E059 A retrospective analysis of the effectiveness & safety of platelet rich plasma injections in primary osteoarthritis in knee joint, in patients attending a tertiary care hospital, Sri Lanka; a cohort study
Authors: Wickramarachchi Rajika M , Janagan Shalini , Udeshika WAE , Chandana G J , Udara YMS , Fernando Sanuri 
Published: April 2023

Abstract

Background/Aims
Osteoarthritis (OA) is a common, challenging condition and is a leading cause of disability and impaired quality of life in Sri Lanka due to its ageing population and obesity pandemic. Conventional therapies for OA such as non-pharmacological measures, analgesics and surgical interventions have their own limitations. Platelet rich plasma (PRP) has been suggested as a second-line treatment by European Alliance of Associations for Rheumatology (EULAR) for early and moderate OA, which needs further evaluation to prove its efficacy and safety. This is a retrospective analysis of the effectiveness and safety of PRP injections, in a cohort of patients, attending the National Hospital of Sri Lanka for primary knee OA.

Methods
A total of 33 patients who had been treated with PRP injections were examined immediately prior to injection as well as 3 weeks, 3 months and 6 months later.
Details of clinical variables, demographic data, and assessment of efficacy and safety were gathered by the pre-treatment form filled at the routine clinics. Pre-treatment form is comprised of inclusion and exclusion criteria, gender, biochemical investigations, radiological evidences in the knee joint, usage of previous pharmacological and non-pharmacological treatment received by the patient, weight, height and body mass index (BMI). Pain at the site of infection, stiffness, bleeding and local infection were examined as measures of safety. Pain score according to visual analogue scale and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score were used as measures of effectiveness. Descriptive statistics was used to present demographic and clinical variables. Friedman test with Wilcoxon signed rank test for pairwise comparisons were used in the analysis of related samples of pain scores and WOMAC scores pre and post PRP therapy in order to assess effectiveness.

Results
Stiffness following PRP injection was experienced by 8 (24.2%) participants but none of the patients developed pain and bleeding. Median of pain score before PRP injection was 7.00 and it was reduced to 3.00 after 6 months of therapy. Median of WOMAC score before PRP injection was 54.00 and it was reduced to 30.00 after 6 months of therapy. Significant reduction of pain score (p = 0.000) as well as WOMAC score (p = 0.000) was observed. A significant gradual reduction of both pain score and WOMAC score was observed at 3 weeks, 3 months and 6 months post PRP injection (p = 0.000).

Conclusion
PRP injections had a good safety profile in our study. A similar trend of improvement of knee OA was observed in terms of both pain score and WOMAC score which ensures its effectiveness. However, with a guidance of these data in Sri Lankan patients, a randomized double blinded clinical trial is recommended.
Disclosure
R.M. Wickramarachchi: None. S. Janagan: None. W. Udeshika: None. G. Chandana: None. Y. Udara: None. S. Fernando: None.