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KNEE OSTEOARTHRITIS AND PLATELET-RICH PLASMA TREATMENT: HOW TO IMPROVE THE EFFICIENCY?
MILANTS, Christophe; Bruyère, Olivier; Kaux, Jean-François
2018In Osteoporosis International, 29 (Supplement 1), p. 380
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Abstract :
[en] Introduction: Knee osteoarthritis (OA) is one of the major causes of pain and physical disability in older sportsmen. The management of chondral disease is challenging because of its inherent low healing potential. New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage, including the use of platelet-rich plasma (PRP), an autologous growth factor treatment. PRP is prepared from autologous blood by centrifugation to obtain a highly concentrated sample of platelets, which is four to five times higher than that of normal blood. Many papers were published on PRP for knee OA, including a lot of randomized controlled trials (RCTs) and different systematic reviews. Due to the mixed results from controlled studies, the clinical efficacy of PRP in the treatment of knee OA is unclear with shortcomings in the current literature. Purpose: The objective of this study was to evaluate the similarities and differences between the variety of PRP formulations, preparation, and uses of this techniques in literature and to try to determine characteristics of the PRP which tend to give the best responses for the treatment of knee osteoarthritis.. Methods: A comparison of the outcomes of randomized controlled trials (RCTs) included in the 3 most recent and high-quality metaanalyses to classify the different studies in 2 groups (bad responders group (BRG) and very good responders group (VGRG)). The minimal clinically important improvement (MCII) was defined to help determining whether an observed difference is clinically important. We used MCII values to classify the different studies in 2 groups depending on the outcomes: BRG < MCII and VGRG > 2xMCII. Results: From the 19 RCTs analyzed, 7 trials were included in the VGRG and 4 in the BRG. In VGRG, 1 or 2 injections were performed in 4/7 trials, time between injections was 2 to 3 weeks in 4/5 studies with many injections, volume injected varied from 2.5 to 8 mL, and single spinning technique was used in 5/7 studies. PRP classification was Mishra 4B and PAWP2Bβ in 5/7 studies. The use of PRP with leukocytes is only found in the BRG. Conclusion: There is a lack of standardization in PRP preparation technique for knee osteoarthritis. However, our study helped identify features of PRP recommended for knee OA treatment, such as the use of a single spinning technique, a platelet concentration lower than 5 times the baseline (from 3 to 4), and avoiding leukocytes and erythrocytes. We recommend leveraging this information about PRP for future studies.
Disciplines :
Orthopedics, rehabilitation & sports medicine
Author, co-author :
MILANTS, Christophe ;  Centre Hospitalier Universitaire de Liège - CHU > Service de médecine de l'appareil locomoteur
Bruyère, Olivier  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Kaux, Jean-François  ;  Université de Liège - ULiège > Département des sciences de la motricité > Médecine physique, réadaptation et traumatologie du sport
Language :
English
Title :
KNEE OSTEOARTHRITIS AND PLATELET-RICH PLASMA TREATMENT: HOW TO IMPROVE THE EFFICIENCY?
Publication date :
April 2018
Event name :
WORLD CONGRESS ON OSTEOPOROSIS, OSTEOARTHRITIS AND MUSCULOSKELETAL DISEASES
Event organizer :
ESCEO
Event place :
Krakow, Poland
Event date :
19-22 April 2018
Audience :
International
Journal title :
Osteoporosis International
ISSN :
0937-941X
eISSN :
1433-2965
Publisher :
Springer, Germany
Volume :
29
Issue :
Supplement 1
Pages :
380
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
The authors thank the Belgian Bone Club to have selected this abstract for the Eli Lilly Scholarship.
Available on ORBi :
since 24 April 2018

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