Usefulness of Platelet Lysate as Treatment for Knee Osteoarthritis
Keywords:
osteoarthrosis, platelet rich plasma, platelet lysate.Abstract
Introduction: The limited capacity for self-regeneration of cartilage increases the importance of finding possible treatments for degenerative joint disorders, as well as of verifying their efficacy.
Objectives: To evaluate the clinical efficacy and safety of intra-articular platelet lysate treatment in patients with knee osteoarthritis.
Methods: A quasi-experimental study (before-after, without control group) was carried out in a universe of 54 patients with knee osteoarthritis, treated at the Provincial Teaching Hospital in Ciego de Ávila, from January 2018 to June 2019. The complied with the inclusion criteria stipulated in the study. The variables evaluated with the WOMAC questionnaire were pain, stiffness and functional capacity before 15 days, 15 days, one month and three months after applying the treatment. The platelet lysate obtained following the conventional technique, referred to in the "Normative Work Procedures" of the Provincial Blood Bank.
Results: The patients in this study aged between 30-65 years and the majority were overweight women. There was a tendency to improve the results over time of the variables pain, stiffness and functional capacity.
Conclusions: The results obtained allow concluding that the intra-articular infiltration of platelet lysate in these conditions contributed to reduce joint pain, improve stiffness and increase the functional capacity of the patients. Until the period evaluated in this study, no important collateral effects appeared to the infiltration of this product.
Downloads
References
- Hawker G. A. Osteoarthritis is a serious disease.ClinExpRheumatol[Internet].2019[citado 27/02/ 2020];37(120): S3-S6.Disponible en: https://www.clinexprheumatol.org/article.asp?a=14780
- Cleveland R J,CallahanLF.Canosteoarthritispredictmortality?.North Carolina Medical Journal[Internet].2017[citado 27/2/ 2020]; 78(5) : 322-325.Disponible en: http://www.ncmedicaljournal.com/content/78/5/322.full.pdf
- Allen K. D, Golightly, Y. M. Epidemiology of osteoarthritis: state of the evidence. Current opinion in rheumatology,[Internet].2015 [citado 27/2/2020];27(3): 276-79. Disponibleen:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405030/
- Reyes Llerena GA. Prevalencia comunitaria de las enfermedades reumáticas. Estudio COPCORD en Cuba. [Tesis]. Centro de Investigaciones Médico-Quirúrgicas (CIMEQ): Universidad de Ciencias Médicas de La Habana; 2005.
- Rodríguez A. G , Olivares C. L, Pérez, R. M. L, Arias, M. P, Alayeto, R. N. Evaluación de la respuesta terapéutica en pacientes con enfermedad artrósica por farmacéuticos comunitarios. Farmacéuticos Comunitarios.
Jun 30 2014; 6(2):33-47 .doi: 10.5672/FC.2173-9218.
- .OARSI.Osteoarthritis: A SeriousDisease, Submittedtothe U.S. Food and DrugAdministration[Internet].Dic.1 2016[citado28/2/2020];Disponible en: en: https://www.oarsi.org/sites/default/files/docs/2016/oarsi_white_paper_oa_serious_disease_121416_1.pdf
- Moatshe G, Morris ER, Cinque ME, Pascual-Garrido C, Chahla J, EngebretsenL y col .Biological treatment of the knee with platelet-rich plasma or bone marrow aspirate concentrates. ActaOrthop[Internet]. 2017; 88(6):670-674. doi:10.1080/17453674.2017.1368899
- Sánchez M, Fiz N, Azofra J, Usabiaga J, AdurizRecalde E, GarciaGutierrez A, Albillos J, Gárate R, Aguirre JJ, Padilla S, Orive G, Anitua E: A randomizedclinical trial evaluating plasma rich in growthfactors (PRGF-Endoret) versus hyaluronicacid in the short-termtreatment of symptomatickneeosteoarthritis.Arthroscopy .(Internet) 2012, [citado 28/2/ 2020];28(8):1070 -78.Disponible en: https://www.clinicalkey.es/#!/content/playContent/1-s2.0-S0749806312005129?scrollTo=%23top
- Mena Pérez R, Fernández Delgado N, Dinza Zamora L. Uso del lisado plaquetario en artrosis de rodilla. Revhabancienméd [Internet]. 2013 [citado 28/2/2020]; 12(3): 374-386. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/124
- Laudy ABM, Bakker EWP, Rekers M, y col. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic re-view and meta-analysis. Br J Sports Med. [Internet]. 2015 [citado 23/2/2020]; 49:657-672.Disponible en:https://bjsm.bmj.com/content/bjsports/49/10/657.full.pdf
