Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis

Kon, Elizaveta; Mandelbaum, Bert R.; Buda, Roberto; Filardo, Giuseppe; Delcogliano, Marco; Timoncini, Antonio; Fornasari, Pier Maria; Giannini, Sandro; Marcacci, Maurilio

doi:10.1016/j.arthro.2011.05.011

Cited by 507 publications

(470 citation statements)

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“…12 More than 30 clinical trials have been conducted, and published results over the last 7 years have more or less successfully established the PRP's role in decreasing pain and improving knee function scores. 12,[16][17][18][19] Studies comparing PRP with viscosupplements also seem to favor PRP over viscosupplements, barring a few reports. 20 The overall consensus is that PRP is effective in early degenerative knees (grade I, II) and in relatively young individuals.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

2018

Journal of Postgraduate Medicine, Education and Research

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Introduction: Platelet-rich plasma (PRP) is fast emerging as a minimally invasive treatment option in a wide variety of orthopedic conditions. We were the forerunners in India in its use in osteoarthritis (OA), lateral epicondylitis, plantar fasciitis, and sports injuries. We present our experience with prospective clinical studies and multiple research projects, and have shown some aspects to be reproducible and evidence-based, whereas some areas of application seem to demand more evidence prior to routine recommendation for use.

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Section: Discussionmentioning

confidence: 99%

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

2018

Journal of Postgraduate Medicine, Education and Research

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“…Kon et al 45 treated three groups of 50 patients with knee OA who received PRP, high and low molecular weight HA respectively and the clinical responses measured by IKDC and EQ-VAS scores were higher in patients that received PRP injections compared to HA. The low molecular weight HA performed better than the high molecular weight; however, still lower than the response obtained by PRP.…”

Section: Platelet-rich Plasma (Prp)mentioning

confidence: 99%

“…However, there is limited quantity of MSCs available in the joint and the process of differentiation is slow and sluggish. 44,45 Therefore external administration of MSCs may help to improve the cartilage repair and regeneration. The bone marrow derived stromal cells have shown promising results for repairing the damaged cartilage tissue.…”

Section: Mesenchymal Stem Cells (Mscs)mentioning

confidence: 99%

“…However, middle-aged patients with moderate to severe OA demonstrated no significant benefit with PRP over HA. 45,70 Knop et al 71 conducted a comprehensive and systematic search of the literature on the use of PRP in the treatment of OA of the knee. A total of 23 studies were selected with nine being controlled trials and of these seven randomized, which included total of 725 patients.…”

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Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

Venkatesh¹

2017

ATROA

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Abbreviations: ACI, autologous chondrocyte implantation;MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; BMC, autologous bone marrow concentrate; TKR, total knee replacement IntroductionOsteoarthritis is a form of arthritis described as a degenerative joint disease that results from the breakdown of articular cartilage and underlying subchondral bone.1,2 Cartilage is firm, rubbery, protein substance that serves as a "cushion" between the bones, providing a smooth, gliding surface for joint motion. As the cartilage breaks down, it causes pain, swelling, stiffness and problems moving the joint.3 Therefore, Osteoarthritis is a chronic disease and a major cause of disability, characterized by irreversible cartilage degeneration, bony changes of the joints, deterioration of tendons and ligaments, and inflammation of the synoviumas shown in Figure 1. 4 An initial degeneration, known as the 'pre-OA' state may be reversible spontaneously or through preventive measures, however, if not stopped, the disease progresses to later stages which results in loss of articular cartilage surface integrity, break down of bone and osteophyte formation.3,5 OA can affect any joint, but it most often occurs in the knee, hip, lower back and neck, small joints in the finger and base of the big toe ( Figure 2). 6,7Osteoarthritis of the knee is the most common chronic condition affecting all races, gender and ages, but known to be the most common in elderly and obese people. 8,9 The knee acts as a conduit for transferring body weight essential for normal human mobility and the menisci is known to maintain the normal function of the knee, distribute load, lubricate the joint and provide joint stability. Injury to the meniscus from ageing cartilage, repetitive activity or trauma results in pain, limits movement and can accelerate the occurrence and development of OA. In general, partial or complete meniscectomy causes OA of the knee. 8,10,11 While the prevalence of OA increases with age and causes significant decline in the quality of life of individuals above the age of 65, there is increasing evidence of OA in younger population as a result of prior injuries such as anterior cruciate ligament tear or meniscal tears. 8,12,13 Figure 1 Comparison schematic between healthy knee and arthritic knee.Osteoarthritis affects about 237 million of the population, of which an estimated 9 million people alone in United States suffer from symptomatic knee osteoarthritis and it is predicted that an additional 19 million people will be affected by arthritis by 2020. 14-17The incidence of chondral defects is frequent with sporting injuries, and in elderly patients specifically 10% of population over the age of 55 years have troublesome knee pain, and of those, 25% are severely disabled.18 Depending on disease severity, management ranges from conservative treatment to surgical intervention, including total knee replacement. 14,19 In recent years the number and cost of TKR has increased dramatically between 2001 and 2012 from 305,000 to 610,000 procedu...

