Prognostic Factors Related to Clinical Response in 210 Knees Treated by Platelet-Rich Plasma for Osteoarthritis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Outcomes
- -
- Improvement in pain or in function ≥ 50% and absolute change ≥ 20;
- -
- Or improvement in at least two of the following:
- Improvement in pain VAS score ≥ 20% and absolute change ≥ 10;
- Improvement in function ≥ 20% and absolute change ≥ 10;
- Improvement in patient’s global assessment ≥ 20% and absolute change ≥ 10.
2.2. Preparation of PRP
2.3. Statistical Analysis
2.4. Ethical Considerations
3. Results
3.1. Study Population
3.2. Efficacy and Patient Satisfaction
3.3. Comparison of Responders vs. Non-Responders
3.4. Tolerance
4. Discussion
Author | PRP Protocol | n | Control Group | Mean BMI | Prior HA | Disease Duration (Years) Median (Q1–Q3) | KL IV | Primary Outcome | Factors Associated with Lack of Efficacy |
---|---|---|---|---|---|---|---|---|---|
Kon et al., 2011 [34] | 3 (/15 days) | 150 | Yes (HA) | 24.6 ± 3.2 | NR | NC | 16% | IKDC at 6 M | Age Physical activity High KL grade |
Filardo et al., 2012 [35] | 1 | 51 | No | 27 (21–39) | 67% | 4 (1.5–10) | 20% | IKDC | High BMI High KL grade |
Patel et al., 2013 [37] | 2 (/21 days) | 156 | Yes (NaCl) | 25.8 ± 3.3 | NR | NR | NR | WOMAC3 M and 6 M | Ahlbäck classification |
Saita et al., 2021 [39] | 3 (/28 days) | 517 | No | 25.0 | NR | NR | 42% | OMERACT-OARSI response at 6 M and 12 M | KL IV |
Alessio-Mazzola et al., 2021 [40] | 4 (/7 days) | 118 | No | 25.9 ± 2.4 | 50% | NR | 0% | Failure (Surgery or recurrence at M6) | KL III High BMI |
Chopin et al., 2022 | 2 (/28 days) | 210 | No | 31.0 ± 6.5 | 58% | 3 (1–6) | 14% | OMERACT-OARSI at 7 M | Physiotherapy Heel-to-buttock distance >35 cm |
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Population | |
---|---|
Number of Patients | 197 |
Number of knees treated | 210 |
Women | 135 (64.3) |
Mean age, years | 59.8 ± 10.8 |
Mean BMI, kg/m2 | 31.0 ± 6.5 |
Time since symptom onset, months | 36 (12; 72) |
Initial WOMAC total score/96 | 49.4 ± 16.1 |
Initial VAS score/100 | 58.5 ± 19.7 |
Initial KOOS-PS score/28 | 16.8 ± 4.8 |
Treatment and comorbidities | |
Diabetes mellitus | 29 (13.9) |
Hypertension | 87 (41.6) |
Current smokers | 28 (11.9) |
Dyslipidemia | 46 (22.0) |
Metabolic syndrome | 49 (23.7) |
Chronic inflammatory rheumatic disease | 38 (18.8) |
Prior surgery on treated knee (meniscus/ligaments) | 25 (12.0) |
Charlson comorbidity index | 2.2 ± 1.7 |
Number of patients with Charlson ≥ 3 | 85 (40.7) |
Aspirin | 27 (12.9) |
Direct oral anticoagulant | 6 (2.9) |
Failed viscosupplementation | 121 (57.6) |
Localization of arthritis | |
Internal femorotibial | 145 (70.1) |
External femorotibial | 34 (16.4) |
Patellofemoral | 71 (34.3) |
Tricompartmental | 28 (13.5) |
Heredity | 37 (17.8) |
Secondary to chronic inflammatory rheumatic disease | 13 (19.7) |
Trauma | 68 (32.9) |
Metabolic | 65 (31.3) |
Static disorders | 100 (48.3) |
Kellgren–Lawrence Classification | |
| 24 (11.8) |
| 68 (33.5) |
| 82 (40.4) |
| 29 (14.3) |
M0 | M1 | M4 | M7 | |
---|---|---|---|---|
WOMAC (0–96) | 49.2 ± 16.0 | 43.6 ± 17.9 * | 31.1 ± 19.0 *# | 31.9 ± 19.8 *# |
KOOS-PS (0–28) | 16.8 ± 4.8 | 14.6 ± 5.3 * | 12.2 ± 5.9 *# | 12.2 ± 6.2 *# |
VAS (0–100) | 58.5 ± 19.7 | 51.6 ± 21.7 * | 43.7 ± 23.2 *# | 43.5 ± 24.6 *# |
