PMID- 33523756
OWN - NLM
STAT- MEDLINE
DCOM- 20210210
LR  - 20210210
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 49
IP  - 2
DP  - 2021 Feb
TI  - Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With 
      Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A 
      Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic 
      Acid.
PG  - 487-496
LID - 10.1177/0363546520986867 [doi]
AB  - BACKGROUND: Although platelet-rich plasma (PRP) has potential as a regenerative 
      treatment for knee osteoarthritis, its efficacy varies. Compositional differences 
      among types of PRP could affect clinical outcomes, but the biological 
      characterization of PRP is lacking. PURPOSE: To assess the efficacy of 
      intra-articular PRP injection in knee osteoarthritis as compared with hyaluronic 
      acid (HA) injection and to determine whether the clinical efficacy of PRP is 
      associated with its biological characteristics. STUDY DESIGN: Randomized 
      controlled trial; Level of evidence, 1. METHODS: A total of 110 patients with 
      symptomatic knee osteoarthritis received a single injection of leukocyte-rich PRP 
      (1 commercial kit) or HA. Clinical data were assessed at baseline and at 6 weeks 
      and 3 and 6 months after injection. The primary endpoint was an improvement in 
      the International Knee Documentation Committee (IKDC) subjective score at 6 
      months, and the secondary endpoints were improvements in scores based on the 
      Patient Global Assessment, the visual analog scale (VAS) for pain, the Western 
      Ontario and McMaster Universities Osteoarthritis Index, and the Samsung Medical 
      Center patellofemoral score. Cell counts and concentrations of growth factors and 
      cytokines in the injected PRP were assessed to determine their association with 
      clinical outcomes. RESULTS: PRP showed significantly improvement in IKDC 
      subjective scores at 6 months (11.5 in the PRP group vs 6.3 in the HA group; P = 
      .029). There were no significant differences between groups in other clinical 
      outcomes. The Patient Global Assessment score at 6 months was better in the PRP 
      group (P = .035). The proportion of patients who scored above the minimal 
      clinically important difference (MCID) for VAS at 6 months was significantly 
      higher in the PRP group (P = .044). Within the PRP group, the concentrations of 
      platelet-derived growth factors were high in patients with a score above the MCID 
      for VAS at 6 months. The incidence of adverse events did not differ between the 
      groups (P > .05). CONCLUSION: PRP had better clinical efficacy than HA. High 
      concentrations of growth factors were observed in patients who scored above the 
      MCID for clinical outcomes in the PRP group. These findings indicate that 
      concentration of growth factors needs to be taken into consideration for future 
      investigations of PRP in knee osteoarthritis. REGISTRATION: NCT02211521 
      (ClinicalTrials.gov identifier).
FAU - Park, Yong-Beom
AU  - Park YB
AD  - Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Kim, Jun-Ho
AU  - Kim JH
AD  - Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Republic of Korea.
FAU - Ha, Chul-Won
AU  - Ha CW
AD  - Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of 
      Korea.
AD  - Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, 
      Republic of Korea.
AD  - Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 
      Seoul, Republic of Korea.
FAU - Lee, Dong-Hyun
AU  - Lee DH
AD  - Department of Orthopedic Surgery, Himchan Hospital, Busan, Republic of Korea.
LA  - eng
SI  - ClinicalTrials.gov/NCT02211521
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
RN  - 9004-61-9 (Hyaluronic Acid)
SB  - IM
MH  - Double-Blind Method
MH  - Humans
MH  - Hyaluronic Acid/therapeutic use
MH  - *Injections, Intra-Articular
MH  - Osteoarthritis, Knee/*therapy
MH  - *Platelet-Rich Plasma
MH  - Treatment Outcome
OTO - NOTNLM
OT  - cytokine
OT  - growth factor
OT  - hyaluronic acid
OT  - osteoarthritis
OT  - platelet-rich plasma
EDAT- 2021/02/02 06:00
MHDA- 2021/02/11 06:00
CRDT- 2021/02/01 17:10
PHST- 2021/02/01 17:10 [entrez]
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2021/02/11 06:00 [medline]
AID - 10.1177/0363546520986867 [doi]
PST - ppublish
SO  - Am J Sports Med. 2021 Feb;49(2):487-496. doi: 10.1177/0363546520986867.