2015 ISAKOS Biennial Congress ePoster #207
Comparing PRP with High Molecular Weight Hyaluronic Acid (HMWHA) Injections for End Career Athletes with Degenerative Cartilage Lesions of the Knee
Rocco Papalia, MD, PhD, Prof., Rome ITALY
Andrea Tecame, MD, Parma ITALY
Lorenzo Alirio Diaz Balzani, MD, Roma ITALY
Cirino Amato, MD, PhD, Roma ITALY
Vincenzo Denaro, MD, PhD, Prof., Rome ITALY
Campus Bio-Medico, Roma, ITALY
FDA Status Not Applicable
Summary: Effectiveness of injections of platelet-rich plasma (PRP) compared with injections with HMWHA for the treatment of cartilage lesions among athletes at the end of their career
Cartilage lesions are very common cause of chronic knee pain in athletes. The current treatment options consist in conservative strategies, such as viscosupplementation and platelet-rich plasma injections.
In this randomized controlled trial we investigate the effectiveness of injections of platelet-rich plasma (PRP) compared with injections with HMWHA for the treatment of cartilage lesions among athletes at the end of their career.
Materials And Methods
Since September 2012, a total of 48 professional soccer players (all men; mean age 37 years) with clinical and radiographic evidence of degenerative changes to the knee were enrolled. The lesions were classified according to the Kellgren-Lawrence radiographic system. Patients were randomized into 2 groups: 24 patients (PRP Group ) received 3 intra-articular injections of 5.5 mL PRP, 24 patients (HA Group) received 2 injections of HMWHA (sodium hyaluronate hexadecylamide, 24mg/3ml).
IKDC, KOOS and VAS score were administered to all patients before starting the treatment, at 3, 6 and 12 months from the end of the management.
All patients achieved a statistically significant clinical improvement from preoperative to postoperative time. But, patients who were treated with platelet concentrates obtained better results earlier than the other group. In particular, "PRP Group" patients, showed a significant increase compared to HA Group of the IKDC scores (P 0.0003), KOOS (P 0.0349), VAS (P 0.0013) at 3 months after treatment. This difference remains significant until 6 months follow-up (P< 0.05). Subsequently, the values decrease gradually until they lose significance at 12 months follow-up.
Athletes with chronic degenerative cartilage lesions of the knee responded positively to both PRP and HMWHA. Although at final follow-up there is not a significant difference among the two groups, the PRP-treated patients demonstrated significantly greater improvements in all scores considered at 3 and 6 months follow up. These data could be advantageous in the treatment of the athlete because it may lead to a greater pain relief and a faster recovery in the short term, leading to a better overall performance