Clinical Outcomes of Intraarticular Platelet-Rich Plasma Injection in Knee Osteoarthritis

KIST Medical and Teaching Hospital59 enrolled

Overview

This prospective single-arm interventional study was designed to assess the short-term clinical outcomes of intra-articular platelet-rich plasma (PRP) injections in patients with Kellgren-Lawrence grade II and III knee osteoarthritis. A total of 59 patients (61 knees) were enrolled and followed for six months. Pain and function were measured using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Safety monitoring included documentation of injection-site pain and other adverse events.

Osteoarthritis of the knee is a leading cause of disability worldwide. Platelet-rich plasma (PRP) therapy has emerged as a biologic intervention to enhance cartilage repair and reduce inflammation. This study was conducted at KIST Medical College and Teaching Hospital, Lalitpur, Nepal, between November 2022 and November 2023. Patients aged ≥50 years with KL grade II or III knee OA were enrolled. PRP was prepared using a double-spin centrifugation protocol to yield leukocyte-poor PRP, and 5 ml was injected intraarticularly via an inferolateral approach. Outcomes were assessed at baseline, 2, 4, and 6 months using validated instruments (VAS and WOMAC). Adverse events were monitored throughout the follow-up period.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Knee Osteoarthritis Osteoarthritis (OA)

Interventions

Platelet-Rich Plasma (PRP)BIOLOGICAL

Autologous PRP prepared from 16 ml of venous blood using a double-spin centrifugation protocol (first spin \~700 g for 12 minutes, second spin \~1700 g for 7 minutes). The final product was leukocyte-poor PRP with a mean 4.2-fold increase in platelet concentration. A single 5 ml dose was injected intraarticularly via an inferolateral approach using an 18G needle under aseptic precautions.

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \>50 years * Persistent knee pain \>4 weeks (In the case of patients presenting with bilateral knee pain, the knee with more severe symptoms was selected for study purposes.) * Patient must have undergone conservative treatment for at least 4 weeks. * Radiologically diagnosed as knee osteoarthritis with Kellgren-Lawrence grading scale, grades 2 and 3 * Primary osteoarthritis of the knee Exclusion Criteria: * Immunosuppressed patients (Examples: uncontrolled diabetes, HIV, under corticosteroid medication, etc.) * History of surgery around the knee joint * History of significant knee injury * Patients diagnosed with connective tissue disorders, inflammatory disorders of joints, congenital anomalies of the lower extremity, tumors, and metabolic diseases of bone * Patients who had received intra-articular steroid injections within the past 6 months * Patient who has not attempted conservative treatment. * Presence or suspected of infection or ulceration at the injection site. * Patients with a platelet count less than 1.5 lakhs/microliters * Congenital anomalies of the lower extremity * Patients on NSAIDs 2 days before and 2 days after PRP injection. * Patients with coexisting backache, hip pain * Pregnant or lactating females. * Cases where the diagnosis is uncertain. * Patients not willing to participate in the study

Outcomes

Primary Outcomes

Pain intensity

Unabbreviated scale title: Visual Analogue Scale (VAS) for pain Range: 0 to 10 Interpretation: Higher scores indicate worse pain intensity (0 = no pain, 10 = worst imaginable pain).

Time frame: Baseline to 6 months

Functional outcome

Unabbreviated scale title: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Range: 0 to 96 (total score) Interpretation: Higher scores indicate worse pain, stiffness, and functional limitation (0 = no symptoms, 96 = extreme symptoms).