PASS VAS < 40, n(%) | 21 (10.0) | 41 (22.9) * | 76 (39.2) *# | 81 (40.9) *# |
PASS WOMAC ≤ 46, n(%) | 80 (38.1) | 89 (50.6) * | 146 (76.0) *# | 148 (75.1) *# |
Characteristics | Responders n = 92 | Non-Responders n = 118 | p-Value |
---|---|---|---|
Age (years) | 59 ± 10 | 60 ± 11 | 0.41 |
Females | 60 (65.2) | 75 (63.6) | 0.80 |
Body mass index, kg/m2 | 30.7 ± 6.9 | 30.9 ± 6.5 | 0.87 |
Platelet count (G/L) | 260 ± 54 | 258 ± 67 | 0.69 |
Time since onset of symptoms, months | 51 ± 47 | 72 ± 91 | 0.27 |
VAS M0 (0–100) | 61.1 ± 18.5 | 56.5 ± 20.5 | 0.17 |
KOOS-PS M0 (/28) | 16.4 ± 4.5 | 17.1 ± 5.0 | 0.16 |
Womac M0 (/96) | 48.9 ± 14.1 | 48.9 ± 17.4 | 0.47 |
Womac function (/68) | 32.4 ± 10.1 | 34.2 ± 13.3 | 0.19 |
Heel-to-buttock distance (cm) | 24 ± 10 | 30 ± 12 | 0.01 |
Physiotherapy ongoing | 21 (23.3) | 46 (40.7) | 0.01 |
Joint effusion | 15 (16.3) | 20 (17.1) | 0.88 |
Current smokers | 12 (13.0) | 13 (11.0) | 0.65 |
Metabolic syndrome | 17 (18.9) | 32 (27.4) | 0.16 |
Chronic inflammatory rheumatic disease | 16 (17.4) | 22 (18.8) | 0.79 |
Prior surgery of treated knee | 9 (9.8) | 16 (13.7) | 0.39 |
Chondrocalcinosis | 7 (7.78) | 11 (9.5) | 0.67 |
Charlson comorbidity index | 2.1 ± 1.6 | 2.3 ± 1.8 | 0.40 |
Aspirin | 10 (10.9) | 17 (14.5) | 0.43 |
Direct oral anticoagulants | 2 (2.20) | 4 (3.4) | 0.70 |
NSAID use <10 days | 9 (10.0) | 13 (11.4) | 0.75 |
Failed viscosupplementation | 52 (56.5) | 69 (58.5) | 0.78 |
Heredity | 39 (42.4) | 56 (48.7) | 0.37 |
Trauma | 29 (31.5) | 39 (33.9) | 0.72 |
Secondary to chronic inflammatory rheumatic disease | 16 (17.4) | 21 (18.1) | 0.89 |
Metabolic | 26 (28.3) | 39 (33.6) | 0.41 |
Static or biomechanical disorders | 45 (49.5) | 55 (47.4) | 0.77 |
Kellgren–Lawrence Grade I | 13 (14) | 11 (10) | 0.30 |
Kellgren–Lawrence Grade II | 28 (31) | 40 (35) | 0.52 |
Kellgren–Lawrence Grade III | 39 (43) | 43 (38) | 0.84 |
Kellgren–Lawrence Grade IV | 10 (11) | 19 (17) | 0.25 |
Internal femorotibial localization | 66 (72.5) | 79 (68.1) | 0.49 |
External femorotibial localization | 16 (17.6) | 18 (15.5) | 0.69 |
Patellofemoral | 26 (28.6) | 45 (38.8) | 0.12 |
Tricompartmental | 11 (12.1) | 17 (14.7) | 0.59 |
Factor | OR (95%CI) |
---|---|
WOMAC | 0.99 (0.97–1.02) |
Physiotherapy | 0.46 (0.24–0.90) |
Patellofemoral localization | 0.62 (0.32–1.19) |
VAS score ≤ 6 | 0.55 (0.29–1.05) |
Heel-to-buttock distance > 35 cm | 0.31 (0.15–0.65) |
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Chopin, C.; Geoffroy, M.; Kanagaratnam, L.; Dorilleau, C.; Ecarnot, F.; Siboni, R.; Salmon, J.-H. Prognostic Factors Related to Clinical Response in 210 Knees Treated by Platelet-Rich Plasma for Osteoarthritis. Diagnostics 2023, 13, 760. https://doi.org/10.3390/diagnostics13040760
Chopin C, Geoffroy M, Kanagaratnam L, Dorilleau C, Ecarnot F, Siboni R, Salmon J-H. Prognostic Factors Related to Clinical Response in 210 Knees Treated by Platelet-Rich Plasma for Osteoarthritis. Diagnostics. 2023; 13(4):760. https://doi.org/10.3390/diagnostics13040760
Chicago/Turabian StyleChopin, Clément, Marion Geoffroy, Lukshe Kanagaratnam, Claire Dorilleau, Fiona Ecarnot, Renaud Siboni, and Jean-Hugues Salmon. 2023. "Prognostic Factors Related to Clinical Response in 210 Knees Treated by Platelet-Rich Plasma for Osteoarthritis" Diagnostics 13, no. 4: 760. https://doi.org/10.3390/diagnostics13040760