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Article Type

Article

Subject Area

Rheumatology and Rehabilitation

Abstract

Backgroud Knee osteoarthritis is the most common articular disease. Different methods are used to alleviate the symptoms of patients with knee osteoarthritis, including analgesics, physical therapy, exercise prescription, and intra-articular injections (glucocorticoids, hyaluronic acid). New studies have focused on modern therapeutic methods that stimulate the cartilage healing process and improve the damage, including the use of platelet-rich plasma as a complex growth factor. Aim of the work To evaluate the effectiveness of intra articular PRP in mild to moderate degree knee osteoarthritis. Objectives To slow the rate of progression of knee Osteoarthritis by injection of PRP intraarticular. Decrease pain and disability of patients with knee osteoarthritis and postpone knee arthroplasty as possible. Patients and methods Ninety patients in the age range of 40–75 years who visited the Physical Medicine, Rheumatology, and Rehabilitation outpatient clinic with knee pain for a minimum of 6 months' duration were studied. In these patients, OA was diagnosed according to the visual analog scale (VAS) score, the American College of Rheumatology criteria, radiographic criteria proposed by the Kellgren and Lawrence score 1957 classification, and MSKUS. The patients were classified into three groups according to the number of ultrasonic-guided PRP injections. group I (GI) included 30 patients who received a single PRP injection. Group II (GII) included 30 patients who received two PRP injections 2 weeks apart. Group III (GIII) included 30 patients who received triple PRP injections with a 2-week gap between every injection. The patients were evaluated before treatment, and at the first, third, and 6 months after the PRP injection with the VAS for pain, the Western Ontario and Mc Master Universities Arthritis Index (WOMAC) for physical activity of the knee and MSKUS for the diagnosis and improvement of radiological signs of knee arthritis (grades, synovial hypertrophy, Doppler vascular activity, decreased usage of NSAIDs). Results After the first and second intra-articular PRP injections [i.e., GI [Table 1] and GII [Table 2]], the following results were obtained: According to demographic data [Table 3], the VAS score and the WOMAC score improved, and synovial hypertrophy and usage of NSAIDs decreased after the first and second injections (in mild and moderate cases); there was no significant difference as 50% of mild patients showed improvement, while 18.2% of moderate patients improved). Decreased numbers of improved patients at the sixth month after PRP injection.{Table 1}{Table 2}{Table 3} Conclusion In conclusion, from our results, it was found that intra-articular injection of PRP in patients with mild and moderate knee OA is an effective and safe method. The maximum improvement was observed in mild cases with triple PRP injections.

Keywords

Intra-articular injection, musculoskeletal ultrasound, osteoarthritis, platelet-rich plasma

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