Intra-articular injection with Autologous Conditioned Plasma does not lead to a clinically relevant improvement of knee osteoarthritis: a prospective case series of 140 patients with 1-year follow-up
Korpershoek, Jasmijn, V; Vonk, Lucienne A.; De Windt, Tommy S.; Admiraal, Jon; Kester, Esmee C.; Van Egmond, Nienke; Saris, Daniel B. F.; Custers, Roel J. H.
(2020) Acta Orthopaedica, volume 91, issue 6, pp. 743 - 749
(Article)
Abstract
Background and purpose — Platelet-rich plasma (PRP) is broadly used in the treatment of knee osteoarthritis, but clinical outcomes are highly variable. We evaluated the effectiveness of intra-articular injections with Autologous Conditioned Plasma (ACP), a commercially available form of platelet-rich plasma, in a tertiary referral center. Second, we aimed to
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identify which patient factors are associated with clinical outcome. Patients and methods — 140 patients (158 knees) with knee osteoarthritis (Kellgren and Lawrence grade 0–4) were treated with 3 intra-articular injections of ACP. The Knee Injury and Osteoarthritis Outcome Score (KOOS), pain (Numeric Rating Scale; NRS), and general health (EuroQol 5 Dimensions; EQ5D) were assessed at baseline and 3, 6, and 12 months’ follow-up. The effect of sex, age, BMI, Kellgren and Lawrence grade, history of knee trauma, and baseline KOOS on clinical outcome at 6 and 12 months was determined using linear regression. Results — Mean KOOS increased from 37 at baseline to 44 at 3 months, 45 at 6 months, and 43 at 12 months’ follow-up. Mean NRS-pain decreased from 6.2 at baseline to 5.3 at 3 months, 5.2 at 6 months, and 5.3 at 12 months. EQ5D did not change significantly. There were no predictors of clinical outcome. Interpretation — ACP does not lead to a clinically relevant improvement (exceeding the minimal clinically important difference) in patients suffering from knee osteoarthritis. None of the investigated factors predicts clinical outcome.
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Keywords: Age Factors, Arthralgia/diagnosis, Body Mass Index, Female, Follow-Up Studies, Humans, Injections, Intra-Articular/methods, Male, Medical History Taking/statistics & numerical data, Middle Aged, Netherlands/epidemiology, Osteoarthritis, Knee/epidemiology, Platelet-Rich Plasma, Prognosis, Risk Assessment/methods, Sex Factors, Treatment Outcome, Surgery, Orthopedics and Sports Medicine, Journal Article, Research Support, Non-U.S. Gov't
ISSN: 1745-3674
Publisher: Informa Healthcare
Note: Funding Information: This study was submitted to the institutional ethical review board of the University Medical Center Utrecht (METC 19-242, 03-04-2019; METC 17-005, 10-01-2017) and was conducted according to the World Medical Association Declaration of Helsinki. Written informed consent was obtained from all individual participants included in the study. This research was supported by the Dutch Arthritis Foundation (LLP-12). The study dataset is available from the corresponding author upon reasonable request. The authors declare that they have no competing interests. Publisher Copyright: © 2020 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.
(Peer reviewed)