MRI-based cartilage changes and clinical effectiveness of autologous intra-articular platelet-rich plasma injections in symptomatic patients with moderate osteoarthritis of the knee

Abstract

Abstract Background An autologous blood product containing a high percentage of various growth factors, cytokines, and modulating factors such as platelet-rich plasma (PRP) is thought to play a role in chondral remodeling by promoting the production of cartilage matrix molecules and repairing and regenerating articular cartilage. In symptomatic patients with moderate osteoarthritis (OA) of the knee, we aimed to investigate MRI-based cartilage changes and the clinical efficacy of autologous intra-articular PRP injections. Results Thirty-three patients with grades 2 and 3 OA of knees as per Kellgren and Lawrence OA classification underwent three consecutive PRP injections at monthly intervals. These patients were followed up monthly for the first 3 months, and then after every 3 months at 6 months, 9 months, and 12 months. There was statistically significant improvement in joint pain and functionality with the visual analogue scale (VAS) scores showing a reduction from 7 ± 2 at baseline to 2.76 ± 1.34 at 12 months and Western Ontario and McMaster Universities Osteoarthritis Index Score (WOMAC) scores declining from 77.91 ± 1 1.6 at baseline to 23.61 ± 19.1 at 12 months (p < 0.05). The reduction in VAS and WOMAC scores was maximum during the first 3 months after PRP therapy. MRI showed a statistically insignificant improvement in cartilage thickness [Whole Organ Magnetic Resonance Imaging Score (WORMS) 3.15 ± 1.41 to 3.3 ± 0.84) (p > 0.05)]. Conclusions PRP had a positive effect on pain alleviation and patient functioning, but there was no significant change in articular cartilage as measured by MRI.