Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 3/2011

01-03-2011 | Orthopaedic Surgery

Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life

Authors: Ana Wang-Saegusa, Ramón Cugat, Oscar Ares, Roberto Seijas, Xavier Cuscó, Montserrat Garcia-Balletbó

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2011

Login to get access

Abstract

Purpose

Osteoarthritis (OA) is a highly prevalent, chronic, degenerative condition that generates a high expense. Alternative and co-adjuvant therapies to improve the quality of life and physical function of affected patients are currently being sought.

Methods

A total of 808 patients with knee pathology were treated with PRGF (plasma rich in growth factors), 312 of them with OA of the knee (Outerbridge grades I–IV) and symptoms of >3 months duration met the inclusion criteria and were evaluated to obtain a sample of 261 patients, 109 women and 152 men, with an average age of 48.39. Three intra-articular injections of autologous PRGF were administered at 2-week intervals in outpatient surgery. The process of obtaining PRGF was carried out following the Anitua Technique. Participants were asked to fill out a questionnaire with personal data and the following assessment instruments: VAS, SF-36, WOMAC Index and Lequesne Index before the first infiltration of PRGF and 6 months after the last infiltration.

Results

Statistically significant differences (P < 0.0001) between pre-treatment and follow-up values were found for pain, stiffness and functional capacity in the WOMAC Index; pain and total score, distance and daily life activities in the Lequesne Index; the VAS pain score; and the SF-36 physical health domain. There were no adverse effects related to PRGF infiltration.

