Degeneration of Knee Joint
Orthopedic and Sports Trauma Researchers at the University of Bologna, Italy observed an increase in joint cartilage disease due to increased participation in physical activity for all age groups. Cartilage has limited healing potential and is a challenge to treat. Therapy usually begins with pain relief measures such as NSAIDs, which are toxic to heart and GI organs; topical agents, which are useful for short-term moderate pain relief, and corticosteroid injections.
Degeneration in Knees PRP Study Shows Potential to Reverse Degeneration of Knee Joint
Steroid injections have short-term benefit and evidence suggests they have harmful effects on joint structures (Behrens, et al.). No traditional orthopedic treatments have been significantly proven to change the disease course of joint degeneration. Current research is focusing on the effect of growth factors on cartilage repair. Platelet Rich Plasma (PRP) is a concentrated natural human product containing growth factors that can be injected into joints in a simple and minimally invasive manner.
The Study Method
• The study had a sample of 100 patients, aged 24 to 82, with at least a 4-month history of knee pain. The degenerative joint disease was confirmed by X-ray or MRI in all patients. Degeneration ranged from mild to severe. Patients were assessed for pain, swelling, a range of motion, and function on three occasions (baseline, 6, and 12 months after therapy).
• 150 cc of blood was drawn from each patient and centrifuged down into a platelet-rich solution that was then split into 4 samples. One sample was submitted for bacterial testing while the other three (5 ccs each) were injected into the patient’s knee 21 days apart. The injected solution contained a 600% increase in platelet concentration over that found in whole blood. Platelets were activated with calcium chloride to form a gel.
Results
• Patients significantly improved on all measures 6 months post-treatment. There was a slight decline in outcomes at 12 months but results were still significantly better than at the beginning of the study.Degeneration in Knees
• Older patients who presented with a more severe disease at baseline did not respond as well as younger patients. These outcomes are probably due to less living and vital cells available to respond to PRP. Results were not influenced by previous surgery, but obese patients and women had fewer improvements. No adverse effects were reported.
Why Does PRP Work?
Platelet Rich Plasma is a storage pool of growth factors that are thought to:
• stimulate bone marrow stem cells to develop into chondrocytes (cartilage cells)
• increase cartilage matrix and proteoglycans (joint proteins that provide structure and lubrication)
• Suppress inflammatory mediators that inhibit cartilage synthesis.
The preparation of PRP as a gel is thought to allow it to adhere to the confines of the joint space and release a cascade of growth factors.
The doctor at Houston Spine & Sports Medicine has many years of experience treating knee joint degeneration and are ready to evaluate you for PRP treatment. The office is located in The Woodlands and is easily reached from Spring, Conroe, Tomball, Magnolia, Kingwood, and Houston. Call us today to schedule an appointment!Degeneration of Knees
Degeneration of Knees
Kon, E, Buda, R, et al. (2009). Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surgery Sports Traumatology Arthroscopy, DOI. 10.1007/s00167-009-0940-8
Behrens, F, Shephard, N, et al. (1975). Alteration of rabbit articular cartilage by intra-articular injections of glucocorticoids. Journal of Bone and Joint Surgery, 75-A(1): 70-76.
Degeneration of Knee Joint