Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2012-10, Vol.20 (10), p.2082-2091
• Main Authors: Filardo, Giuseppe, Kon, Elizaveta, Pereira Ruiz, Maria Teresa, Vaccaro, Franca, Guitaldi, Rita, Di Martino, Alessandro, Cenacchi, Annarita, Fornasari, Pier Maria, Marcacci, Maurilio
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthritis; Blood; Blood & organ donations; Blood platelets; Cartilage; Cartilage Diseases - complications; Cartilage Diseases - therapy; Female; Follow-Up Studies; Humans; Injections, Intra-Articular; Knee; Linear Models; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedic Procedures - methods; Orthopedics; Osteoarthritis; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - therapy; Patient Satisfaction; Plasma; Platelet-Rich Plasma; Prospective Studies; Treatment Outcome
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-011-1837-x

Purpose To compare the safety and efficacy of two different approaches of platelet-rich plasma (PRP) production methods as intra-articular injection treatment for knee cartilage degenerative lesions and osteoarthritis (OA). Methods The study involved 144 symptomatic patients affected by cartilage degenerative lesions and OA. Seventy-two patients were treated with 3 injections of platelet concentrate prepared with a single-spinning procedure (PRGF), the other 72 with 3 injections of PRP obtained with a double-spinning approach. The patients were evaluated prospectively at the enrollment and at 2, 6, and 12 months’ follow-up with IKDC, EQ-VAS and Tegner scores; adverse events and patient satisfaction were also recorded. Results Both treatment groups presented a statistically significant improvement in all the scores evaluated at all the follow-up times. Better results were achieved in both groups in younger patients with a lower degree of cartilage degeneration. The comparative analysis showed similar improvements with the two procedures: in particular, IKDC subjective evaluation increased from 45.0 ± 10.1 to 59.0 ± 16.2, 61.3 ± 16.3, and 61.6 ± 16.2 at 2, 6, and 12 months in the PRGF group, and from 42.1 ± 13.5 to 60.8 ± 16.6, 62.5 ± 19.9, and 59.9 ± 20.0 at 2, 6, and 12 months in the PRP group, respectively. Concerning adverse events, more swelling ( P  = 0.03) and pain reaction ( P  = 0.0005), were found after PRP injections. Conclusions Although PRP injections produced more pain and swelling reaction with respect to that produced by PRGF, similar results were found at the follow-up times, with a significant clinical improvement with respect to the basal level. Better results were achieved in younger patients with a low degree of cartilage degeneration. Level of evidence II.