Comparative Study Between Intra Articular Injection of Hyaluronic Acid (HA) With Platelet Rich Plasma (PRP) Versus Genicular Nerve Thermal Radiation in Management of Pain in Knee Osteoarthritis
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional
Phase: Phase 4

Summary: 
      Intraarticular injection (IAI) of Platelet rich plasma (PRP) with Hyaluronic acid (HA) Versus
      Radiofrequency (RF) of genicular nerve for pain reduction of of knee osteoarthritis ,
      Improving daily activity and reduction analgesia requirements
    

Detailed description: 
      In this study the investigators to comparing between the effect of Intra articular injection
      of hyaluronic acid (HA) with platelet rich plasma (PRP) versus genicular nerve thermal
      radiation in management of pain in knee osteoarthritis.

      Knee assessment and pain score recorded according to Visual Analogue Scale (VAS) after one
      week, one month, three months, six months following intraarticular injection and radiation.

      All analgesics stopped and only (Arcoxia "etoricoxib" 60 mg, 90 mg) was taken after the
      procedure, total day dose and frequency will be reported, other analgesics taken by the
      patient is reported also.

      Improvement of daily activities and clinical examination for the studied knees is observed.
    

Intervention name(s): Intra articular injection Group; Radiofrequency Group
Intervention type(s): Drug; Device
Intervention description(s): Patients included in the study had been received 2 ml high molecular weight (1.476 x 106 average Daltons) hyaluronic acid with concentration of 22mg/ml (OPTIVISC UK hyaluronic acid for intra articular injection). Platelet rich plasma is arranged by withdrawing 10 ml of patient's personal venous blood, anticoagulant is added, and centrifuged by duo-spin method, at the rate of 3500 rpm for five minutes then injected twice with 2 weeks interval. 3 distinct layers are produced by the end of the centrifugation: plasma, buffy coat (platelet) and RBCs, about 3 - 3.5 ml of PRP is produced
at the end with platelet concentration of 1.4 - 1.6 million/μl on average.; Thermal radiation is done by Neurotherm 2000 (Neurotherm NT 2000 Radiofrequency (RF) Generator is a four electrode pain management (RF) generator for interventional pain management procedures. Neurotherm's newest system offers accurate independent controls of each electrode through the touch screen interface and output control knobs.), Patients from the radiofrequency (RF) group had been placed in the supine position and their knee will be supported by a small pillow placed beneath the popliteal fossa. Fluoroscopic images of knee joint had been obtained. Possible locations of genicular nerves had been determined on the lateral, medial aspects of the lower end of the femoral bone and on the medial aspect of the tibia, under fluoroscopic guidance.
Other intervention name(s): Intra articular injection of hyaluronic acid and platelet rich plasma; Thermal radiation of Genicular nerve
Intervention MeSH terms: Hyaluronic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This Prospective randomized study was conducted on (100) knees with mild to moderate osteoarthritis and scheduled for Intra articular injection or Genicular nerve radiofrequency at Tanta University Hospital (Intra articular injection was done in pain clinic and Radiofrequency was done in operating room
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment