Comparison of Intra-Articular Injections of Plasma Rich in Growth Factors (PRGF-Endoret) Versus Durolane Hyaluronic Acid in the Treatment of Patients With Symptomatic Osteoarthritis: A Randomized Controlled Trial

Vaquerizo, Víctor; Plasencia, Miguel; Arribas, Ignacio; Seijas, Roberto; Padilla, Sabino; Orive, Gorka; Anitua, Eduardo

doi:10.1016/j.arthro.2013.07.264

Cited by 222 publications

(269 citation statements)

References 24 publications

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“…Filardo et al 20 reported mild pain and/or slight swelling, which resolved spontaneously within 24 to 48 hours, without reporting number of patients. Vaquerizo et al 22 reported mild postinjection pain after PRGF injection in 8 patients (out of 48). Patel et al 23 reported nonspecific 19 adverse effects during the course of PRP treatment (148 knees).…”

Section: Adverse Effectsmentioning

confidence: 99%

“…These benefits are emphasized in RCTs when compared to HA as a control 15,22,[33][34][35] and even saline. 23 The duration of these benefits is still very controversial, as long-term follow-up studies are lacking, and many of the existing studies report only up to 6 months of follow-up.…”

Section: Leukocyte Concentrationmentioning

confidence: 99%

“…An interesting finding in this study was that the improvement was maximal at first follow-up with deterioration in the second and third follow-ups, suggesting a temporary nature of the benefits of PRP injections. In their multicenter RCT, Vaquerizo et al 22 compared 3 injections of PRGF to one single intraarticular injection of HA. Each group included 48 patients.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

“…Nine RCTs were included in the results, 15,16,[21][22][23][33][34][35]38 3 of which were double blinded ( Table 2). Hyaluronic acid was used for the control groups in 7 RCTs, saline was used in 1 study, and an exercise program was used in another.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

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PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

et al. 2016

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Objective: To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects. Design: Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis." Results: The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies. Conclusion: Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

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Section: Adverse Effectsmentioning

confidence: 99%

Section: Leukocyte Concentrationmentioning

confidence: 99%

Section: Randomized Controlled Trialsmentioning

confidence: 99%

Section: Randomized Controlled Trialsmentioning

confidence: 99%

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PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

et al. 2016

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“…In alcuni studi comparativi tra HA e PRP, il PRP è risultato maggiormente efficace, nel ridurre la sintomatologia dolorosa e la limitazione funzionale, rispetto all'HA (28,(34)(35)(36)(37)(38). I risultati di diverse metanalisi confermano la maggiore efficacia del PRP (39)(40)(41)(42).…”

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Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Landi

Landa

Russo

2016

Global & Regional Health Technology Assessment

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ORIGINAL RESEARCH ARTICLErischio, tra i quali il genere (le donne sono più predisposte), l'età, il tipo di attività lavorativa, l'obesità (1-3).Le patologie muscoloscheletriche sono l'ottava causa a livello mondiale, e la quarta nei Paesi occidentali, per anni di vita persi per disabilità (disability-adjusted life-year, DALY). Almeno la metà delle patologie muscoloscheletriche sono attribuibili all'osteoartrosi (4) ed essa risulta essere l'undicesima patologia per peso di contribuzione alla disabilità a livello mondiale su 291 patologie, e trentottesima per DALY (5).Il carico medico e sociale dell'OA determina un forte impatto economico sui sistemi sanitari (6, 7), in particolare nei Paesi occidentali dove l'incidenza è più elevata. I costi sanitari diretti sono dovuti ai farmaci utilizzati per ridurre il dolore e la limitazione funzionale, esami medici, ricoveri e interventi chirurgici di sostituzione dell'articolazione danneggiata (artroprotesi). The increasing incidence of total joint arthroplasty reflects the rises of osteoarthritis (OA) prevalence. OA is a degenerative pathology affecting joints with a significant impact on quality of life causing pain, leading to social life limitations and loss of work productivity. According to the World Health Organization, OA is one of the most important causes of people's disability. The burden of the disease is correlated with a huge economic impact on the health care systems. Intra-articular infiltration therapies are used between the pharmacological and the surgical phases, in order to delay surgery. This work aims to carry out an economic evaluation on the use of the Platelet-RichPlasma (PRP) therapy in the treatment of knee OA. The comparator is the hyaluronic acid, i.e. the standard therapy for drug-resistant OA that does not benefit or has short term benefits (<1 month) with intra-articular corticosteroids. Methods: A cost-effectiveness analysis has been performed using a decision-analytic model considering two scenarios: short period and medium period. The effectiveness outcomes are reported in term of quality-adjusted life-years (QALYs), while costs are expressed in euro (€). The adopted perspective is the Italian National Health System (INHS). The results are shown through the incremental cost-effectiveness ratio (ICER) examining the PRP versus the comparator. Moreover, deterministic and probabilistic sensitivity analyses have been performed to test the robustness of the results. Results: The PRP therapy, for patients with moderate to severe knee OA in the Italian context, is cost-effective versus HA with ICERs of €1,524/QALY in the 1 year and €162/QALY in the 5 year scenarios. Conclusions: In the short term, it seems that the PRP therapy is cost-effective in the treatment of knee OA versus the HA therapy. However, more research is needed to assess its cost-effectiveness in the long term and to figure out if this treatment may be an efficient resource allocation for the INHS.

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Extracellular matrix‐blood composite injection reduces post‐traumatic osteoarthritis after anterior cruciate ligament injury in the rat

Proffen

Sieker

Murray

et al. 2015

Journal Orthopaedic Research

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Purpose The objective of this study was to determine if an injection of a novel extracellular matrix scaffold and blood composite (EMBC) after anterior cruciate ligament (ACL) injury would have a mitigating effect on post-traumatic osteoarthritis (PTOA) development in rat knees. Methods Lewis rats underwent unilateral ACL transection and were divided into three groups: 1) no further treatment (ACLT; n = 10), 2) an intraarticular injection of EMBC on day 0 (INJ0; n = 11), and 3) an intra-articular injection of EMBC on day 14 (INJ14; n = 11). Ten animals received capsulotomy only (n = 10, SHAM group). The OARSI histology scoring of the tibial cartilage and micro-CT of the tibial epiphysis were performed after 35 days. The ratio of intact/treated hind limb forces during gait was determined using a variable resistor walkway. Results The OARSI cartilage degradation sum score and total degeneration width were significantly greater in the ACLT group when compared to the INJ0 (P = 0.031, and P = 0.005) and INJ14 (P =0.022 and P =0.04) group. Weight bearing on the operated limb only decreased significantly in the ACLT group (P = 0.048). Conclusion In the rat ACL transection model, early or delayed injection of EMBC ameliorated the significant decrease in weight bearing and cartilage degradation seen in knees subjected to ACL transection without injection. The results indicate that the injection of EMBC may slow the process of PTOA following ACL injury and may provide a promising treatment for PTOA.

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Comparison of Intra-Articular Injections of Plasma Rich in Growth Factors (PRGF-Endoret) Versus Durolane Hyaluronic Acid in the Treatment of Patients With Symptomatic Osteoarthritis: A Randomized Controlled Trial

Cited by 222 publications

References 24 publications

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Extracellular matrix‐blood composite injection reduces post‐traumatic osteoarthritis after anterior cruciate ligament injury in the rat

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