2015 ISAKOS Biennial Congress ePoster #416

Traetment of Tibiofemoral Chondromalatia with Platelet-Rich Plasma and Hyaluronic Acid

Adel Safi, MD, PhD, Znojmo CZECH REPUBLIC
Radek Hart, MD, PhD, FRCS, Prof., Znojmo CZECH REPUBLIC
Martin Komzák, MD, Znojmo CZECH REPUBLIC
Hospital of Znojmo, Znojmo, CZECH REPUBLIC

FDA Status Not Applicable

Summary: The PRP treatment of tibiofemoral chondromalatia done with the described protocol has no significant influence on cartilage height in the magnetic resonance imaging, but this technique is safe and provides pain reduction and improves function and the histological structure of the cartilage.

Abstract:

Introduction

Recently an articular cartilage repair has been given much attention in the orthopaedic field. Cartilage regeneration capacity is very limited. The objective of the present study was to determine if PRP can increase tibiofemoral cartilage regeneration and improve knee function.

Methods

Fourty consecutive and strictly selected patients affected only Grade II or III chondromalatia, underwent one year treatment (9 injections) with autologous PRP in a liquid form with 2,0 to 2,5-fold platelets concentration (20 cases) or with hyaluronic acid (HA) (20 patients). Outcome measures included the Lysholm, Tegner, IKDC, WOMAC, and SF-36 scores. Magnetic resonance imaging, arthroscopical and histological assessment was used to evaluate cartilage thickness and degree of its degeneration before and after the treatment (one year after the primary arthroscopy). Microscopic structure improved in 5 cases after PRP as well as after HA treatment.

Results

The study demonstrated significant improvement in Lysholm, Tegner, IKDC, WOMAC and SF-36 scores in both groups. Cartilage assessment revealed no significant macroscopic structural regeneration as well as no cartilage height increase in both groups. Higher content of chondrocytes and proteoglycans in cartilage was proved in both groups after the treatment, without the statistically significant difference between both groups.

Conclusions

PRP and HA significantly reduced pain and improved quality of life in patients with low degree of cartilage degeneration. Magnetic resonance imaging and arthroscopic assessement did not confirmed any significant cartilage structural improvement. The content of chondrocytes and proteoglycans in cartilage was higher in the PRP group than in the HA group after the treatment, but without statistical significance.