<p>MRI Changes After Platelet Rich Plasma Injection in Knee Osteoarthritis (Randomized Clinical Trial)</p>

Abstract

Purpose: Few papers have studied the objective effects of PRP on cartilage. In this study, we investigated the effect of PRP on cartilage characteristics by special MRI sequencing in knee osteoarthritis (IRCT registration number: 2014020413442N6). Patients and methods: In this double blind randomized clinical trial, patients with bilateral knees osteoarthritis-grade 1, 2, and 3 were included in the study. Each patient's knees were randomly allocated to either control or treatment groups. PRP was injected in two sessions with 4 week intervals in PRP group. The VAS (visual analog scale) and WOMAC (Western Ontario and McMaster Universities Arthritis Index) were utilized and MRI was performed for all patients, before, and 8 months after treatment. The MRI sequences taken were transverse 3D TRUFISP and coronal and sagittal fat saturated proton-density. Imaging was scored according to four cartilage characteristics. Results: 46 knees (from 23 patients) were included in this study. 23 knees in the case group and 23 knees in control group were studied. All patients were female with mean age of 57.57±5.9 years. Mean total WOMAC and VAS changes before and after treatment in control group were 11.61±8.5 and 1.3±1.1 respectively. In PRP group, mean total WOMAC and VAS changes showed better improvement with 20±12.3 and 3.2±1.6 respectively (P-value <0.05). In PRP group, all of the radiologic variables (patellofemoral cartilage volume, synovitis and medial and lateral meniscal disintegrity), with the exception of subarticular bone marrow abnormality, had significant improvement (P-value <0.05). In a comparison between the two groups, patellofemoral cartilage volume and synovitis had significantly changed in the PRP group (P-value <0.05). Conclusion: In this study, in addition to the effect of PRP on VAS and WOMAC, there was a significant effect on radiologic characteristics (patellofemoral cartilage volume and synovitis). For further evaluation, a longer study with a larger sample size is recommended.

The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial

“…Moreover, over the time the exogenous HA is destroyed in the inflammatory site and thus the symptoms start again after a period post-injection. In the case of the PRP or PRGF, it has been shown that these products could stimulate chondrogenesis, modulate the intra-articular microenvironment as well as cellular composition and proliferation, and directly affect the expression of some major inflammatory mediators in the joint, thus their effect may remain for a longer time compared to the ozone or HA [ 41 ].…”

Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study

“…The flexion range of motion became better with the increase in the total number of visits among grade IV knees, and we observed an overall improvement in flexion in grade IV more than grade II knees. Radiological imaging showed an improvement in our patients in comparison to the patients included in the Raeissadat et al study (Figure 6 ) [ 30 ].…”

“…The flexion range of motion became better with the increase in the total number of visits among grade IV knees, and we observed an overall improvement in flexion in grade IV more than grade II knees. Radiological imaging showed an improvement in our patients in comparison to the patients included in the Raeissadat et al study ( Figure 6) [30]. Despite the positive outcomes that are reported in the literature, the diversity of the methodological studies that include preparation, administration and intervals of the injection.…”

Effects and mechanism of platelet-rich plasma on military drill injury: a review

“…In summary, although there are still many controversies, some clinical trials have also confirmed the application value of PRP in promoting repair, relieving pain and providing some functional benefits, such as osteoarthritis [ 81 , 82 ], synovitis [ 83 ], and refractory wounds [ 84 , 85 ]. In the future, PRP may be a potential auxiliary therapy for military drill injury.…”