Platelet‐rich plasma intra‐articular injections for cartilage degeneration and osteoarthritis: single‐ versus double‐spinning approach

• DOI: 10.1007/s00167-011-1837-x
• Publication Date: 2011-12-27T08:58:07Z
• Authors: Giuseppe Filardo; Elizaveta Kon; Maria Teresa Pere...; Franca Vaccaro; Rita Guitaldi; Alessandro Di Mar...; Annarita Cenacchi; Pier Maria Fornasari; Maurilio Marcacci
• Keywords: Adult; Male; Platelet-Rich Plasma; Middle Aged; Osteoarthritis, Knee; Injections, Intra-Articular; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Patient Satisfaction; Linear Models; Humans; Female; Orthopedic Procedures; Prospective Studies; platelet rich plasma; cartilage degneration; OSTEOARTHRITIS; Cartilage Diseases; Aged; Follow-Up Studies

AbstractPurposeTo compare the safety and efficacy of two different approaches of platelet‐rich plasma (PRP) production methods as intra‐articular injection treatment for knee cartilage degenerative lesions and osteoarthritis (OA).MethodsThe study involved 144 symptomatic patients affected by cartilage degenerative lesions and OA. Seventy‐two patients were treated with 3 injections of platelet concentrate prepared with a single‐spinning procedure (PRGF), the other 72 with 3 injections of PRP obtained with a double‐spinning approach. The patients were evaluated prospectively at the enrollment and at 2, 6, and 12 months’ follow‐up with IKDC, EQ‐VAS and Tegner scores; adverse events and patient satisfaction were also recorded.ResultsBoth treatment groups presented a statistically significant improvement in all the scores evaluated at all the follow‐up times. Better results were achieved in both groups in younger patients with a lower degree of cartilage degeneration. The comparative analysis showed similar improvements with the two procedures: in particular, IKDC subjective evaluation increased from 45.0 ± 10.1 to 59.0 ± 16.2, 61.3 ± 16.3, and 61.6 ± 16.2 at 2, 6, and 12 months in the PRGF group, and from 42.1 ± 13.5 to 60.8 ± 16.6, 62.5 ± 19.9, and 59.9 ± 20.0 at 2, 6, and 12 months in the PRP group, respectively. Concerning adverse events, more swelling (P = 0.03) and pain reaction (P = 0.0005), were found after PRP injections.ConclusionsAlthough PRP injections produced more pain and swelling reaction with respect to that produced by PRGF, similar results were found at the follow‐up times, with a significant clinical improvement with respect to the basal level. Better results were achieved in younger patients with a low degree of cartilage degeneration.Level of evidenceII.