P191 - PRP therapy for knee osteoarthritis improved the articular cartilage condition at the opposite side of the treatment target area in MRI.
Abstract
Purpose
To evaluate the effect of PRP therapy on the articular cartilage in the patients with knee osteoarthritis (OA).
Methods and Materials
Consecutive 85patients (29 males: 33 knees, 56 females: 76 knees, age 67.9±11.3 (mean±SD) years K-L1/2/3/4 (6/21/25/57)) with knee OA who underwent PRP therapy in our hospital were included this study. All patients were evaluated with articular cartilage scoring (W) with semi-quantified whole organ MRI scoring system (WORMS) at the initiation of PRP therapy and 6 months after the treatment. In the patients with varus knee deformity, we set medial FTJ (femorotibial joint) as a treatment target area (TTA), while in the patients with valgus knee deformity, lateral FTJ is TTA. The patients with severe patellofemoral joint OA were excluded in this study. The efficacy of PRP therapy was assessed using visual analogue scale (VAS) and knee injury and Osteoarthritis Outcome Score (KOOS), and the patients who met the OMERACT-OARSI responder criteria was defined as responder (R). We injected leukocyte-poor PRP prepared with MyCells kit three times every 2-4 weeks.
Results
The ratio of R was 58.4% in the patient with KL1-3, while it was 56.3% in KL4. (Figure 1) The W score in TTA didn’t improve after the treatment (pre: 17.7±8.5, post: 17.7±8.6 (p=0.82, paired t-test). On the other hand, W-score at the opposite TTA was significantly improved (pre: 5.1±6.1, post: 4.7±5.8 (p=0.02), and patellar femoral joint tended to improve (pre: 7.5±7.0/7.2, post:6.7±6.7 (p=0.06). (Figure 2) When comparing by KL, KL1-3 pre: 17.6±13.0, post: 17.1±12.7, KL4 pre: 40.9±14.5, post: 40.2±13.2.
Conclusion
In our data, although the W-score at TTA didn’t improve, opposite TTA significantly improved, suggesting that PRP would exert an anabolic effect to the articular cartilage at the mechanically stable site. Therefore, the combination of surgical realignment and PRP injection would improve the clinical outcomes in knee OA with malalignment of lower limb.
