Platelet Rich Plasma for Chronic Synovitis Treatment in Patients with Haemophilia

Caviglia, Horacio; Landro, María Eulalia; Daffunchio, Carla; Galatro, Gustavo; Price, Ana Laura Douglas; Salgado, Pablo; Neme, Daniela

doi:10.1111/hae.13212

Cited by 22 publications

(44 citation statements)

References 30 publications

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“…tissue and osteochondral alterations in HA [15][16][17][18]. In this regard, regular prophylactic therapy should be the most effective treatment for synovial hyperplasia in patients aged ≤10 years, but insufficient for older patients, who may benefit from extra-local therapies, such as radiosynovectomy19 and intra-articular drug injection [20][21][22][23][24]. Synovial hyperplasia is thought to be a reversible pathological process caused by joint bleeding, 1 but repeated haemarthroses or occult subclinical bleeding tend to cause chronic synovitis, which is harder to eliminate.…”

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confidence: 99%

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

et al. 2019

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Introduction and aims Age‐related severity and distribution of haemophilic arthropathy (HA) among Chinese patients with haemophilia using the Haemophilia Early Detection with Ultrasound (HEAD‐US) system have not been extensively studied. Methods In our study, 89 patients with moderate and severe haemophilia were recruited. A total of 534 joints (knees, ankles and elbows on both sides included) were evaluated using musculoskeletal ultrasound (MSKUS) and scored using the HEAD‐US system. Results Prevalence and average number of HA were 39.1% and 0.7, 90.6% and 3.2, 94.1% and 4.5, and 100% and 4.3 for ages ≤10, 11‐20, 21‐30 and 31‐40 years, respectively. Prevalence and mean number of knee, ankle and elbow arthropathies also increased with age, although joint damages progressed in unparallel patterns. A significant difference in synovium subscores was observed between patients aged <10 and >10 years. An increasing tendency was observed in cartilage and subchondral bone subscores along with age before 30 years. No significant difference in mean joint scores was found between patients receiving on‐demand therapy and those receiving on‐demand to low‐dose prophylactic therapy. Conclusions Haemophilic arthropathy developed in early childhood and progressed mainly before 30 years of age among Chinese patients with haemophilia, although in different ways among the knee, ankle and elbow.

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confidence: 99%

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

et al. 2019

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“…6 In the two studies of our search, the use of PRP appeared to be safe without any complications. The outcomes regarded a statistically significant (P < .001) decrease in the HJHS score and in joint bleeding episodes (P < .001).…”

Section: Platelet-rich Plasmamentioning

confidence: 83%

“…The inflammatory components represented by synovitis and bone resorption are similar to RA, while the joint cartilage degeneration is similar to OA. [3][4][5][6][7] The aims of this study were (a) to evaluate the efficacy of HAc, CO, PRP and MSC in patients with haemophilic arthropathy, (b) to compare the efficacy of these 4 drugs and (c) to establish the scientific validity of the use of these drugs and determine their safety. 4 Intra-articular injections of hyaluronic acid and corticosteroids are commonly used, alone or in combination, in patients with painful knee osteoarthritis and provide pain relief for weeks (corticosteroids) or months (hyaluronic acid).…”

Section: Introductionmentioning

confidence: 99%

Haemophilic arthropathy: A narrative review on the use of intra‐articular drugs for arthritis

