Abstract
Background: Arthrosis is particularly prevalent in the knee. Infiltration treatment for gonarthrosis is among the most widely used techniques in orthopaedic practice.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: A total of 120 patients affected by clinically and radiographically documented gonarthrosis were included in this study. The gonarthrosis was graded using the Kellgren-Lawrence radiographic classification scale. The 120 patients were randomized into 2 study groups in a 1:1 ratio: 60 patients received 4 intra-articular injections of PRP (specifically, autologous conditioned plasma [ACP], 5.5 mL), and 60 patients received 4 intra-articular injections of HA (20 mg/2 mL). An unblinded physician performed infiltration once a week for 4 weeks into the knee affected by clinically relevant gonarthrosis (in both groups). All patients were evaluated with the Western Ontario and McMaster (WOMAC) score before the infiltration and at 4, 12, and 24 weeks after the first injection.
Results: Treatment
with a local injection of ACP had a significant effect shortly after the
final infiltration and a continuously
improving sustained effect up to 24 weeks (WOMAC
score, 65.1 and 36.5 in the HA and ACP groups, respectively; P
< .001), where the clinical outcomes were better compared with the
results with HA. In the HA group, the worst results were
obtained for grade III gonarthrosis, whereas the
clinical results obtained in the ACP group did not show any
statistically
significant difference in terms of the grade of
gonarthrosis. The mean WOMAC scores for grade III gonarthrosis were
74.85
in the HA group and 41.20 in the ACP group (P < .001).
Conclusion: Treatment with ACP showed a significantly better clinical outcome than did treatment with HA, with sustained lower WOMAC
scores. Treatment with HA did not seem to be effective in the patients with grade III gonarthrosis.
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