- Montanez-Heredia E, Irizar S, Huertas PJ y col. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritis knee pain: a randomized clinical trial in the context of the Spanish national health care system. Intl J Molec Sci. [Internet]. 2016[citado 23/2/2020];17:1064-1077.Disponible en:https://www.mdpi.com/1422-0067/17/7/1064/htm
- Oshi-JubertN, Rodríguez L, RevertéVinaixa MM, Navarro A. Platelet-rich plasma injections for advanced knee osteoarthritis: A prospective, randomized, double -blinded clinical trial. Orthop J SportsMed. [Internet]. 2017 [citado 23/2/2020]; 5(2):2325967116689386Disponible en:https://journals.sagepub.com/doi/abs/10.1177/2325967116689386
- Cole BJ, Karas V, Hussey K, Pilz K, Fortier LA. Hyaluronic acid versus platelet -rich plasma: A prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J SportsMed. 2017; 45(2):339-346. doi.10.1016/j.yexcr.2017.02.012
- Shen L, Yuan T, Chen S, et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J OrthoSurg Res. [Internet]. 2017 [citado 23/2/ 2020];12:16.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5260061/falta páginas
- Bennel KL, Hunter DJ, Paterson KL. Platelet-rich plasma for the management of hip and knee osteoarthritis. CurrRheumatol Rep.[Internet]. 2017 [citado23/2/ 2020]; 19(5):24. https://doi.org/10.1007/s11926-017-0652xver
- Di Martino, Alessandro y col.Platelet-rich plasma versus hyaluronic acid injections for the treatment of knee osteoarthritis: results at 5 years of a double-blind, randomized controlled trial.The American journal of sports medicine[Internet]. 2019 [citado 23/2/2020 ]; 47(2) : 347-354.Disponible en: https://www.grantgarciamd.com/articles/prp-vs-ha.pdf
- Lin, K. Y, Yang, C. C, Hsu, C. J, Yeh, M. L, Renn, J. H. Intra-articular injection of platelet-rich plasma is superior to hyaluronic acid or saline solution in the treatment of mild to moderate knee osteoarthritis: a randomized, double-blind, triple-parallel, placebo-controlled clinical trial. Arthroscopy.[Internet]. 2019 [citado 23/2/2020 ];35(1), 106- 11 Disponible en: https://www.clinicalkey.es/#!/content/playContent/1-s2.0-S0749806318305231?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0749806318305231%3Fshowall%3Dtrue&referrer=
- Dório, M., Pereira, R. M., Oliveira, R. M., Luz, A. G, Fuller, R. Platelet-rich plasma and plasma for treatment of knee osteoarthritis: a double-blind placebo-controlled randomized clinical trial. Osteoarthritis and Cartilage, [Internet]. 2019 [citado 23/2/2020 ];27 (supl 1): S481-82. Disponible en: https://www.oarsijournal.com/article/S1063-4584(19)30573-
- Raeissadat SA, Ghorbani E, SaneiTaheri M, y col.MRI Changes After Platelet Rich Plasma Injection in Knee Osteoarthritis (Randomized Clinical Trial). J Pain Res. [Internet].ene10 2020 [citado23/2/2020];13:65–73. doi:10.2147/JPR.S204788
- Rodríguez Orta Cd, Cruz Sánchez PM, Gámez Pérez A, Cruz Pérez Y, Blanco Guzman S, Pérez Lara I, López González E, González Cordero F, Soler Quintana BT, González Portales Y, Ricardo Sosa O, Pérez Mesa DS, Barrabi Arango I, Cabrera Fernández J, González González JA, Pedrera Valdés JL, Díaz Hernández P, et al. Efectividad del lisado plaquetario en el tratamiento de la osteoartritis de rodilla. Rev Cubana de Reumatolo [Internet]. 2014 [citado 18/3/2020 ];16(3 Suppl. 1):[aprox. 7 p.]. Disponible en: http://www.revreumatologia.sld.cu/index.php/reumatologia/article/view/376
- Lugo González AO, Arce González MA, Castillo Oliva GJ, García Quintana R, Sánchez Gravié A, López Gil HR. Uso de plasma rico en factores de crecimiento en pacientes con osteoartritis de rodilla. Acta Médica del Centro [Internet]. 2018 [citado 2020 Mar 18];12(2):[aprox. 9 p.]. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/886
- Bayarre Vera HD, Oliva Pérez M, Horsford Saing R, Ranero Aparicio V, Coutin Marie G, Díaz Llanes G. Metodología de la investigación en la APS. Ciudad de la Habana: Ciencias Médicas; 2004. Pág. 179-95
- Escobar A, VrotsouK, Bilbao A, Quintana J M, García Pérez L, Herrera-Espiñeira C. Validación de una escala reducida de capacidad funcional del cuestionario WOMAC. GacSanit [Internet]. 2011 Dic [citado 8/2/2020 ] ; 25(6):513-18. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-91112011000600013&lng=es.
