Clinical outcomes of intraarticular PRP and corticosteroid combination in advanced osteoarthritis

Abstract

Aim: The objective of this study is to compare the clinical response of corticosteroid (CS) and platelet-rich plasma (PRP) treatment in 2 groups of patients affected by advanced osteoarthritis Material and Methods: A total of 68 patients affected by clinically and radiographically documented with grade 4 gonarthrosis according to the Kellgren-Lawrence classification were included in this study. The patients were identified into 2 study groups. Thirty-two patients (Group 1) received 3 intra-articular injections of PRP (5mL) and steroid (1 cc - 5 mgr triamcinolone). Thirty-six patients (Group 2) received 3 intra-articular injections of PRP with one-week interval (5 mL). An unblinded physician performed injection once a week for 3 weeks into the affected knee in both groups. All patients were evaluated with the VAS score and the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales before the infiltration, at 2nd and 6th month after the first injection. Results: Two groups are similar with regard to demographic variables (age, gender, BMI, stage of arthritis). The combination of intra-articular PRP with steroids resulted in a significantly superior clinical outcome, with sustained lower VAS (p<0.01) and improved KOOS subscales (p<0.01) except for KOOS sporting activity and quality of life within 6 months compared to intra-articular PRP only injection. Discussion: Treatment with intra-articular PRP and steroids showed a significantly better clinical outcome than did treatment with PRP, with sustained better KOOS scores.