Intra‐articular injections in sport‐active patients with degenerative cartilage lesions or osteoarthritis of the knee: a systematic review

Abstract

Purpose The aim of this systematic review was to analyse the available clinical evidence on intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis (OA) in sport-active patients. Methods A literature search was performed in July 2023 according to the PRISMA guidelines on three electronic databases (PubMed, Cochrane, Web of Science). Studies addressing intra-articular injections for degenerative knee cartilage lesions or knee OA in sport-active patients were included. The Downs and Black’s “checklist for measuring quality” was used to evaluate risk of bias and quality of the included studies. Results Only 10 clinical studies for a total of 296 sport-active patients were included, with a publication trend increasing over time. The studies were 9 case series and 1 RCT; 7 studies focused on hyaluronic acid (HA), 2 studies focused on platelet-rich plasma (PRP), while 1 study compared HA and PRP. Overall, safety and positive clinical findings were for both HA and PRP, although not always with satisfactory results in terms of return to sport. The Downs and Black evaluation showed an overall poor quality of the included studies, with an average score of 21.1 points (range 19–25). Conclusions The available clinical evidence is still limited, with only a few studies published and an overall low-quality of evidence, suggesting a potential role of HA and PRP injections to treat these patients. However, further high-level trials are needed to confirm the real benefits of these treatments for the management of sport-active patients affected by degenerative cartilage lesions or OA of the knee.

Chitosan‐based scaffold augmentation to microfractures: Stable results at mid‐term follow‐up in patients with patellar cartilage lesions

“…In a previous study by Pettit et al, it has been demonstrated how untreated cartilaginous lesions increase by 0.11 cm 2 every month and how cartilaginous lesions of the patella tend to progress more quickly towards high‐grade lesions [ 37 ]. The worse clinical results found in patients with pain for longer could be linked not only to an increase in the size of the original cartilage defect but also to degenerative processes of the surrounding cartilage [ 11 , 32 , 37 ]. There is a complex interaction of macroscopic and microscopic factors, such as altered edge stress on the defect that can lead to increased pressure, expansion and consequent increased loading on the subchondral bone [ 21 ].…”

“…Furthermore, women often start from lower scores of knee function and activity level compared to men [ 15 , 30 ]. Men and women have numerous biomechanical and biological differences, and analysing the peculiarities of men and women is a pressing aspect of orthopaedics [ 11 ]. The importance of studying gender‐based specific characteristics and outcomes is confirmed by the lower scores documented in the current study in women treated with this bioscaffold for patellar defects.…”

Spatial distribution proteoglycans articular cartilage of femoral condyles and tibial plateau in experimental osteoarthritis in rats

“…Остеоартроз (ОА) -одно из самых распространенных заболеваний в мире [1,2]. На развитие ОА влияет большое число разных факторов, одним из которых является высокая физическая нагрузка на опорно-двигательную систему [3] получила вискосапплементарная терапия [4]. В данной работе уделяется внимание белкам сурфактанта, выполняющим лубрикативную функцию в легочных альвеолах.…”