et al. 2019

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Introduction: Intra-articular injections of various drugs are commonly used in patients with degenerative osteoarthritis and also in haemophilic patients. Haemophilic arthropathy is a particular type of secondary osteoarthritis (OA), but the degeneration of strong synovial, cartilaginous and subchondral constituents is provoked by the direct action of iron and blood in the joint.Aim of the study: The aim of this study is to review the literature regarding the use of various intra-articular drugs in joints affected by haemophilic arthropathy. Methods: We reviewed the data from the literature; the search was performed on three medical electronic databases (PubMed, Cochrane Library and Scopus Web of Science) by three authors (B. E., A. M. and V. N.) from 3 December 2018 till 15 December 2018. The search string was as follows: (hyaluronic acid OR viscosupplementation OR platelet-rich plasma OR corticosteroid OR mesenchymal stem cells) AND (haemophilia OR haemophilic arthropathy OR haemophilic arthritis).Results: Once the research was performed, a total of 300 articles were identified. 47 selected articles were analysed by the reviewers, and the eligibility of the study inclusion was assessed independently. Twelve papers were included based on clear fulfilment of the inclusion criteria. Thirty-five articles were excluded for the following reasons: no full text or accessible data for 14 of them, 15 involved surgery or rehabilitation therapy as the primary topic and 6 were systematic reviews (the main topics were beyond the haemophilic arthropathy). Conclusion:Although the degree of scientific evidence of the publications on intraarticular injections of various drugs (hyaluronic acid, corticosteriods, PRP and MSCs) in haemophilia is very low, it seems that intra-articular injections of hyaluronic acid can relieve joint pain for months and can be repeated every 6-12 months, which is why they can be recommended. Corticosteroid injections seem to relieve joint pain for a few weeks, but their routine use is not recommended in haemophilia. The efficacy of PRP and MSCs in haemophilic arthropathy is pending confirmation, which is why they are not currently recommended. K E Y W O R D Sarthritis, arthropathy, drugs, haemophilia

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“…Intra‐articular platelet‐rich plasma (PRP) injection is an easy and minimally invasive therapy that provides a natural concentrate of autologous growth factors from the blood . This regenerative therapy has been increasingly applied in clinical practice to treat musculoskeletal disorders such as tendon injury and osteoarthritis .…”

Section: Introductionmentioning

confidence: 99%

An exploratory comparison of single intra‐articular injection of platelet‐rich plasma vs hyaluronic acid in treatment of haemophilic arthropathy of the knee

Cheng

et al. 2019

Haemophilia

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Introduction Intra‐articular platelet‐rich plasma (PRP) injection therapy has been extensively applied in clinical practice to treat musculoskeletal disorders such as osteoarthritis, but the treatment for haemophilic arthropathy is rarely reported. Aims This study aimed to compare the efficacy of intra‐articular PRP vs hyaluronic acid (HA) injections in treating haemophilic arthropathy of knee joints. Patients Twenty‐two haemophilia patients (mean age, 41.1 ± 1.7 [range, 20‐50] years) with painful haemophilic arthropathy of the knee were enrolled for this open‐label and observer‐blind study. Methods Eleven patients were treated with a single intra‐articular injection of PRP and the other 11 received five consecutively weekly intra‐articular injections of HA. Outcome assessment included pain by visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Chinese Version and synovial change determined by ultrasonography. Results Platelet‐rich plasma and HA intra‐articular injection showed statistically significant reduction in VAS, WOMAC total score and hyperaemia score from baseline to 6‐month post‐treatment. Inter‐group comparison showed statistically significant difference in the change in VAS score, WOMAC pain score, physical function score and total score at 6 months, wherein PRP group showed sustained beneficial effect than HA group at 6 months. Conclusion Our study demonstrates that, in comparison with five weekly injections of HA, a single PRP injection resulted in better improvement in pain relief and knee joint function, and greater reduction in synovial hyperaemia for up to 6 months. Our results suggest that PRP may be practical and effective for haemophilic knee arthropathy, and further investigation is warranted.

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Platelet Rich Plasma for Chronic Synovitis Treatment in Patients with Haemophilia

Abstract: Platelet-rich plasma is a useful, safe, and inexpensive treatment for chronic haemophilic synovitis.

Cited by 22 publications

References 30 publications

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

Age‐related severity and distribution of haemophilic arthropathy of the knee, ankle and elbow among Chinese patients with haemophilia

Haemophilic arthropathy: A narrative review on the use of intra‐articular drugs for arthritis

An exploratory comparison of single intra‐articular injection of platelet‐rich plasma vs hyaluronic acid in treatment of haemophilic arthropathy of the knee

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