Intraosseous With Intra-articular Injection of Platelet Rich Plasma in Treatment of Knee Osteoarthritis

Study Overview
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Brief Summary
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The aim of this study was to compare the efficacy of treatment in three groups of patients with knee osteoarthritis (OA) given a combination of intraosseous with intra-articular injection of platelet rich plasma (PRP), intra-articular injection of PRP and a single application of hyaluronic acid (HA).

Detailed Description
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Methods Eighty-six patients from January 2015 to June 2015 with grade II to grade III knee osteoarthritis according to the Kellgren-Lawrence classification were randomly divided into 3 groups to receive either PRP or HA. Group A received intra-articular injection of PRP 2 ml combination with medial tibial plateau and medial femoral condyle injection of PRP 2 ml (once more 2 weeks later). Group B were treated with 2 ml of PRP intra-articular injection every 14 days for a total of two injections. Group C received intra-articular injection of hyaluronic acid 2 ml every 7 days for five injections. All patients were evaluated by the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) score before the treatment and at 1st, 3rd, 6th, 12th and 18th months.

Official Title
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Intraosseous With Intra-articular Injection of Platelet Rich Plasma Versus Hyaluronic Acid in Treatment of Knee Osteoarthritis

Conditions
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Osteoarthritis, Knee

Intervention / Treatment
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* Drug: PRP
* Drug: HA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unilateral symptomatic knee with pain for at least 1 month or swelling. Radiographic findings of knee degeneration (Kellgren-Lawrence score of II - III). Age 40-73 years. Body mass index (BMI) 18-32.5). Knee stability without a severe trauma history. Exclusion Criteria: Bilateral knee osteoarthritis indicative of treatment for both knees. Kellgren-Lawrence score greater than III. BMI >32. Age >73 years. Systemic autoimmune rheumatic diseases and blood disorders. Active immunosuppressive or anticoagulant therapy. Intra-articular injection to the knee within the previous 1 year or previous joint infection. use of corticosteroids for 3 weeks before the procedure. use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the 3 weeks before treatment.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 73 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intraosseous and intra-articular<br>injection of PRP 2 ml | Drug: PRP<br>* platelet rich plasma<br>|
| Active Comparator: intra-articular PRP<br>injection PRP 2 ml | Drug: PRP<br>* platelet rich plasma<br>|
| Active Comparator: Intra-articular injection of HA<br>injection of HA 2 ml | Drug: HA<br>* hyaluronic acid<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| WOMAC scores | The evaluation was performed with WOMAC, which were recorded on a five-point Likert scale scoring, with a response of none scored as 0, mild as 1, moderate as 2, severe as 3 and extreme as 4. | At the 18th month |