Intraarticular Injection of Platelet Rich Plasma Versus Corticosteroid in Osteoarthritis Knee

Background & Aims

The use of intraarticular injection of knee has been widely accepted as a therapy for pain due to osteoarthritis of the knee. We compared the efficacy of intraarticular injection of platelet rich plasma with combination of bupivacaine and corticosteroid in osteoarthritis knee.

Methods

Fifty patients (aged more than 50 years) with pain pattern consistent with osteoarthritis knee who did not respond to conservative treatment were included in the study. They were randomly divided in two groups of 25 each: group I (n = 25) patients were administered fluoroscope guided intraarticular knee injection of bupivacaine and steroid, and group ? (n = 25) patients were administered intraarticular knee injection of platelet rich plasma. In group I patients were administered 9 ml drug solution comprising of 8ml of 0.25 % bupivacaine and 1 ml of triamcinolone (40 mg). In group II patients were administered 6 ml of PRP. Pain {Numeric Rating Scale (NRS)}, patient satisfaction and the WOMAC Index were assessed at half hour before the procedure, half hour after the injection, two weeks, one month, two months, three months, six months and twelve months after the procedure.

Results

The two groups were comparable in age, weight, and gender distribution (p>0.05). The variations in pain score (NRS) and WOMAC index in both the groups when compared to baseline at different time intervals were clinically and statistically significant (p<0.05). When compared in between the two groups, NRS and WOMAC index were both clinically and statistically better at two weeks and one month after injection in group I (p<0.05); where as they were better in group II at 2 months, 3 months, 6 months and 12 months after the procedure (p<0.05). Similar results were obtained when different subscales of WOMAC Index like pain, stiffness and physical activity were compared in between the two groups (p<0.05). More than 50% of patients in both groups had excellent satisfaction. However, at two, three, six and twelve months, patient satisfaction was clinically and statistically better in group II (p<0.05). No serious side effects related to the technique or the injectate were observed.

Conclusions

Both the techniques of injection that is fluoroscope guided intraarticular injection of bupivacaine with corticosteroids and platelet rich plasma are effective and provided good pain relief to the patients with symptomatic osteoarthritis knee. However, pain relief and improvement in disability are better and sustained over a period of one year with administration of platelet rich plasma.

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Presenting Author

Naveen Malhotra

Poster Authors

Naveen Malhotra

MD, DNBE, FIAPM

Pt. BDS PGIMS, Rohtak, Haryana, India

Lead Author

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