Purpose

Background: PRP has established its short term role in symptomatic relief in early OA knee. New variants and modification of PRP may give prolonged and better results

Null Hypothesis: Chitosan poloxamer gel with PRP (Chitosan PRP) is better than PRP in terms of anti-inflammatory effects.

Study Design: Controlled Laboratory Study

Methods and Materials

44 Dunkin Hartley guinea pigs were included (weighing ~ 700g). Ten animals (group DC) were randomized into disease control group where no intervention was done in either knees. Groups 1, 2 and 3 (Ten animals each) were given single intraarticular Injection of PRP, Chitosan gel alone and Chitosan+PRP in one knee respectively. Isotonic saline injection was given in the contralateral knees in groups 1,2 and 3 as control. Five animals from each group (subgroup DC.3, 1.3,2.3 and 3.3) were euthanized at three months and the remaining five (subgroup DC.6, 1.6, 2.6 and 3.6) at six months post intervention. Upon euthanasia, knee joint synovial fluid samples were collected from each joint for COMP estimation by ELISA and histologic assessment of articular cartilage and synovium was done.

Results

Mean synovitis scores was significantly lower in PRP and Chitosan PRP group compared to disease control and Chitosan gel group at 3 months (p < 0.05). No difference was noted at 6 months. However, there was no significant difference between Chitosan PRP and PRP groups at 3 or 6 months. There was no significant difference in total articular scores and mean synovial fluid COMP concentration among the groups at 3 or 6 months.

Conclusion

Single injection of PRP exerts an anti-inflammatory effect in the short term but not in the long term. Addition of chitosan poloxamer gel did not offer any additional advantage compared to PRP and hence Null hypothesis is rejected