10.2.10 - Leukocyte-Rich Versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial
- A. Boffa (Bologna, IT)
- A. Boffa (Bologna, IT)
- A. Di Martino (Bologna, IT)
- L. Andriolo (Bologna, IT)
- I. Romandini (Bologna, IT)
- E. Asunis (Bologna, IT)
- A. Cenacchi (Bologna, IT)
- S. Zaffagnini (Bologna, IT)
- G. Filardo (Bologna, IT)
Abstract
Purpose
Platelet-rich plasma (PRP) gained a large interest as a minimally invasive treatment for knee osteoarthritis (OA). Different preparation methods are available, and the presence of leukocytes, deemed detrimental from preclinical study results, is one of the most debated aspects regarding PRP efficacy. Aim of this study was to compare safety and effectiveness of Leukocyte-Rich PRP (LR-PRP) and Leukocyte-Poor PRP (LP-PRP) for the treatment of knee OA.
Methods and Materials
A total of 192 patients with symptomatic knee OA (Kellgren-Lawrence 1-3) was randomly allocated to 3 weekly injections of LR-PRP or LP-PRP. LP-PRP was obtained with a filter for leukodepletion. LR-PRP or LP-PRP were divided into aliquots of 5 mL with a mean platelet concentration of 1146.8x109/L and 1074.9x109/L and a mean leukocyte concentration of 7991.4x106/L and 0.1x106/L, respectively (Figure 1). Patients were evaluated at baseline and at 2-6-12 months with IKDC subjective score, KOOS subscales, EQ-VAS, and Tegner scores.
Results
Both LR-PRP and LP-PRP groups reported a significant clinical improvement at all evaluations performed up to 12 months. No differences were observed in terms of absolute values and improvement of the clinical scores at all follow-ups (IKDC subjective: 60.7±21.1 vs 62.9±19.9, respectively - Figure 2). No severe adverse events were described for both groups, while a total of 15 mild adverse events were reported: 4.7% for the LP-PRP and 12.2% for the LR-PRP group, without a statistically significant difference. No statistically significant difference was found between LP-PRP and LR-PRP in terms of failures (3.5%vs7.8%, respectively).
Conclusion
This double-blind RCT showed that three intra-articular LR-PRP or LP-PRP injections provided a significant and similar clinical improvement up to 12 months of follow-up in patients with symptomatic knee OA. Both treatment groups reported a low number of failures and adverse events, without inter-group differences. The presence of leukocytes did not significantly affect the clinical results of PRP injections.