Comparative Effectiveness of Knee Arthroscopy Versus Intra-Articular Platelet Rich Plasma Injection for Osteoarthritis of the Knee: A Randomized Study
Authors/Creators
- 1. Associate Professor, Department of Orthopaedic, Varunarjun Medical College, Shahjahanpur, UP
- 2. Resident, Department of Anesthesia, Rohilkhand Medical College & Hospital Bareilly, UP
Description
Objective: The objective of this randomized study was to compare the efficacy of osteoarthritis knee arthroscopy and intra-articular platelet-rich plasma (PRP) injection in the treatment of osteoarthritis of the knee. Methods: Forty patients diagnosed with osteoarthritis of the knee were randomly assigned to two treatment groups: arthroscopy (n=20) and PRP injection (n=20). The arthroscopy group underwent a minimally invasive surgical procedure to remove damaged cartilage and smooth joint surfaces, while the PRP group received intra-articular injections of autologous platelet-rich plasma. Pain scores, functional outcome measures, and radiographic evaluations were recorded at baseline and at 3 months, 6 months, and 12 months post-treatment. Results: Both treatment groups improved pain scores and functional outcomes over the study. The arthroscopy group had a mean VAS pain reduction of 45% (± 10.5) at three months, while the PRP group had 38% (± 9.7). This difference was insignificant (p=0.14). At 6 months, arthroscopy reduced pain by 58% (± 12.3) and PRP by 51% (± 11.2) (p=0.26). The arthroscopy group had a mean pain reduction of 62% (± 13.8) at 12 months, while the PRP group had 56% (± 12.4) (p=0.35). Both groups improved functional outcome measures at each follow-up. At 3 months, the arthroscopy group had a greater knee ROM increase (38° ± 8.2) than the PRP group (30° ± 7.6) (p=0.04). At 6 and 12 months, knee ROM did not differ significantly between groups (p>0.05). Radiographs showed no significant differences in joint space narrowing or cartilage thickness between treatment groups at any time (p>0.05). Conclusion: Both osteoarthritis knee arthroscopy and intra-articular platelet-rich plasma injection were found to be effective treatment options for osteoarthritis of the knee. While arthroscopy demonstrated a greater improvement in knee range of motion at 3 months, no significant differences were observed between the two groups in terms of pain reduction, functional outcome measures, or radiographic evaluations at any other time points. These findings suggest that PRP injection could be a viable alternative to arthroscopy in selected patients, considering its non-invasiveness and potential for fewer complications. Further studies with larger sample sizes are warranted to confirm these results and investigate long-term outcomes.
Abstract (English)
Objective: The objective of this randomized study was to compare the efficacy of osteoarthritis knee arthroscopy and intra-articular platelet-rich plasma (PRP) injection in the treatment of osteoarthritis of the knee. Methods: Forty patients diagnosed with osteoarthritis of the knee were randomly assigned to two treatment groups: arthroscopy (n=20) and PRP injection (n=20). The arthroscopy group underwent a minimally invasive surgical procedure to remove damaged cartilage and smooth joint surfaces, while the PRP group received intra-articular injections of autologous platelet-rich plasma. Pain scores, functional outcome measures, and radiographic evaluations were recorded at baseline and at 3 months, 6 months, and 12 months post-treatment. Results: Both treatment groups improved pain scores and functional outcomes over the study. The arthroscopy group had a mean VAS pain reduction of 45% (± 10.5) at three months, while the PRP group had 38% (± 9.7). This difference was insignificant (p=0.14). At 6 months, arthroscopy reduced pain by 58% (± 12.3) and PRP by 51% (± 11.2) (p=0.26). The arthroscopy group had a mean pain reduction of 62% (± 13.8) at 12 months, while the PRP group had 56% (± 12.4) (p=0.35). Both groups improved functional outcome measures at each follow-up. At 3 months, the arthroscopy group had a greater knee ROM increase (38° ± 8.2) than the PRP group (30° ± 7.6) (p=0.04). At 6 and 12 months, knee ROM did not differ significantly between groups (p>0.05). Radiographs showed no significant differences in joint space narrowing or cartilage thickness between treatment groups at any time (p>0.05). Conclusion: Both osteoarthritis knee arthroscopy and intra-articular platelet-rich plasma injection were found to be effective treatment options for osteoarthritis of the knee. While arthroscopy demonstrated a greater improvement in knee range of motion at 3 months, no significant differences were observed between the two groups in terms of pain reduction, functional outcome measures, or radiographic evaluations at any other time points. These findings suggest that PRP injection could be a viable alternative to arthroscopy in selected patients, considering its non-invasiveness and potential for fewer complications. Further studies with larger sample sizes are warranted to confirm these results and investigate long-term outcomes.
Files
IJPCR,Vol15,Issue7,Article146.pdf
Files
(288.2 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:77219dcdd91333615502520eb0552fae
|
288.2 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-05-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue7,Article146.pdf
- Development Status
- Active
References
- 1. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: A disease of the joint as an organ. Arthritis Rheum. 2012; 64(6):1697-1707. 2. Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73(7):1323-1330. 3. Bannuru RR, Osani MC, Vaysbrot EE, McAlindon TE. Comparative safety profile of knee osteoarthritis treatments: A structured literature review. J Clin Rheumatol. 2016; 22(8):405-420. 4. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopy up to date: Hip femoroacetabular impingement. Arthroscopy. 2016; 32(1):177-189. 5. LaPrade RF, Chahla J, Dean CS, et al. The central pivot of the knee and its significance to the ACL. Knee Surg Sports Traumatol Arthrosc. 2017; 25(12):3752-3754. 6. Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus: A systematic review and meta-analysis. CMAJ. 2014; 186(14):1057-1064. 7. Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013; 369(26):2515-2524. 8. Filardo G, Di Matteo B, Di Martino A, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011; 19(4):528- 535. 9. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: From pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009; 27(3):158- 167. 10. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: A prospective, double-blind, randomized trial. Am J Sports Med. 2013; 41(2):356-364. 11. Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of intraarticular platelet-rich plasma injections in knee osteoarthritis: A systematic review. Arthroscopy. 2016; 32(3):495-505.