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ORIGINAL ARTICLE
Year : 2018  |  Volume : 4  |  Issue : 3  |  Page : 91-95

Intra-articular Injection of Platelet-rich Plasma vs. Local Anesthetic with Steroid to Treat Knee Osteoarthritis: A Prospective Randomized Controlled Study


1 Consultant, Pain and Palliative Care Unit, Department of Anaesthesiology, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Senior Resident, Department of Anaesthesiology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
3 Junior Resident, Department of Anaesthesiology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
4 Professor, Department of Anaesthesiology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India

Correspondence Address:
H Kavya
Junior Resident, Department of Anaesthesiology, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0116

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Introduction: Osteoarthritis (OA) of the knee is a prevailing, chronic degenerative condition that generates a high expense. Alternative and adjuvant therapies are currently being foraged to improve the physical function and quality of life of affected patients. Intraarticular (IA) corticosteroid injection provides a short-term reduction in OA knee pain. Platelet-rich plasma (PRP) is now an emerging modality for OA knee, but there is still a lack of clinical evidence. Aim: To evaluate the clinical effectiveness of knee IA injection of corticosteroid + local anesthetic (LA) with that of autologous PRP using standard scoring systems. To assess the degree of pain relief, improvement in range of motion of the knee joint and incidence of adverse effects. Materials and methods: Sixty-four patients selected according to the inclusion criteria were treated with two IA injections given 4 weeks. All patients were divided into two groups–group P and S. Thirty two patients in group P were treated with PRP and 32-patients in group S with LA + Steroid. All patients were prospectively evaluated at the pain clinic and 3 and 6 months after the treatment for the following parameters: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, index of severity for knee osteoarthritis (ISK) score by Lequesne et al., visual analog score (VAS) score and range of motion of knee. Adverse events were also chronicled. Results: There was an improvement in both the groups at 3 months, but there was no statistically significant difference between the ISK scores, MWI scores, and ROM whereas VAS score in group S was significantly lower than group P (p value = 0.03). At 6 months follow-up, the mean VAS score, the ISK scores, MWI scores and ROM in the group P were significantly lower than group S (p value = 0.0001; 0.0001; 0.003; 0.001). No significant complications related to injection were observed during the treatment and follow-up. Conclusion: Improvement in the knee function was better with PRP than steroid group at short term follow-up. PRP issafe and more effective than steroids in alleviating pain in symptomatic OA knee.


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