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Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Efficacy of Intra-articular, intra-osseous Injections of Platelet-Rich Plasma in Osteoarthritis Knee: A Randomized Clinical Trial

Thursday, November 10, 2022

3:24 PM – 3:29 PM

Location: Station 2

Presenting Author(s)

Apurba Barman, MD, DNB (PMR)

Additional Professor
All India Institute of Medical Sciences, Bhubaneswar, India
Bhubaneswar, Orissa, India

Research Objectives: To evaluate the efficacy of intra-articular, intra-osseous Injections of platelet-rich plasma (PRP) and compare its efficacy with intra-articular injection of PRP in OA Knee

Design: A parallel 2 group, prospective randomized clinical trial

Setting: A tertiary care teaching hospital in India

Participants: A total of 64 persons with OA knee with a Kellgren-Lawrence score of 3 were randomized into two groups.

Interventions: Persons in Group-I received 8ml of single intra-articular PRP injection, and persons in Group II received 18 ml of PRP (two-intra-osseous injections (5ml each in femoral-condyle and tibia plateau) and one intra-articular injection (8ml) of PRP (total 18 ml of PRP, for single joint)) the in the target knee joint under fluoroscopic guidance. All persons (n=64) were followed up at 3 and 6 months.

Main Outcome Measures: Clinical outcomes were evaluated using the visual analog (VAS) pain intensity scores and knee injury and osteoarthritis outcome score (KOOS) questionnaire.

Results: There was no disparity between the two groups in baseline demographic and clinical parameters. Both groups demonstrated statistically significant improvement in VAS pain scores and KOOS scores (pain, symptoms, ADL, sport/recreation, and quality of life) at baseline, 3- and 6 months. However, comparing the two groups revealed no significant difference in VAS scores and KOOS scores at six months. Persons in Group-II reported increased injection-associated pain following interventions. Except for injection-associated pain, no other adverse events were reported in any person.

Conclusions: Though both groups showed significant improvement following PRP injections, additional injections of PRP in the subchondral region did not provide additional benefits (pain-relief and KOOS scores) than intra-articular-PRP injections at 6 months.

Author(s) Disclosures: The institutional intramural research grant supported the study.

Learning Objectives:
Learn about 'intra-articular' and 'intra-articular, intra-osseous' injections of platelet-rich plasma (PRP) in the treatment of osteoarthritis (OA) knee
Learn about treatment effect and adverse events following 'intra-articular' and 'intra-articular, intra-osseous' injections of PRP in OA Knee- Grade III
Learn how to perform 'intra-articular' and 'intra-articular, intra-osseous' injections of PRP in OA Knee