DOI: http://dx.doi.org/10.18203/2349-3933.ijam20214129

Comparison between single spin and double spin platelet rich plasma in pain and functional outcome of Osteoarthritis knee: A randomized controlled trial

Khwairakpam Selina Devi, Akoijam Joy Singh, Longjam Nilachandra Singh, Kanti Rajkumari, Margaret Chabungbam, Monica Moirangthem, Tasso Opo, Prashant Kami Rasaily

Abstract


Background: Osteoarthritis (OA) is condition characterised by progressive degeneration of joint cartilage, eventually leading to deformity of the joint. OA causes pain and disability and impacts on quality-of-life. Intra-articular platelet rich plasma gives favourable outcomes in OA knee; however, efficacy may be affected by method of preparation. Hence, this study comparing single spin and double spin platelet-rich plasma (PRP).

Methods: A randomised controlled trial done among patients of OA who visited Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences, Imphal during August 2019-July 2021. Patients with OA knee having radiological findings of Kellgren Lawrence (KL) grade 2 and 3 (n=62) randomized into single spin PRP, (n=31) and double spin PRP, (n=31) groups and intra-articular PRP injection was given.

Results: Baseline characteristics were not statistically significant. At the end of 1 week, improvement in mean difference of VAS was observe however not statistically significant (p=0.71). At end of 12 weeks and 24 weeks, there were statistically significant improvement in both mean difference of VAS (p=0.00) and WOMAC (p=0.002). Post intervention, out of the single spin PRP group, (64.51%, n=20) had complaints of adverse effects swelling, pain, redness whereas (6.45%, n=2) patients who received double spin PRP had adverse effects.

Conclusions: Platelet rich plasma obtained by double spin method has long term improvement in both pain and function in patients with KL grade 2 and 3 OA knee than PRP from single spin method. Patient who received single spin PRP has more frequent post injection flare ups.


Keywords


OA, PRP, Regenerative therapy, Single spin and double spin PRP, Intra-articular injection, Western Ontario and McMaster Universities OA Index (WOMAC)

Full Text:

PDF

References


Pereira D, Peleteiro B, Araujo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: A systematic review. Osteoarth Cart. 2011;19:1270-85.

Dai WL, Zhou AG, Zhang H, Zhang H. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. J Arthroscop Related Surg. 2016(9);1-12.

Hamza S, Ustünsoy S. The short-term effect of PRP on chronic pain in knee osteoarthritis. AGRI. 2019;31(2):63-9.

Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthopaed Surg Res. 2017;12:6.

Filardo G, Kon E, Buda R. Platelet-rich plasma intra- articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19(1):528-35.

Kon E, Buda R, Filardo G. Platelet-rich plasma: intra- articular knee injections produced favourable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc. 2010;18:472-9.

Patel S, Dhillon MS, Aggarwal S. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-64.

Sundman EA, Cole BJ, Fortier LA. Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med. 2011;39:2135-40.

Pereira RC, Scaranari M, Benelli R, Strada P, Reis RL, Cancedda R et al. Dual effect of platelet lysate on human articular cartilage: a maintenance of chondrogenic potential and a transient pro-inflammatory activity followed by an inflammation resolution. Tissue Eng Part A. 2013;19:1476-88.

Hegaze AH, Hamdi AS, Alqrache A. Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study. Cureus. 2010;13(3):e13909.

Bennell KL, Hunter DJ, Paterson KL. Platelet-rich plasma for the management of hip and knee osteoarthritis. Curr rheumatol rep. 2017;19(5):1-32.

Xie X, Zhang C, Tuan RS. Biology of platelet-rich plasma and its clinical application in cartilage repair. Arthritis Res Therapy. 2014;16:204.

Bhatia A, Ramya BS, Biligi DS, Panchakshari PBK. Comparison of different methods of centrifugation for preparation of platelet- rich plasma (PRP). Indian J Pathol Oncol. 2016;3(4);535-9.

Abrams GD, Frank RM, Fortier LA, Cole BJ. Platelet-rich Plasma for Articular Cartilage Repair. Sports Med Arthrosc Rev. 2013;21(4):213-9.

Kisiday JD, Mcllwraith CW, Rodkey WG, Frisbie DD, Steadman JR. Effects of Platelet-Rich Plasma Composition on Anabolic and Catabolic Activities in Equine Cartilage and Meniscal Explants. Cartilage. 2012;3(3):245-54.

Mascarenhas R, Saltzman BM, Fortier LA, Cole BJ. Role of Platelet-Rich Plasma in Articular Cartilage Injury and Disease. J Knee Surg. 2015;28:3-10.

Bendinelli P, Matteucci E, Dogliotti G, Corsi MM, Banfi G, Maroni P et al. Molecular Basis of Anti-Inflammatory Action of Platelet-Rich Plasma on Human Chondrocytes: Mechanisms of NF-kB Inhibition Via HGF. J Cell. Physiol. 2010;225:757-66.