الفهرس | Only 14 pages are availabe for public view |
Abstract Platelet rich plasma (PRP) is a simple, low-cost, and minimally invasive method that allows a high concentrate of autologous growth factors in physiologic proportions to be obtained from blood, which can be easily and safely injected. Transforming growth factor-beta-1 (TGF-B1) induces a positive change in the articular environment, regulate angiogenesis, and induce the synthesis of hyaluronic acid in the synovial membrane. Intra-articular injection of autologous PRP has been increasingly implemented on patients with osteoarthritis. PRP reduces pain and improves function over time and currently seems to be considered as one of the treatment options for osteoarthritis. The aim of this study is to determine the efficacy of intra-articular injections of PRP in patients with Knee Osteoarthritis. This study is carried out on 28 patients suffering from primary knee osteoarthritis grade II, grade III. There were 21 female and 6 male patients. Their age range from 40 to 63 years with average 53 years, their body mass index (BMI) ranged from 26 to 45 kg/m2 with average 34 kg/m2, the period of complaint ranged from 1 to144 months with average 27 months, the laterality was left (11 cases) and right (17 cases), grade was 19 cases grade II, 9 cases grade III. All patients were treated by 2 intra-articular injection of PRP treatment, post injection follow up period was six months. Summery 92 The clinical results were classified on subjective base and were graded as Excellent in 18 patients (64.3%), Good in 8 patients (28.6 %) and Poor in 2 patients (7.1%). Platelets had significant effect on the results as it increased, activated and released growth factors which had role in osteoarthritis improvement. TGFB-1 had significant effect on the results as it is essential for cartilage integrity and repair cartilage lesion. There was direct correlation between platelet and TGFb-1 in PRP injected. Age and Sex had no statistically significant effect on the results. Period of complaint had statistically significant effect on results as the more time for time for cartilage pathology, the more time exposed to physical force, the less response to treatment. Grade of osteoarthritis had statistically significant effect on results as the more degeneration of the joint the less viable cells the smaller potential for growth factors response. Body mass index (BMI) had statistically significant effect on results as the large weight cause cartilage degeneration. The level of platelets at cut of point 1001.25 predicts excellent success, by sensitivity 88.9%, specificity 90%, positive predictive value (PPV) 94.1%, negative predictive value (NPV) 81.1% and accuracy 89.3%. The level of TGFB-1 at cut of point 128.25 predicts excellent success, by sensitivity 88.9%, specificity 80%, PPV 88.9%, NPV 80% and accuracy 85.7%. |