- Asociación Médica Mundial. Declaración de Helsinki de la AMM. Principios éticos para las investigaciones médicas en seres humanos [Internet] Francia: Asociación Médica Mundial; 2013 [Citado 8/10/2020]. Disponible en: http://www.wma.net/es/30publications/10policiesb3/index.html
- Litwic A, Edwards H, Dennison E, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull [Internet]. 2013 Ene 20 [citado 23/2/2020 ]; 105(1):185-99. Disponible en: http://bmb.oxfordjournals.org/content/early/2013/01/18/bmb.lds038.full.pdf+htm
- Organización Mundial de la Salud. Informe mundial sobre el envejecimiento y la salud. Ginebra: OMS; 2015. Disponible en: http://apps.who.int/iris/bitstream/10665/186466/1/9789240694873_spa.pdf
- Neogi T, Zhang Y. Epidemiology of osteoarthritis. Rheum Dis Clin North Am.[Internet]. 2013 [citado 23/2/2020]; 39 (1) :1–19. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545412/.
- Leung YY, Allen JC Jr, Noviani M y col .Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study.Osteoarthritis Cartilage.[Internet]. 2015 [citado23/2/2020]; 23 (1) :41–47. Disponible en: https://europepmc.org/articles/pmc4275403.
- Shin D. Association between metabolic syndrome, radiographic knee osteoarthritis, and intensity of knee pain: results of a national survey. J ClinEndocrinolMetab. [Internet]. 2014 [citado23/2/ 2020]; 99 (9):3177–3183. Disponibleen: https://academic.oup.com/jcem/article/99/9/3177/2537993.
- Solis Cartas U, Calvo Piña B Silvia J. Comorbilidades y calidad de vida en Osteoartritis. Rev Cuba Reumatol [Internet]. 2018 Ago [citado 11/3/2020 ] ; 20( 2 ): e17. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1817-59962018000200002&lng=es. http://dx.doi.org/10.5281/zenodo.1188918.
- Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. ArchOrthop Trauma Surg.[Internet]. 2011 Mar;[citado 11/3 2020 ];131(3):311-7. Disponible en: https://www.researchgate.net/publication/45661183_Infiltration_of_plasma_rich_in_growth_factors_for_osteoarthritis_of_the_knee_short-term_effects_on_function_and_quality_of_life
- Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML,
Ce-nacchi A, Fornasari PM, Marcacci M . Platelet-rich plasmavs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial.BMCMusculoskeletDisord[Internet]. 2012 [citado23/2/ 2020]; 23(13):229-30. Disponible en: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-13-229
- Montañez-Heredia E, Irízar S, Huertas PJ, Otero E, Del Valle M, Prat I, Díaz-Gallardo MS, Perán M, Marchal JA, Hernandez-Lamas Mdel C. Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in the Treatment of Osteoarthritic Knee Pain: A Randomized Clinical Trial in the Context of the Spanish National Health Care System. Int J Mol Sci. 2016 Jul 2;17(7):1064. doi: 10.3390/ijms17071064. PMID: 27384560; PMCID: PMC4964440
- Dai WL, Zhou AG, Zhang H, Zhang J Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials.Arthroscopy. 2017 Mar;33(3):659-670.e1. doi: 10.1016/j.arthro.2016.09.024
- Pellicer García V. Controversias del empleo de plasma rico en plaquetas en COT. Reparación y Aplicación. Revista Española de Cirugía Osteoarticular. [Internet]. 2015 [citado 23/2/2020];264;( 50):50-6 Disponible en: http://www.cirugia-osteoarticular.org/adaptingsystem/intercambio/revistas/articulos/2401_184.pdf
- Martínez JM, Cano J, Gonzalo JC, Campo J, Esparza GC, Seoane JM. ¿Existen riesgos al utilizar los concentrados de Plasma Rico en Plaquetas (PRP) de usoambulatorio? Medicina Oral [Internet]. 2002 [citado 23/2/2020]; 7: 375-90.Disponible en: http://files.c-cloud-]diagnostics.webnode.cl/200000344(5 118)
