Efficacy of intraarticular injection Of autologous platelet rich plasma in patients with knee osteoarthritis

Osteoarthritis is a degenerative disease involving joint damage, an inadequate healing response and progressive deterioration of the joint architecture the commonly affects the knee joints. The most common conservative management for osteoarthritis is NSAIDS drugs, chondroitin sulfate, glucocorticoid. However these methods have various adverse effect & healing ability of cartilage tissue is not up to the mark.so it can give only short time resolution. • Autologous blood derived products possess much promise in the repair and regeneration of tissue and have important role in inflammation, angiogenesis, cell migration and metabolism in pathological conditions including osteoarthritis • PRP is an autologous mixture of highly concentrated platelets and associated growth factors and other bioactive components produced by centrifugal separation of whole blood that is mostly used in orthopaedic and sports medicine practice to treat bone, tendon and ligament injuries. • PRP may induce a regenerative response by improving the metabolic function of damaged structures • PRP also contains high concentration of growth factors,VEGF,PDGF,TGFbeta • The supra-physiological release of platelet derived growth factors directly at the site of cartilage disease, may stimulate the natural regenerative signalling cascade and enhance the healing of tissue with further mediation of the anti-inflammatory response The Ultimate aim of the study to assess the therapeutic effectiveness of platelet rich plasma as intraarticular knee joint injection for a patients with osteoarthritis by using WOMAC scoring

This study includes the sample size of between 4070 86 patients belong the age group year and history of knee pain more than 3 months hi story of patient was taken in pain clinic and they underwent . Detailed a thorough physical examination. Patient s fulfilling the criteria were explained about treatment modality in detail and informed consent was obtained & their pain sc ore by WOMAC scoring was assessed

P latelet Rich Plasma(PRP) PREPARATION : About 30 ml of patients blood was taken from vials 4.2ml of acid dextrose solution in sterile 5 ml of PRP. antecubital vein and mixed with to get about 3 and it centrifuged telet After centrifuging the concentration of pla patients blood was assessed. Procedure: in PRP and After all those initial preparation, the patient was taken to operating with proper monitoring with pulse oximeter, ECG, non invasive blood pressure through room out the procedure. Two large IV cannula was established and one unit of RL was started in one IV cannula and inj. Ondansetron 4mg IV , inj. Midazolam 1mg IV , inj. Fentanyl 25 mcg was given as antiemetic, anxiolytic, analgesic basis respectively. Patient was lies on his back , exposing slightly flexed the knee joint and the affected knee joint . Routine disinfection was done with iodophor . inj. lignocaine p 2% was infiltrated in to the skin / subcutaneous tissue. And then 3 ml of autologous PRP was administered in the patellofemoral joint space at outer edge of patella and then knee joint was slightly flexed and extended for several times to ma ke sure PRP fully cover the articular surface. After the injection patient was instructed to avoid strenuous same exercise And the procedure was done once in a week for a 3 consecutive week After the 3 shot of PRP injection in 3 consecutive week, the patients WOMAC score was assessed and it was compared with their initial WOMAC scoring.