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“…PRP'nin eklem içi enjeksiyonları diz, kalça gibi birçok eklemi içeren dejenerasyonların tedavisi için başarılı bir şekilde kullanılmasına rağmen 13,14 , TME-OA tedavisinde etkinliğini inceleyen sınırlı sayıda çalışmalar vardır. 6,[15][16][17] Bu son dönem yapılan çalışmalarda PRP nin daha iyi klinik ve radyolojik iyileşme sağladığı ve ayrıca eklem sesi ve ağrılarda azalmanın yanı sıra ağız açma miktarlarındada artış sağladığı belirlilmiştir.…”

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Temporomandi̇bular Eklem Osteoartri̇tli̇ Hastalarda Artrosentezi̇ Taki̇ben Yapilan Trombosi̇tten Zengi̇n Plazma, Hyaluroni̇k Asi̇t Ve Korti̇kosteroi̇d Enjeksi̇yonlarinin Temporomandi̇bular Eklem Palpasyonunda Oluşan Ağriya Etki̇leri̇ni̇n Karşilaştirilmasi

Kilinç¹,

Güngörmüş²

2016

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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ÖZAmaç: Bu çalışmanın amacı temporomandibular eklem (TME) osteoartritli hastalarda uygulanan 4 farklı tedavi yönteminin Temporomandibular eklemin lateral ve posterior palpasyonundaki ağrıda meydana getirdiği değişimleri karşılaştırmaktır. Yöntem: Bu çalışmaya hem klinik inceleme ile ve hem de konik ışınlı bilgisayarlı tomografik değerlendirme (CBCT) ile TME osteoartriti (TME-OA) teşhisi konulan erişkin hastalar dahil edilmiş ve bu hastalar rastgele bir şekilde 4 farklı tedavi grubuna ayrılmıştır: sadece artrosentez (1), artrosenteze ilave yapılan trombositten zengin plazma (PRP) (2), hyaluronikasid (HA) (3) veya kortikosteroid (KS) (4) enjeksiyonları. Kontrol grubu15 dejeneratif ekleme sahip 12 hasta, PRP grubu32 dejeneratif ekleme sahip 18 hasta, HA grubu 17 dejeneratif ekleme sahip 13 hasta ve KS grubu ise 17 dejeneratif ekleme sahip 12 hasta içermiştir. Bu hastalara tedavi başlangıcında tek seans artrosentez işlemi uygulanmıştır. PRP grubunda ilave 5 seans, HA grubunda ilave 1 seans Hyalgan ve KS grubunda ilave 1 seans Depomedrol'uneklem içi enjeksiyonları uygulanmıştır. Temporomandibular eklemin lateral ve posteriorpalpasyonundaki ağrı, 5 dereceli ağrı skalası (0 = yok; 1= hafif; 2= orta; 3= yoğun; 4= şiddetli) kullanılarak tedavi öncesi ve tedaviden sonraki ortalama 1. yılda değerlendirilmiştir. Gruplar arası karşılaştırma Mann Whitney U testi yapılarak değerlendirilmiştir. Bulgular: Kontrol grubu ile karşılaştırıldığında, PRP grubunda posterior TME palpasyonunda, HA grubunda ise lateral ve posterior TME palpasyonunda oluşan ağrı skorlarında istatistiksel olarak daha fazla iyileşme gözlemlen-miştir. KS grubunda anlamlı bir iyileşme görülmemiştir. PRP grubunda lateral TME palpasyonunda oluşan ağrı skorlarında ise, HA ve KS grupları ile karşılaştırıldığında istatistiksel olarak daha fazla iyileşme gözlemlenmiştir. Sonuç: Bu çalışmanın bulguları, artrosentezi takiben uygulanan eklem içi PRP enjeksiyonlarının kontrol, HA ve KS gruplarına nazaran TME palpasyonundaki ağrı üzerinde daha fazla iyileşme sağladığını göstermiştir. Anahtar Kelimeler: Ağrı, Artrosentez, Hyaluronik asit, Kortikosteroid, TME Osteoartriti, Trombositten zengin plazma. ABSTRACT Aim:To compare long-term changes of pain during lateral and posterior palpation of the joint with osteoarthritis (TMJ-OA) treated with four different treatment options. Methods: The sample composed of the adult patients with TMJ-OA met the inclusion criteria, and they were randomly divided into four groups: arthrocentesis alone (Control group), arthrocentesis plus platelet-rich plasma (PRP), arthrocentesis plus hyaluronic acid (HA), and arthrocentesis plus corticosteroid (CS) (Methylprednisolone acetate) injections. Control group consisted 15 osteoarthritic joints of 12 subjects, PRP group consis-ted 32 osteoarthritic joints of 18 subjects, CS group consisted 17 joints of 12 subjects, and HA group consisted of 17 joints of 13 subjects. Arthrocentesis was performed in the all groups. Additional five sessions PRP injections and one session HA or CS injections were perfo...

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Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis

Cited by 507 publications

References 42 publications

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

Temporomandi̇bular Eklem Osteoartri̇tli̇ Hastalarda Artrosentezi̇ Taki̇ben Yapilan Trombosi̇tten Zengi̇n Plazma, Hyaluroni̇k Asi̇t Ve Korti̇kosteroi̇d Enjeksi̇yonlarinin Temporomandi̇bular Eklem Palpasyonunda Oluşan Ağriya Etki̇leri̇ni̇n Karşilaştirilmasi

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