Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in Knee Osteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation
| Autor: | Marie Laure Louis, Christophe Chagnaud, Florence Sabatier, J.-C. Mattei, Charles Eric Bornet, Julie Veran, Jeremy Magalon, Alexandre Rochwerger, Elizabeth Jouve |
|---|---|
| Přispěvatelé: | Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Vascular Endothelial Growth Factor A medicine.medical_specialty WOMAC Arthritis Platelet Transfusion Osteoarthritis Severity of Illness Index Injections Intra-Articular law.invention Transforming Growth Factor beta1 Viscosupplementation Young Adult 03 medical and health sciences 0302 clinical medicine Patient satisfaction Double-Blind Method Randomized controlled trial law Internal medicine Severity of illness Clinical endpoint Humans Pain Management Medicine Orthopedics and Sports Medicine [SDV.BBM]Life Sciences [q-bio]/Biochemistry Molecular Biology Hyaluronic Acid Growth Substances ComputingMilieux_MISCELLANEOUS Aged Pain Measurement Platelet-Derived Growth Factor 030222 orthopedics Platelet-Rich Plasma business.industry 030229 sport sciences Middle Aged Osteoarthritis Knee medicine.disease Treatment Outcome Patient Satisfaction Female business |
| Zdroj: | Arthroscopy: The Journal of Arthroscopy and Related Surgery Arthroscopy: The Journal of Arthroscopy and Related Surgery, 2018, 34 (5), pp.1530-1540.e2. ⟨10.1016/j.arthro.2017.11.035⟩ |
| ISSN: | 0749-8063 1526-3231 |
| DOI: | 10.1016/j.arthro.2017.11.035⟩ |
| Popis: | Purpose To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in knee osteoarthritis, and identify biological characteristics of PRP that may affect their efficacy. Methods Fifty-four patients with symptomatic knee osteoarthritis received a single injection of either PRP (26 patients) or HA (28 patients). They were assessed at baseline and at 1, 3, and 6 months. The primary endpoint was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at 3 months, and secondary endpoints were responders' rate (improvement of at least 5 points or 40% of WOMAC total score at 3 months) of pain evaluation and patient's subjective satisfaction. Cell counts and the contents of vascular endothelial growth factor (VEGF), platelet-derived growth factor–AB (PDGF-AB), transforming growth factor beta 1 (TGF-β1) content of injected PRP were assessed to analyze their relationship with clinical outcome. Results Both treatments proved their improvement in knee functional status and symptom relief, with a significant decrease observed at 1 month on all scores except for pain VAS in PRP group and WOMAC function score in the HA group. No difference between groups regarding WOMAC and VAS scores was observed. A higher percentage of responders was observed in the PRP group (72.7%) than in the HA group (45.8%) without significance ( P = .064). The quantity of injected PDGF-AB and TGF-β1 correlated with the change in WOMAC scores at 3 months and was lower in responders than in nonresponders ( P = .009 and P = .003, respectively). Conclusions Current results indicated that a single injection of very pure PRP offers a significant clinical improvement in the management of knee osteoarthritis, equivalent to a single HA injection in this patient population. Moreover, a significant correlation between the doses of TGF-β1 and PDGF-AB and the worsening of WOMAC score 3 months after the procedure was found. Level of Evidence Level II, randomized double blind controlled trial. |
| Databáze: | OpenAIRE |
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