Summary

Role of Growth factor concentrate intra-articular injection for degenerative or osteoarthritis ankle joint disease: a prospective clinical case series of 30 cases & review of literature

Abstract

Introduction

Degenerative joint disease & osteoarthritis are the most common and disabling of the orthopaedic diseases. Currently, the conservative treatment is limited to symptomatic treatment, whose goal is to improve function and pain control. Osteoarthritis or degenerative ankle joint disease is comparatively uncommon, as compared with osteoarthritis of the hip and knee, and so the therapeutic options (both conservative and surgical). With surgeries providing poorer and less predictable results for such cases. The effectiveness of Growth factor concentrate (GFC) injections for such cases is still controversial, particularly so for ankle joint arthritis, owing to the lack of evidence. The objective of this study was to evaluate the safety and the efficacy of intra-articular injections of intra-articular injection of Growth factor concentrate (GFC) for degenerative or osteoarthritis (OA) ankle joint disease in patients affected by degenerative or osteoarthritis ankle joint disease.

Methods

A total of 30 symptomatic patients, aged 37-89 years, affected by either degenerative or OA ankle, were treated with 2 dose of 5 ml of autologous GFC intra-articular injection one month apart followed by yearly injection of the same. Clinical evaluations before the treatment and after one, 6, 12, and 24 months were performed. We evaluated the presence of pain using the visual analog scale, function using the Foot and Ankle Disability Index, and subjective satisfaction by physical quotient of life index (PQLI) for patients. Adverse events were recorded.

Results

No severe complications were noted during the treatment and the follow-up period. Basal follow up evaluation to the patients was done for pre- and post-treatment scores at one, 6, 12, and then yearly up to for 5 years and a statistically significant improvement was noticed with overall improvement of physical quotient of life index (PQLI) for patients. We found a strong positive effect for yearly GFC injections on pain (p= .0001) and function (p = .001), with 90% of patients very satisfied and satisfied, and only 3 patients (10%) required surgery because of early treatment failure.

Conclusion

GFC intra articular injection is safe and minimally invasive therapeutic option for patients with degenerative or osteoarthritis ankle joint disease and good alternative to postpone the need for surgery. We advocate a yearly injection for such cases for gaining the best long-term results & improving PQLI of patients. Further high-quality multicentre studies are needed to confirm findings.

Keywords: Growth factor concentrate (GFC), intra-articular injection, Degenerative joint disease, osteoarthritis ankle