Mattia Alessio-Mazzola1,2, Lamberto Felli1,2, Roberto Trentini2, Matteo Formica1,2, Andrea Giorgio Capello2, Stefano Lovisolo2, Nicola Maffulli3,4,5,6. 1. Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy. 2. Clinica Ortopedica e Traumatologica, Ospedale Policlinico San Martino, Genoa, Italy. 3. Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy. 4. Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy. 5. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK. 6. School of Pharmacy and Bioengineering, Keele University of School of Medicine, Guy Hilton Research Centre, Hartshill, Stoke-on-Trent, UK.
Abstract
BACKGROUND: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. HYPOTHESIS: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. STUDY DESIGN: Prospective case series. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. RESULTS: Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale (P = 0.03) and WOMAC (P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months (P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. CONCLUSION: PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. CLINICAL RELEVANCE: This research supports the use of autologous PRP injections for symptomatic DMLs.
BACKGROUND: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. HYPOTHESIS: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. STUDY DESIGN: Prospective case series. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. RESULTS: Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale (P = 0.03) and WOMAC (P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months (P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. CONCLUSION: PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. CLINICAL RELEVANCE: This research supports the use of autologous PRP injections for symptomatic DMLs.
Authors: Marlene Fransen; Sara McConnell; Alison R Harmer; Martin Van der Esch; Milena Simic; Kim L Bennell Journal: Br J Sports Med Date: 2015-09-24 Impact factor: 13.800
Authors: Undine Freymann; Lucia Degrassi; Jan Philipp Krüger; Sebastian Metzlaff; Michaela Endres; Wolf Petersen Journal: Connect Tissue Res Date: 2016-12-08 Impact factor: 3.417
Authors: Joshua S Everhart; Parker A Cavendish; Alex Eikenberry; Robert A Magnussen; Christopher C Kaeding; David C Flanigan Journal: Am J Sports Med Date: 2019-06-05 Impact factor: 6.202
Authors: Ronald E Delanois; Jennifer I Etcheson; Nipun Sodhi; Ralph F Henn; Chukwuweike U Gwam; Nicole E George; Michael A Mont Journal: J Arthroplasty Date: 2018-12-17 Impact factor: 4.757
Authors: Filippo Migliorini; Francesco Cuozzo; Lucio Cipollaro; Francesco Oliva; Frank Hildebrand; Nicola Maffulli Journal: J Orthop Traumatol Date: 2022-02-07