Annals of the Rheumatic Diseases | 2019
THU0422\u2005COMPARISON OF PRP DERIVED GROWTH FACTOR (PRGF) VERSUS HYALURONIC ACID (HA) IN MILD TO MODERATE KNEE OSTEOARTHRITIS; A SINGLE BLIND ONE YEAR RANDOMIZED CLINICAL TRIAL STUDY
Abstract
Background Osteoarthritis (OA) is the most common joint disease with characteristics of progressive loss of joint cartilage. Objectives Aim of this study was to evaluate clinical outcomes of intra-articular injection of PRP derived growth factor (PRGF) versus hyaluronic acid (HA) in patients with knee osteoarthritis. Methods 102 patients with grade П or grade Ш knee OA were randomly assigned to 2 intra-articular injections of PRGF 3 weeks apart or 3 weekly injections of HA. Primary outcome was the mean change from baseline until 2, 6 and 12 months post intervention in scores of visual analog scale (VAS), WOMAC and Lequesne index. Results The mean age of patients was 57.08±7.3 in PRGF compared to 58.63±7.09 in HA group. In PRGF group, VAS decreased from 7.8±1.5 to 4.5±1.7, and from 7.8±1.1 to 6.1±1.8 in the HA group after 12 months (P<0.0001). Total WOMAC score decreased from 41.96±11.71 to 27.10±12.3 (P = 0.02), and from 39.71±10.4 to 32.41±11.8 after 12 months, respectively (P > 0.05). In Lequesne index, all scores were significantly decreased after 12 months in PRGF group in comparison to HA group (P<0.001). Conclusion Although PRGF and HA were both effective, but PRGF injection resulted in significantly higher satisfaction, lower VAS and Lequesne pain score and improvement in function of patients with symptomatic mild to moderate knee osteoarthritis. References [1] Raeissadat SA, Rayegani SM, Tabibian E, Rahimi Dehgolan S. Intra-articular ozone injection efficacy in knee osteoarthritis: A systematic review with meta-analysis. Annals of Physical and Rehabilitation Medicine. 2018;61:e132-e3. [2] Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, et al. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) versus Hyaluronic Acid (A one-year randomized clinical trial). Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2015;8:CMAMD.S17894. [3] Raeissadat SA, Rayegani SM, Ahangar AG, Abadi PH, Mojgani P, Ahangar OG. Efficacy of Intra-articular Injection of a Newly Developed Plasma Rich in Growth Factor (PRGF) Versus Hyaluronic Acid on Pain and Function of Patients with Knee Osteoarthritis: A Single-Blinded Randomized Clinical Trial. Clinical medicine insights Arthritis and musculoskeletal disorders. 2017;10:1179544117733452.Abstract THU0422 – Figure 1 Mean values of Lequesne total at baseline, 2, 6 and 12 months after injection. PRGF indicates plasma rich in growth factor Disclosure of Interests None declaredAbstract THU0422 – Table 2 WOMAC and VAS mean scores at baseline, 2, 6 and 12 months after injection. WOMAC index Pain Stiffness Function Total VAS PRGF HA PRGF HA PRGF HA PRGF HA PRGF HA Baseline 8.25±2.7 8.14±2.6 2.86±1.8 2.57±.1.4 30.75±8.5 29±8.1 41.96±11.71 39.71±10.4 7.8±1.5 7.8±1.1 At 2 mo 4.98±2.6 5.31±2.3 1.53±1.4 1.2±1.1 19.75±8.2 20.78±6.6 26.25±11.17 27.37±9.09 4.2±2.01 4.4±1.6 At 6 mo 5.22±3.05 5.9±2.3 1.43±1.5 1.2±1.2 18.22±9.9 21.12±6.6 24.86±14 28.35±9.4 4.3±2.3 4.7±1.9 At 12 mo 5.47±2.6 6.3±2.6 1.8±1.34 1.6±1.2 19.82±8.9 24.43±8.4 b27.10±12.3 32.41±11.8 4.5±1.7 6.1±1.8 P-value Within groups <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 <0.0001 P-value Between groups 0.339 0.856 a0.009 b0.02 c 0.0001