Platelet Rich Plasma and Neural Prolotherapy Injections in Treating Knee Osteoarthritis

Launched by CHANG GUNG MEMORIAL HOSPITAL · Jul 1, 2019

Keywords

ClinConnect Summary

Patients will receive monthly injections for a total of 3 months. In short, if inflammatory proteins in the SF are not reduced after PRP injections, this indicates that PRP is not a good treatment choice for patients with moderate to severe degrees of knee OA. If inflammatory protein concentrations are further increased after NPT as patients may start strenuous exercises with reduced knee pain, more knee joint destruction may result. This signifies that NPT has pain reduction effect only and is not a viable treatment option. Roentgenograms may not show immediate signs of increased degenerat...

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Eligibility criteria

• Inclusion Criteria:
• • 1. Patients suffered from chronic unilateral knee pain for more than 4 months and with roentgenogram degenerative findings of grades 3 and 4 on the Kellgren-Lawrence Classification of Osteoarthritis scale (meaning moderate to severe degrees of knee OA) will be recruited.
• • 2. The volume of the SF in the supra-patellar bursa region is enough (at least 2 mm thickness in bursa fluid as measured by ultrasound) to be aspirated via ultrasound guidance.
• • 3. Small volume of SF will be aspirated first and sent for SF analysis. SF showing evidences of crystals suggesting possible gouty arthritis and infection will not be included in this study.
• • 4. Patient has previously received oral NSAIDs and physical modality treatments but WITHOUT any obvious improvements in knee pain and function.
• • 5. The usage of musculoskeletal ultrasound to confirm that the supra-patellar bursa is in communication with the synovial cavity of the knee joint. This is to prevent the aspiration of isolated cystic lesion at the supra-patellar region.
• Exclusion Criteria:
• • 1. Total obliteration of knee joint as shown on the roentgenogram images.
• • 2. Patient has systemic disorders such as diabetes, rheumatoid arthritis, major axial deviation of the knee joint (varus \>5°, valgus \>5°), hematological diseases (coagulopathy), severe cardiovascular diseases, infections, and immune-depression.
• • 3. Patients in therapy with anticoagulants, and taking NSAIDs within the 5 days before blood harvest.
• • 4. Patients with hemoglobin value of less than 11 g/dl, and platelet counts of less than 150,000/mm3.