Buddhadeb Nayak, Harshal S Sakale, Alok C Agrawal, , Bikram K Kar, Sankalp Sharma, Shubham Bhardwaj
Introduction: Osteoarthritis (OA) represents a failure of the diarthrodial, synovial lined joints. It is a degenerative non-inflammatory joint disease. Osteoarthritis is the leading cause of chronic disability, affecting more than 80% of the human population above 55 years. It is due to an imbalance between the destructive and reparative processes involved in repairing and regenerating articular cartilage in the synovial joints. Many options for management of early OA knee are already established in previous literature. Autologous PRP injection in knee joint is an early method of management of early OA knee. The Supra-physiological release of platelet-derived growth factors directly at the site of diseased cartilage may stimulate the natural regenerative signaling cascade and enhance the healing of tissue with further mediation of the anti- inflammatory response. We did autologous PRP injection in knee joint and assessed for its long term outcome and also documented any complications after PRP injection.
Aim: To evaluate the effectiveness of Platelet Rich Plasma in the treatment of patients presenting with primary osteoarthritis of the knee joint in reducing pain and improving physical function. To document the side effects of PRP intraarticular injection and its long term outcome.
Materials and methods: patients with primary OA knee (Alhback score 1-2) received intraarticular PRP injection. Patients were assessed on variables, namely-stiffness and physical function using the WOMAC scale and pain using the Visual Analog Scale (VAS). Knee cap and tablet Paracetamol (for pain relief as required) were advised to the patients following the procedure.
Results: In final (6 months) follow-ups, we found significant improvement in both WOMAC score and VAS score after PRP injection in the knee joint. We also observed that four patients (12.5%) among the participants developed inflammatory reactions, like redness around the knee joint, intolerable pain not responding to the paracetamol, joint effusion, etc., in the knee joint intra-articular PRP was injected. Two patients developed mild inflammation which was treated with oral medication in out-patient basis. Another two patients developed moderate to severe inflammation which warranted surgical intervention. One patient was undergone arthrocentesis and other was undergone arthrotomy. Synovial fluid analysis was sterile, with increased inflammatory markers. Long term follow-up for those four patients were also satisfactory.
Conclusion: We found significant improvement in the final (6 months) of follow-ups after intraarticular PRP injection for the treatment of early OA. Four patients developed inflammatory reaction after injection. Though we found some early inflammatory reaction after PRP injection, we feel that this management line is safe and satisfactory for early arthritis of the knee joint.