Conclusion

At 6 months following intra-articular infiltration of PRGF in patients with OA of the knee, improvements in function and quality of life were documented by OA-specific and general clinical assessment instruments. These favourable findings point to consider PRGF as a therapy for OA.
Literature
1.
go back to reference Agung M, Ochi M, Yanada S, Adachi N, Izuta Y, Yamasaki T, Toda K (2006) Mobilization of bone marrow-derived mesenchymal stem cells into the injured tissues after intraarticular injection and their contribution to tissue regeneration. Knee Surg Sports Traumatol Arthrosc 14(12):1307–1314CrossRefPubMed Agung M, Ochi M, Yanada S, Adachi N, Izuta Y, Yamasaki T, Toda K (2006) Mobilization of bone marrow-derived mesenchymal stem cells into the injured tissues after intraarticular injection and their contribution to tissue regeneration. Knee Surg Sports Traumatol Arthrosc 14(12):1307–1314CrossRefPubMed
2.
go back to reference Akeda K, An H, Okuma M, Attawia M, Miyamoto K, Thonar EJMA, Lenz M, Sah R, Masuda K (2006) Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage 14(12):1272–1280CrossRefPubMed Akeda K, An H, Okuma M, Attawia M, Miyamoto K, Thonar EJMA, Lenz M, Sah R, Masuda K (2006) Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage 14(12):1272–1280CrossRefPubMed
3.
go back to reference Altman RD, Moskowitz R, Adjuvants I, Injections IA, Adjuvants I, Outcome T (1998) Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol 25:2203–2212PubMed Altman RD, Moskowitz R, Adjuvants I, Injections IA, Adjuvants I, Outcome T (1998) Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol 25:2203–2212PubMed
4.
go back to reference AI AnituaE (2000) Un nuevo enfoque en la regeneración ósea. Plasma rico en factores de crecimiento (PRGF). SL, Vitoria, Ed. Puesta al dia publicaciones AI AnituaE (2000) Un nuevo enfoque en la regeneración ósea. Plasma rico en factores de crecimiento (PRGF). SL, Vitoria, Ed. Puesta al dia publicaciones
5.
go back to reference Anitua E, Sánchez M, Nurden AT, Nurden P, Orive G, Andía I (2006) New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol 24:227–234CrossRefPubMed Anitua E, Sánchez M, Nurden AT, Nurden P, Orive G, Andía I (2006) New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol 24:227–234CrossRefPubMed
6.
go back to reference Anitua E, Sanchez M, Nurden AT, Zalduendo MM, de la Fuente M, Azofra J, Andia I (2007) Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford). doi:10.1093/rheumatology/kem234 Anitua E, Sanchez M, Nurden AT, Zalduendo MM, de la Fuente M, Azofra J, Andia I (2007) Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford). doi:10.​1093/​rheumatology/​kem234
7.
go back to reference Baysal O, Baysal T, Alkan A, Altay Z, Yologlu S (2004) Comparison of MRI graded cartilage and MRI based volume measurement in knee osteoarthritis. Swiss Med Wkly 134(19–20):283–288PubMed Baysal O, Baysal T, Alkan A, Altay Z, Yologlu S (2004) Comparison of MRI graded cartilage and MRI based volume measurement in knee osteoarthritis. Swiss Med Wkly 134(19–20):283–288PubMed
8.
9.
go back to reference Cugat R, Carrillo JM, Serra I, Soler C (2006) Articular cartilage defects reconstruction by plasma rich growth factors. In: Anonymous. Basic science, clinical repair and reconstruction of articular cartilage defects: current status and prospects. Timeo, pp 801–807 Cugat R, Carrillo JM, Serra I, Soler C (2006) Articular cartilage defects reconstruction by plasma rich growth factors. In: Anonymous. Basic science, clinical repair and reconstruction of articular cartilage defects: current status and prospects. Timeo, pp 801–807
10.
go back to reference Cugat R (2008) PRGF: application in orthopaedic surgery and trauma. Orthopaedics Today Europe. SLACK 11 (editorial) Cugat R (2008) PRGF: application in orthopaedic surgery and trauma. Orthopaedics Today Europe. SLACK 11 (editorial)
11.
go back to reference Dawson J, Juszczak E, Thorogood M, Marks SA, Dodd C, Fitzpatrick R (2003) An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach. J Epidemiol Community Health 57(10):823–830CrossRefPubMed Dawson J, Juszczak E, Thorogood M, Marks SA, Dodd C, Fitzpatrick R (2003) An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach. J Epidemiol Community Health 57(10):823–830CrossRefPubMed
12.
go back to reference Eppley BL, Woodell JE, Higgins J (2004) Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 114:1502–1508CrossRefPubMed Eppley BL, Woodell JE, Higgins J (2004) Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 114:1502–1508CrossRefPubMed
13.
go back to reference Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma. Am J Sports Med 37:2259–2272CrossRefPubMed Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma. Am J Sports Med 37:2259–2272CrossRefPubMed
14.
go back to reference Frei R, Biosca FE, Handl M, Trc T (2008) Conservative treatment using plasma rich in growth factors (PRGF) for injury to the ligamentous complex of the ankle. Acta Chir Orthop Traumatol Cech 75(1):28–33PubMed Frei R, Biosca FE, Handl M, Trc T (2008) Conservative treatment using plasma rich in growth factors (PRGF) for injury to the ligamentous complex of the ankle. Acta Chir Orthop Traumatol Cech 75(1):28–33PubMed
15.
16.
go back to reference Gobbi A, Bathan L, Boldrini L (2009) Primary repair combined with bone marrow stimulation in acute anterior cruciate ligament lesions: results in a group of athletes. Am J Sports Med 37:571–578CrossRefPubMed Gobbi A, Bathan L, Boldrini L (2009) Primary repair combined with bone marrow stimulation in acute anterior cruciate ligament lesions: results in a group of athletes. Am J Sports Med 37:571–578CrossRefPubMed
17.
go back to reference Huskisson E (1999) Hyaluronic acid in the treatment of osteoarthritis of the knee. Rheumatology 38:602–607CrossRefPubMed Huskisson E (1999) Hyaluronic acid in the treatment of osteoarthritis of the knee. Rheumatology 38:602–607CrossRefPubMed
18.
go back to reference Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2009) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4):472–479CrossRefPubMed Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2009) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4):472–479CrossRefPubMed
19.
