Early osteoarthritis of knee amounts to significant disability among middle aged patients. Various studies shows significant outcomes with injection of platelet rich plasma (PRP) and Mesenchymal stem cells (MSC’s) in treating this common indication. This study aims to assess any difference in outcome obtained in patients treated with adipose derived MSC injection and patients treated using PRP combined with Hyaluronic Acid (HA) injection.
A group of 50 patients affected by Kellgren-Lawrence grade 2 or grade 3 knee osteoarthritis were randomly allocated into two equal groups of 25 patients each. Group 1 were treated with 3 intra-articular injections (1 month apart) using autologous P.R.P combined with HA (Cellular Matrix, RegenLab, Switzerland) and group 2 patients were injected with adipose derived MSC (Lipogems, Italy) by supra-patellar approach. Outcomes were measured by collecting Tegner, Marx, VAS, IKDC and KOOS scores at before treatment, 6 months and 12 months after treatment.
Patients were prospectively evaluated in the 12 month study period between November2016-December2017. The mean age was 62.7 ± 10.7 in group 1 patients and 59.9 ± 8.7 in group 2 patients. At 12 months follow-up, patient in both groups showed improvements in all scores. Median pre-treatment values of group 1 patients were, IKDC=56.98, KOOS Scores:S=75/P=78/ADL=87/SP=40/QOL=38; VAS scale 3.7. Median pre-treatment values of group 2 patients were, IKDC=40.23, KOOS Scores:S=69.5/P=67/ADL=69/SP=35/QOL=41; VAS scale 5.1. At final follow-up median scores in group 1 are: IKDC=62, KOOS Scores:S=80/P=72/ADL=83.5/SP=40/QOL=60; VAS scale 2.1 and at final follow up median scores in group 2 are: IKDC=61.49, KOOS Scores:S=75/P=86.5/ADL=89/SP=52.5/QOL=56; VAS scale 3.6.
This report shows, both groups lead to clinical and functional improvement at 6 and 12 months. But, there is no statistical significance between the groups. However, there are subtle advantages over one another. This finding will aid clinicians in formulating an algorithm when treating patients with early osteoarthritis.