Tahir Mutlu Duymus1, Serhat Mutlu2, Bahar Dernek3, Baran Komur2, Suavi Aydogmus4, Fatma Nur Kesiktas5. 1. Department of Orthopaedics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey. dr.tahirmutlu@gmail.com. 2. Department of Orthopaedics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey. 3. Department of Physical Medicine and Rehabilitation, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303, Küçükçekmece, Istanbul, Turkey. 4. Department of Orthopedic Surgery and Traumatology, Haydarpaşa Numune Education and Research Hospital, 34668, Üsküdar, Istanbul, Turkey. 5. Physical Medicine and Rehabilitation Education and Research Hospital, Kocasinan Merkez Mah. Karadeniz Cad.No 48, 34147, Bahcelievler, Istanbul, Turkey.
Abstract
PURPOSE: This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis (OA) given anintra-articular injection of platelet-rich plasma (PRP), hyaluronic acid (HA) or ozone gas. METHODS: A total of 102 patients with mild-moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were randomly separated into three groups. Group 1 (PRP group) received intra-articular injection of PRP × 2 doses, Group 2 (HA group) received a single dose of HA, and Group 3 (Ozone group) received ozone × four doses. Weight-bearing anteroposterior-lateral and Merchant's radiographs of both knees were evaluated. WOMAC and VAS scores were applied to all patients on first presentation and at 1, 3, 6 and 12 months. RESULTS: At the end of the 1st month after injection, significant improvements were seen in all groups. In the 3rd month, the improvements in WOMAC and VAS scores were similar in Groups 1 and 2, while those in Group 3 were lower (p < 0.001). At the 6th month, while the clinical efficacies of PRP and HA were similar and continued, the clinical effect of ozone had disappeared (p < 0.001). At the end of the 12th month, PRP was determined to be both statistically and clinically superior to HA (p < 0.001). CONCLUSION: In the treatment of mild-moderate knee OA, PRP was more successful than HA and ozone injections, as the application alone was sufficient to provide at least 12 months of pain-free daily living activities. LEVEL OF EVIDENCE: Therapeutic study, Level I.
RCT Entities:
PURPOSE: This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis (OA) given an intra-articular injection of platelet-rich plasma (PRP), hyaluronic acid (HA) or ozone gas. METHODS: A total of 102 patients with mild-moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were randomly separated into three groups. Group 1 (PRP group) received intra-articular injection of PRP × 2 doses, Group 2 (HA group) received a single dose of HA, and Group 3 (Ozone group) received ozone × four doses. Weight-bearing anteroposterior-lateral and Merchant's radiographs of both knees were evaluated. WOMAC and VAS scores were applied to all patients on first presentation and at 1, 3, 6 and 12 months. RESULTS: At the end of the 1st month after injection, significant improvements were seen in all groups. In the 3rd month, the improvements in WOMAC and VAS scores were similar in Groups 1 and 2, while those in Group 3 were lower (p < 0.001). At the 6th month, while the clinical efficacies of PRP and HA were similar and continued, the clinical effect of ozone had disappeared (p < 0.001). At the end of the 12th month, PRP was determined to be both statistically and clinically superior to HA (p < 0.001). CONCLUSION: In the treatment of mild-moderate knee OA, PRP was more successful than HA and ozone injections, as the application alone was sufficient to provide at least 12 months of pain-free daily living activities. LEVEL OF EVIDENCE: Therapeutic study, Level I.
Authors: Niall A Smyth; Christopher D Murawski; Lisa A Fortier; Brian J Cole; John G Kennedy Journal: Arthroscopy Date: 2013-05-11 Impact factor: 4.772
Authors: M E Adams; M H Atkinson; A J Lussier; J I Schulz; K A Siminovitch; J P Wade; M Zummer Journal: Osteoarthritis Cartilage Date: 1995-12 Impact factor: 6.576
Authors: G Filardo; E Kon; A Roffi; B Di Matteo; M L Merli; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-11-26 Impact factor: 4.342