Intra-articular Injections of Platelet-rich Plasma, Hyaluronic Acid, or Corticosteroids for Knee Osteoarthritis

Study Overview
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Brief Summary
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To assess if there are any differences among platelet-rich plasma, hyaluronic acid, and corticosteroid knee intra-articular injection regarding function and pain.

Official Title
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Intra-articular Injections of Platelet-rich Plasma, Hyaluronic Acid, or Corticosteroids for Knee Osteoarthritis, Which is Better? A Prospective Study of a Single-blind Randomized Control Trial RCT From the Iraqi Population

Conditions
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Osteoarthritis, Knee

Intervention / Treatment
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* Biological: Platelet-rich plasma
* Drug: Hyaluronic acid
* Drug: Methylprednisolone acetate injectable suspension (DEPO-MEDROL®)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient aged 35-65 years old Patient with knee pain that had been continuing for at least 12 months with no relief using anti-inﬂammatory medications and that deteriorated with weight-bearing Knee osteoarthritis that classified as mild-moderate or moderate-severe (Kellgren-Lawrence Grade 2, 3, or 4) Exclusion Criteria: Age > 65 years The recent history of knee trauma Autoimmune rheumatic diseases Accompanying severe hip OA Thrombocytopenia or other blood diseases Immunosuppressive or anticoagulant treatment The invasive procedure applied to the knee Intra-articular steroid injection to the knee within the previous 12 months Previous joint infection Uncontrolled systemic diseases such as diabetes or hypertension, and cancer Excessive varus/valgus knee deformity

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A total of 150 participants fulfilling the inclusion criteria, patients were randomly assigned into three groups by a computer-based protocol. The patients were separated into three groups according to the type of treatment administered.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Platelet-rich plasma arm<br> | Biological: Platelet-rich plasma<br>* Two intra-articular injections of autologous platelets-rich plasma (PRP) in two weeks intervals between the first and the second injection.<br>|
| Active Comparator: Hyaluronic acid arm<br> | Drug: Hyaluronic acid<br>* Two intraarticular injections of hyaluronic acid (60 mg) in two weeks intervals between the first and the second injection<br>|
| Active Comparator: Methylprednisolone acetate arm<br> | Drug: Methylprednisolone acetate injectable suspension (DEPO-MEDROL®)<br>* Single methylprednisolone acetate intraarticular injection (DEPO-MEDROL® pfizer 80 mg) mixed with 3cc of (xylocaine 2% concentration)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed Up and Go test (TUG) | The Timed Up and Go test (TUG) is a simple test used to assess a person's mobility and requires both static and dynamic balance. It uses the time that a person takes to rise from a chair, walk three meters, turn around 180 degrees, walk back to the chair, and sit down while turning 180 degrees | 18th months | 
| Visual Analogue Scale (VAS) | The VAS uses a straight 10 centimeter line with one end being 'no pain' and on the other end the 'worst imaginable pain'. The patient chooses a spot on the line then places a perpendicular line to indicate their pain level | 18th months |