The PPT is on Effectiveness platelet rich plasma in the treatment of osteoarthritis of knee

1. EFFECTIVENESS OF PLATETLET RICH
PLASMA IN THE TREATMENT OF MILD TO
MODERATE KNEE OSTEOARTHRITIS
Presentation By : Dr. Bindusar
Moderator: Dr. Vinay Patil

2. INTERNATIONAL JOURNAL OF
ORTHOPAEDICS SCIENCES
Published in 2020;
6th EDITION, 4th
Volume

3. CONTENTS

4. CONTENTS AIM:
To assess the functional outcome of
the treatment of Osteoarthritis of
knee by intra-articular injection of
platelet Rich Plasma

5. CONTENTS METHODS:
 50 Patients with Grade 0 -3 OA Knee - selected
 2 Doses of Intra-articular PLATELET RICH PLASMA given
with 1month interval.
 Outcomes assessed with at 1, 3, & 6 months interval.
1) Visual Analog Scale
2) WOMAC(Western Ontario Memaster University
of Arthritis Index)
Kellgren Lawrence Grading System

6. CONTENTS RESULTS:
Better improvements noted in VAS and WOMAC Scale.
 Best Scores - 2months interval
 Scores deteoriated over 6 months .
 But, Final Outcome still better than Pre-injection scores.
 No significant complications were observed other than
transient increasein local for 2-3 days
With a two doses of PRP, there was significant reduction in
in pain and significant improvement in functoional outcome.

7. CONTENTS HOW DID
THIS
HAPPEN

8. ege
CONTENTS

9. CONTENTS  Osteoarthritis is a Degenerative condition of the cartilage.
Also called Degenerative joint disease, degenerative
arthritis, Osteoarthrosis .
Then WHY suffix -itis?
 Some evidence of synovitis is often present
 Inflammation is not the major componenet of the disorder.

10. CONTENTS
 Osteoarthritis is a condition of Retrogressive sequele of
Cell and Matrix Changes
LOSS of articular Cartilage Structure & Function
Cartilage Repair and Bone Remodelling reactions

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23. CONTENTS

24. CONTENTS 30ml
10ml PRP
Separates RBCs

25. CONTENTS

26. CONTENTS

27. CONTENTS ALPHA GRANULES

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29. CONTENTS 50 patients with grade 0 – 3 osteoarthritis of knee in
the age 40-70 were studied from 2018- 2020
Exclusion Criteria
Patients with
1) Immunocompromised patients
2) Secondary Osteoarthritis
3) Connective tissue disorders
4) Inflammatory disorders of Joints
5) Recipients of Hyaluronic acid, steroid
injections within past 8 months
6) hemoglobin less than 10 gm%
7) Tumors

30. CONTENTS MEDICAL HISTORY
Examination done
Routine investigation done
Participants were given 2 doses of PRP injections at 1
month interval on OPD basis

31. CONTENTS
S
Under Aseptic Precautions, Patient in supine position,
with knee in extension
5 cc PRP in a sterile syringe is injected into the
articular space of knee by 2 approach
1) Superiolateral approach
2) Para patellar approach

32. CONTENTS
S
Point of Entry:
1 finger breadth
Above and lateral to
superio-lateral pole of
patella
5 cc of PRP injected with 22 G Needle, directing
the needle 45 degree to the saggital and to the
coronal plane

33. CONTENTS
S
Point of Entry:
Medial and lateral to
patellar tendon in the
Joint tendon

34. CONTENTS Sampson et al.
 Reported a case series of 14 patients with primary knee
OA
 Each patient receiving 3 PRP at 4-week intervals.
. At 1-year follow-up,
 There was a reduction in pain at rest, with moving, and
with the knee bent.
 There were no adverse outcomes and 8 of 13 patients felt
they achieved their goal with the injection

35. CONTENTS In 2012, Sanchez et al.
conducted the first multicenter, double-blind
randomized controlled trial
Comparing PRP to HA.
The study of 176 patients with symptomatic
knee OA
patients treated with PRP had greater than
50% reduction of pain at 6 months
This was significantly higher than the pain
reduction scores for patients treated with HA.

36. Kon et-al
patients younger than age 50 had
greater benefit
better response to PRP
than HA
CONTENTS

37. CONTENTS IN SEVERE STAGES OF OA (Chagas et al)

38. CONTENTS Platelet rich plasma injection -major advancement in
the treatment of mild to moderate knee OA
Short-term studies showed that PRP is effective in
reducing pain and increasing activity in patient with knee
OA.
Ideal patients : should be
with mild to moderate OA
less than 50Yrs

39. Do you know :
Why Osteoarthritis
involes some joints
and usually spares
some
Our Joints are designed , in an evolutionary sense for
Quadri-pedal locomotion like in apes.
Thus we develop OA in joints that are ill designed for
human tasks, like
1) Pincer grasp – base of thumb OA
2) Walking upright – OA Hip and Knee, Spine
SPARED: WRIST, ELBOW AND ANKLE
May be articular Cartilage is uniquely
resistant to bear weight.