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Archives of Orthopaedic and Trauma Surgery

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09.08.2016 | Arthroscopy and Sports Medicine

Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis

verfasst von: Mario Simental-Mendía, José F. Vílchez-Cavazos, Víctor M. Peña-Martínez, Salvador Said-Fernández, Jorge Lara-Arias, Herminia Guadalupe Martínez-Rodríguez

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 12/2016

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Abstract

Introduction

Knee osteoarthritis (OA) is a degenerative and progressive articular cartilage disease. Infiltration of autologous platelet-rich plasma (PRP) has been proposed as a therapeutic alternative due to the content of biologically active cytokines in PRP. We aimed to compare the clinical response of acetaminophen and intra-articular leukocyte-poor PRP (LP-PRP) in early knee OA.

Materials and methods

A total of 65 patients with clinically and radiographically documented knee OA (grade 1–2) were analyzed. Patients were randomized into two groups: 32 were treated with acetaminophen (500 mg/8 h) over 6 weeks, and 33 received three intra-articular injections of autologous LP-PRP (once every 2 weeks). All patients were evaluated by the Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities (WOMAC) score, and the SF-12 health survey at baseline and 6, 12, and 24 weeks of follow-up. All LP-PRP preparations were analyzed for the platelet, leukocyte, IL-1ra, and TGF-β concentrations.

Results

The decrease in the VAS pain level in the LP-PRP group was greater than that in the acetaminophen group (p < 0.05). Patients treated with LP-PRP showed a sustained improvement in knee function at week 24 (p < 0.01). The SF-12 results only indicated an improvement in quality-of-life in the LP-PRP group at 6, 12, and 24 weeks of follow-up (p < 0.01). Both IL-1ra and TGF-β were detected in the LP-PRP samples (313.8 ± 231.6 and 21,183.8 ± 8556.3 pg/mL, respectively).

Conclusions

Treatment with LP-PRP injections resulted in a significantly better clinical outcome than did treatment with acetaminophen, with sustained lower EVA and WOMAC scores and improvement in quality-of-life (higher SF-12 score). Therapy with LP-PRP may positively modify the inflammatory joint environment by counteracting IL-1β action.

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Titel: Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis
verfasst von: Mario Simental-Mendía
José F. Vílchez-Cavazos
Víctor M. Peña-Martínez
Salvador Said-Fernández
Jorge Lara-Arias
Herminia Guadalupe Martínez-Rodríguez
Publikationsdatum: 09.08.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 12/2016
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2545-2

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