Pure platelet rich plasma injections in the management of knee osteoarthritis

Abstract

Introduction: Osteoarthritis is a degenerative joint disease. It is a slowly progressive disease that affects individuals from the fourth decade and continues to progress at a variable rate. Knee is the most common joint affected in this condition. Osteoarthritis of the knee is a common problem in India among the population above 40 years of age. Platelets have known roles in coagulation, inflammatory processes, and immunity modulation. Moreover, during degranulation, platelets release various cytokines and growth factors (vascular endothelial growth factor, platelet-derived growth factor, transforming growth factor-B, insulin growth factor-I, and hepatocyte growth factor) which promote angiogenesis, tissue remodelling, and wound healing. In addition, platelets can reduce painful symptoms by an unknown mechanism which is apparently dependent on the release of proteases with analgesic properties. Pure Platelet rich plasma is a rapid and cost effective method which decreases the symptoms of osteoarthritis for a variable period and results in better functional outcome. Materials and Methods: This is a prospective observational study conducted on 100 knees in 75 patients suffering from Osteoarthritis treated from Feb 2017 till Jan 2018, in the Department Of Orthopaedics, Dr D. Y. Patil Hospital, Pimpri, Pune. All the baseline characteristics of the patients, like demographics, symptoms, Kellegren and Lawrence criteria and functional outcome were recorded. The patients were treated at our hospital with Pure Platelet rich plasma and followed up for a minimum period of nine months. The follow-up information included range of motion, scoring, patient satisfaction and overall outcome of the procedure in terms of patient acceptance. The data was analyzed to determine the functional outcome at nine months.Results: There was satisfaction in terms of symptoms of pain and range of movements of the knee. 37% patients showed excellent prognosis, good and fair prognosis was showed by 30% of the patients while only 3% people showed poor prognosis after a follow up of nine months duration.Conclusion: Pure Platelet Rich Plasma was not only associated with excellent functional outcome and short term recovery in terms of patient satisfaction and range of movements of the knee with decrease in pain nine months post-procedure but also was found to be cost effective.