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Are the underlying factors (age, gender, and body mass index) involved in the effectiveness of PPR injection in the treatment of knee osteoarthritis? A blinded randomized study
ESSKA Academy. Mardani-kivi M. May 11, 2018; 218124
Mohsen Mardani-kivi
Mohsen Mardani-kivi
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Abstract
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Objectives: To investigate the therapeutic effects of PRP injection plus conservative treatment as intervention group versus normal saline injection plus conservative treatment as control group. We also determined the effects of underlying factors including age, sex and body mass index (BMI) on the therapeutic effects of PRP.

Methods: In this single-blinded randomized clinical trial, all patients aged from 40-65 years with grade 3 of knee OA (moderate grade based on Kellgren-Lawrence radiological classification scale) were evaluated for eligibility. In intervention group leukocyte-poor PRP with double spinning and in control group normal saline was injected with similar protocol. All patients in both group were also provided with a conservative protocol including oral Celecoxib 100mg BID for 4 weeks, modifying physical activity and performing physiotherapy (15 sessions). The VAS score, and WOMAC scores were measured prior to treatment and at 1 week, 3 and 6 months post treatment.

Results: 60 patients with the mean age of 61.6±6.2 years (21 men and 39 women) were randomly assigned into each arm. Demographic characteristics (age, gender and BMI) and pre-treatment scores were similar between the two groups. WOMAC score was improved from pre-treatment to first week post-treatment in both groups (from 54.9±4.8 to 64.4±5.1 in intervention group and from 53.4±4.3 to 62.7±4.8 in control groups). It means that PRP+conservative treatment was effective, similar to placebo+conservative treatment. After adjusting BMI as underlying variable, it was indicated that in the patients with lower BMI, PRP provided better outcome in comparison to conservative treatment alone (P=0.014 and P=0.019, respectively). Also, comparison of functional scores changes with age as underlying variable demonstrated that younger cases obtained better response from PRP rather than conservative alone (P=0.012 and P=0.007, respectively).

Conclusions: PRP seems to be an appropriate choice for treatment of moderate osteoarthritis especially in younger patients and those with lower BMI.

Keywords:
PPR injection, underlying factors,knee, osteoarthritis
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