Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Chondral Injuries In Young Patients<sup/>

Danieli, Marcus Vinicius; Guerreiro, João Paulo Fernandes; Vimercati, Telvio Ataide; Mendes, Pedro Henrique Favaro; Miyazaki, Paulo Raphael Tsutomu Katayama; Cataneo, Daniele Cristina

doi:10.1055/s-0041-1724075

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Revista Brasileira de Ortopedia

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Sumário

Original Article • Rev. bras. ortop. 56 (5) • Nov-Dec 2021 • https://doi.org/10.1055/s-0041-1724075 copy

Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Chondral Injuries In Young Patients^* * Study developed at the Knee Surgery Group, Uniorte Hospital de Ortopedia, Londrina, PR, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

The present study aimed to compare the clinical and functional outcomes of hyaluronic acid (HA) or platelet-rich plasma (PRP) applications to treat young patients with knee chondral lesions with no arthrosis.

Methods

Prospective clinical and functional evaluation of 30 young adult patients with knee chondral lesions submitted to conservative treatment with HA or PRP for a minimum follow-up time of 12 months. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analog scale (VAS) were used for the evaluation.

Results

According to the WOMAC score, the PRP group showed significant improvement in all evaluated points, whereas the HA group presented no score improvement. In the VAS, the PRP group showed improvement in all evaluated points, and the HA group presented improvement at 6 and 12 months. Compared to the HA group, the PRP group presented better WOMAC scores at all evaluated points and better VAS scores up to 6 months after treatment.

Conclusion

Platelet-rich plasma application resulted in better clinical and functional outcomes at both the WOMAC and VAS scores when applied to knees from young patients with chondral lesions, but no arthrosis. These outcomes were sustained for up to 12 months.

Level of evidence

Randomized clinical trial (Type 2B)

GROUP	HA	PRP
N	15	14
Mean age (minimum and maximum value)	36.47 (22−50)	34.93 (18−50)
Female gender	4	3
Male gender	11	11
Right side	7	3
Left side	3	8
Bilateral	5	4

WOMAC
GROUP	Time	Mean	Standard deviation	Minimum value	Median	Maximum value
PRP	Preoperative	34.78	16.99	1	37.5	61
	Postoperative	20.56	13.56	1	17.0	50
	3 months	16.94	10.32	1	13.5	45
	6 months	16.39	10.81	1	14.5	40
	12 months	19.33	13.86	1	16.0	48
HA	Preoperative	23.95	17.48	2	20.5	62
	Postoperative	21.35	21.18	1	15.0	79
	3 months	24.45	25.96	2	14.5	85
	6 months	21.80	19.69	1	13.5	63
	12 months	25.80	19.68	2	21.5	63

Comparisons	Estimated value	P-value
PRP (preoperative x postoperative)	14.22	< 0.01
PRP (preoperative x 3 months)	17.83	< 0.01
PRP (preoperative x 6 months)	18.39	< 0.01
PRP (preoperative x 12 months)	15.44	< 0.01
HA (preoperative x postoperative)	2.6	0.34
HA (preoperative x 3 months)	–0.5	0.85
HA (preoperative x 6 months)	2.15	0.43
HA (preoperative x 12 months)	–1.85	0.50
Postoperative (PRP x HA)	15.70	< 0.01
3 months (PRP x HA)	16.27	< 0.01
6 months (PRP x HA)	16.67	< 0.01
12 months (PRP x HA)	17.72	< 0.01

PAIN SCORE
GROUP	Time	Mean	Standard deviation	Minimum value	Median	Maximum value
PRP	Preoperative	6.06	2.62	0	6.0	10
	Postoperative	4.50	2.36	0	5.0	8
	3 months	4.50	2.36	0	5.0	8
	6 months	3.67	2.11	0	4.5	7
	12 months	4.06	1.76	1	4.5	6
HA	Preoperative	5.95	2.58	0	6.0	10
	Postoperative	5.20	3.12	0	5.5	10
	3 months	5.20	3.40	0	5.0	10
	6 months	4.85	2.96	0	5.0	10
	12 months	4.50	2.31	1	5.0	8

Comparisons	Estimated value	P-value
PRP (preoperative x postoperative)	1.56	< 0.01
PRP (preoperative x 3 months)	1.56	< 0.01
PRP (preoperative x 6 months)	2.39	< 0.01
PRP (preoperative x 12 months)	2.00	< 0.01
HA (preoperative x postoperative)	0.75	0.09
HA (preoperative x 3 months)	0.75	0.09
HA (preoperative x 6 months)	1.10	0.01
HA (preoperative x 12 months)	1.45	< 0.01
Postoperative (PRP x HA)	2.12	< 0.01
3 months (PRP x HA)	2.12	< 0.01
6 months (PRP x HA)	1.98	0.02
12 months (PRP x HA)	1.24	0.14

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Marcus Vinicius Danieli, PhD, Uniorte Hospital de Ortopedia, Av. Higienópolis, 2600, Londrina, PR, 86050-000, Brazil (e-mail: mvdanieli@hotmail.com).

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Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Chondral Injuries In Young Patients* * Study developed at the Knee Surgery Group, Uniorte Hospital de Ortopedia, Londrina, PR, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Level of evidence

Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Chondral Injuries In Young Patients^* * Study developed at the Knee Surgery Group, Uniorte Hospital de Ortopedia, Londrina, PR, Brazil.