author information

1
Department of Health, University of Witten/Herdecke, Witten, Germany. rene.burchard@uni-wh.de.
2
Department of Trauma- and Orthopaedic Surgery, Kreisklinikum Siegen, Siegen, Germany. rene.burchard@uni-wh.de.
3
School of Science and Technology, University of Siegen, Siegen, Germany. rene.burchard@uni-wh.de.
4
Department of Health, University of Witten/Herdecke, Witten, Germany.
5
Department of Statistics an Econometrics, University of Siegen, Siegen, Germany.
6
Institute of Diagnostic Radiology at Kreisklinikum Siegen, Siegen, Germany.
7
Department of Orthopaedics, Trauma Surgery and Sports Traumatology, Kliniken der Stadt Köln, Köln, Germany.
8
Department of Anaesthesiology and Operative Intensive Care Medicine (CCM, CVK) Charité, Universitätsmedizin Berlin, Berlin, Germany.
9
Berlin Institute of Health (BIH), Berlin, Germany.

Abstract

OBJECTIVES:

Osteoarthritis of the knee is common and often leads to significant physical disability. While classic conservative therapeutic approaches aim for symptoms like pain and inflammation, procedures like the intraarticular application of hyaluronic acids (HA) or platelet-rich plasma (PRP) are thought to stimulate the endogenous HA production, stop catabolism of cartilage tissue, and promote tissue regeneration. To analyse whether the positive effects of PRP injections are associated with the level of cartilage damage, patient satisfaction with the treatment was correlated with the level of knee joint osteoarthritis quantified by MRI.

METHODS:

PRP was performed with a low-leukocyte autologous conditioned plasma (ACP) system in 59 patients. A pre-treatment MRI was performed and a Whole-Organ MRI Score (WORMS) was used to score the level of knee osteoarthritis by 14 features: integrity of the cartilage, affection of the bone marrow, subcortical cysts, bone attrition, osteophytes, integrity of the menisci and ligaments, presence of synovitis, loose bodies, and periarticular cysts. A multivariate analysis with ordinary least squares regressions was used.

RESULTS:

Although pain symptoms and severity of clinical osteoarthritis symptoms decreased, regression analysis could not detect a correlation between the degree of cartilage damage measured by the WORMS score and a positive response to PRP therapy.

CONCLUSION:

This study suggests that intraarticular injection of PRP might improve osteoarthritis symptoms and reduces the pain in patients suffering from osteoarthritis of the knee joint independent from the level of cartilage damages quantified by the whole-organ MRI scoring method WORMS.

KEYWORDS:

Cartilage damage; Knee; Osteoarthritis; Platelet-rich plasma

PMID:
31126348
PMCID:
PMC6534904
DOI:
10.1186/s13018-019-1203-0
[Indexed for MEDLINE]
Free PMC Article

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