Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlePlatelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis
Section snippets
Patient Selection
Clinical experimentation of this prospective comparative study was approved by our hospital's ethics committee and internal review board, and informed consent in all patients was obtained.
The following diagnostic criteria for patient selection were used: patients affected by a unilateral lesion with a history of chronic (≥4 months) pain or swelling of the knee and imaging findings (radiography or magnetic resonance imaging [MRI]) of degenerative changes of the joint. Exclusion criteria included
Results
No complications related to the infiltrations were observed during the treatment and follow-up period. A statistically significant improvement in all clinical scores from basal evaluation to the 2- and 6-month follow-up visits was observed in all treatment groups (Table 2, Figure 3, Figure 4). These results were confirmed, including age as a covariate in the analysis.
Further analysis showed the overall worst results in patients aged over 50 years: at 6 months of follow-up, IKDC evaluation
Discussion
The results of this study showed positive effects of PRP in patients affected by knee degeneration, with an improvement of symptoms and function.
Articular cartilage lesions and degeneration are difficult to treat and present a challenge for orthopaedic surgeons because of the distinctive structure and function of hyaline cartilage and its inherent low healing potential.3, 4, 5, 29 For therapeutic intervention, laboratory investigations are focusing on the possibility of preserving normal
Conclusions
The clinical results of this comparative study suggest that this procedure may be useful for the treatment of degenerative articular pathology of the knee. Autologous PRP injections showed more and longer efficacy than HA injections in reducing pain and symptoms and recovering articular function, in particular in more active patients with a low degree of cartilage degeneration. In patients aged 50 years or younger, LW HA and PRP were more effective than HW HA at 2 months and PRP was more
Acknowledgment
The authors thank A. Di Martino, G. Altadonna, F. Balboni, M. Lo Presti, A. Bondi, S. Bassini, A. Montaperto, B. Di Matteo, and L. D'Orazio at the Biomechanics Laboratory–III Clinic, Rizzoli Orthopaedic Institute; A. Gabriele, F. Pieretti, M. Vaccari, A.M. Del Vento, M. Zagarella, V. Roverini, I. Brognara, L. D'Amato, and S. Ardone at the Immunohematology and Transfusion Medicine Service, Rizzoli Orthopaedic Institute; and E. Pignotti from the Task Force, Rizzoli Orthopaedic Institute, Bologna,
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The authors report no conflict of interest.