Plasma rich in platelets versus hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis

Background: Knee osteoarthritis is the most frequent disease among elder population. The present study aimed to compare and analyze between three methods of the treatment of knee osteoarthritis at Department of Orthopaedics and Traumatology of Locomotory Apparatus University of P. J. Safarik, Faculty of Medicine and University Hospital of L. Pasteur in Kosice in Slovakia and its outpatient clinics for a period of one year. Methods: We performed a randomized double blind study with two control groups. A total of 382 patients with Grade 1, 2 or 3 osteoarthritis according to Kellgren and Lawrence grading scale were enrolled in the study. One group of patients was treated with three intra-articular application of PRP and the second group of patients with three injections of hyaluronic acid and the third group of patients with one intra articular injection of glucocorticoid. Outcome measured by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, Patient´s global impression of change (PGIC) and 11-point pain intensity Numeric Rating Scale (NRS) measured during one year. Results: A comparison of the results between groups was recorded significantly better in the group with PRP applied, and in the evaluation of the scheme of NRS index as well as WOMAC index and PGIC (p < 0,01). The evaluation of the platelet concentration was found that the average concentration of platelets in the PRP preparation was 4,34 times higher than the concentration of platelets in the peripheral blood of the volume. Conclusions: Autologous platelet-rich plasma as an effective, simple, relatively low cost, minimally invasive and safe method in treatment of initial stages of knee osteoarthritis in long term, which is based on the body's own concentrate with no additives. Biological potential of PRP in the regeneration of tissues, the relative Easy to prepare and application security in terms of exclusion risk of transmission of infectious diseases and allergic reactions. Intra-articular injections of PRP significantly reduce pain and restore function of the knee joint in patients with knee osteoarthritis. This value is consistent with the literature recommended concentration of platelets in the PRP.most suitable of all possibilities when considering the severity of the follow-up and mortality of AP. (author)