go back to reference Kon E, Buda R, Filardo G, Timocini A, Marcacci M, Giannini S (2009) The treatment of severe chondropathies of the knee: platelet rich plasma vs hyaluronic acid. Presented at 8th world congress of the international cartilage repair society (ICRS), Miami, USA, 23–26 May 2009 Kon E, Buda R, Filardo G, Timocini A, Marcacci M, Giannini S (2009) The treatment of severe chondropathies of the knee: platelet rich plasma vs hyaluronic acid. Presented at 8th world congress of the international cartilage repair society (ICRS), Miami, USA, 23–26 May 2009
20.
go back to reference Lequesne M, Brandt K, Bellamy N, Moskowitz R, Cj Menkes, Pelletier JP (1994) Guidelines for testing show-acting drugs in osteoarthritis. J Rheumatol 21:65–71 Lequesne M, Brandt K, Bellamy N, Moskowitz R, Cj Menkes, Pelletier JP (1994) Guidelines for testing show-acting drugs in osteoarthritis. J Rheumatol 21:65–71
21.
go back to reference Lopez-Vidriero E, Goulding KA, Simon DA, Sanchez M, Johnson DH (2010) The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy 26(2):269–278CrossRefPubMed Lopez-Vidriero E, Goulding KA, Simon DA, Sanchez M, Johnson DH (2010) The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy 26(2):269–278CrossRefPubMed
22.
go back to reference Martinez-Zapata MJ, Marti-Carvajal A, Sola I, Bolibar I, Angel Exposito J, Rodriguez L, Garcia J (2009) Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion 49:44–56CrossRefPubMed Martinez-Zapata MJ, Marti-Carvajal A, Sola I, Bolibar I, Angel Exposito J, Rodriguez L, Garcia J (2009) Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion 49:44–56CrossRefPubMed
23.
go back to reference Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, Jacobs CR (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15(3):431–435CrossRefPubMed Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, Jacobs CR (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15(3):431–435CrossRefPubMed
24.
go back to reference Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E (2008) Platelets and wound healing. Front Biosci 13:3532–3548PubMed Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E (2008) Platelets and wound healing. Front Biosci 13:3532–3548PubMed
25.
go back to reference Ochi M, Adachi T, Kobayashi M, Deie M (2009) Current bio-therapies for chondral lesions. Presented at 8th world congress of the international cartilage repair society (ICRS), Miami, USA, May 23–26 Ochi M, Adachi T, Kobayashi M, Deie M (2009) Current bio-therapies for chondral lesions. Presented at 8th world congress of the international cartilage repair society (ICRS), Miami, USA, May 23–26
26.
go back to reference Ochi M, Uchio Y, Kawasaki K, Wakitani S, Iwasa J (2002) Transplantation of cartilage-like tissue made by tissue engineering in the treatment of cartilage defects of the knee. J Bone Joint Surg Br 84(4):571–578CrossRefPubMed Ochi M, Uchio Y, Kawasaki K, Wakitani S, Iwasa J (2002) Transplantation of cartilage-like tissue made by tissue engineering in the treatment of cartilage defects of the knee. J Bone Joint Surg Br 84(4):571–578CrossRefPubMed
27.
go back to reference Ochi M, Adachi N, Nobuto H, Yanada S, Ito Y, Agung M (2004) Articular cartilage repair using tissue engineering technique-novel approach with minimally invasive procedure. Artif Organs 28(1):28–32CrossRefPubMed Ochi M, Adachi N, Nobuto H, Yanada S, Ito Y, Agung M (2004) Articular cartilage repair using tissue engineering technique-novel approach with minimally invasive procedure. Artif Organs 28(1):28–32CrossRefPubMed
28.
go back to reference Sampson S, Gerhardt M, Mandelbaum B (2008) Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med 1:165–174CrossRefPubMed Sampson S, Gerhardt M, Mandelbaum B (2008) Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med 1:165–174CrossRefPubMed
29.
go back to reference Sánchez M, Anitua E, Azofra J, Prado R, Muruzabal F, Andia I (2010) Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology. Arthroscopy 26(4):470–480CrossRefPubMed Sánchez M, Anitua E, Azofra J, Prado R, Muruzabal F, Andia I (2010) Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology. Arthroscopy 26(4):470–480CrossRefPubMed
30.
go back to reference Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. doi:10.1177/0363546506294078 Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. doi:10.​1177/​0363546506294078​
31.
go back to reference Sanchez M, Anitua E, Azofra J, Aguirre JJ, Andia I (2008) Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 26(5):910–913PubMed Sanchez M, Anitua E, Azofra J, Aguirre JJ, Andia I (2008) Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 26(5):910–913PubMed
32.
go back to reference Serra Aguado IC (2006) Análisis biomecánico e histológico del tejido de reparación en defectos condrales de espesor completo tras la aplicación de plasma rico en plaquetas antólogo. Estudio experimental. Thesis Doctoral Serra Aguado IC (2006) Análisis biomecánico e histológico del tejido de reparación en defectos condrales de espesor completo tras la aplicación de plasma rico en plaquetas antólogo. Estudio experimental. Thesis Doctoral
33.
go back to reference Soler MC (2006) Macroscópico, histológico e inmunohistoquímico del efecto del plasma rico en plaquetas autólogo en la reparación de defectos condrales en conejo. Estudio experimental. Thesis Doctoral Soler MC (2006) Macroscópico, histológico e inmunohistoquímico del efecto del plasma rico en plaquetas autólogo en la reparación de defectos condrales en conejo. Estudio experimental. Thesis Doctoral
34.
go back to reference Soler C, Serra I, Cugat R, Sopena J, Rubio M, Redondo I, Carrillo J (2006) Biomechanical study in chondral lesions treated with plasma rich in growth factors. Thesis Doctoral Soler C, Serra I, Cugat R, Sopena J, Rubio M, Redondo I, Carrillo J (2006) Biomechanical study in chondral lesions treated with plasma rich in growth factors. Thesis Doctoral
36.
go back to reference Wakitani S, Mitsuoka T, Nakamura N, Toritsuka Y, Nakamura Y, Horibe S (2004) Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: two case reports. Cell Transplant 13:595–600CrossRefPubMed Wakitani S, Mitsuoka T, Nakamura N, Toritsuka Y, Nakamura Y, Horibe S (2004) Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: two case reports. Cell Transplant 13:595–600CrossRefPubMed
Metadata
Title
Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life
Authors
Ana Wang-Saegusa
Ramón Cugat
Oscar Ares
Roberto Seijas
Xavier Cuscó
Montserrat Garcia-Balletbó
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-010-1167-3

Other articles of this Issue 3/2011

Archives of Orthopaedic and Trauma Surgery 3/2011 Go to the issue