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Comparison of Autologous Platelet-rich Plasma With Hyaluronic Acid for the Treatment of Osteoarthritis of the Knee Joint

Phase 3
Completed
Conditions
Osteoarthritis, Knee
Interventions
Biological: PRP
Registration Number
NCT02211521
Lead Sponsor
Samsung Medical Center
Brief Summary

The purpose of this study is to compare the efficacy of platelet-rich plasma versus hyaluronic acid intra-articular injections for the treatment of osteoarthritis of knee joint.

The hypothesis is that PRP intra-articular injection is comparable or even better than hyaluronic acid injection.

Detailed Description

Osteoarthritis (OA) has a significant impact on our society. The limited regenerative capacity of cartilage is part of this problem. Existing degenerative lesions lead to accelerated deterioration of the articular (joint) surface leading to end-stage arthritis. In particular, the most recent knowledge regarding tissue biology highlights a complex regulation of growth factors (GFs) for the normal tissue structure and the reaction to tissue damage. The influence of GFs on cartilage repair is now widely investigated in vitro and in vivo. Platelet Rich Plasma (PRP) is a simple, low- cost and minimally- invasive method that allows one to obtain a natural concentrate of autologous GFs from the blood, and it is increasingly applied in the clinical practice to treat knee degenerative pathology, such as chondropathy and early OA. The biological rational of PRP is that platelets contain storage pools of GFs, cytokines, chemokines and many other mediators.Although its widespread application, there are little high level studies in the literature to demonstrate the real efficacy of PRP.

The investigators hypothesized that intra-articular injections of PRP to treat knee osteoarthritis could determine pain relief and recovery of knee function with overall clinical outcome comparable or even better than viscosupplementation, which is a common injective approach applied in this kind of pathology. To this purpose the investigators designed a double blind randomized controlled trial comparing PRP vs viscosupplementation.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
110
Inclusion Criteria
  • Patients with osteoarthritis of knee (by American College of Rheumatology Criteria) and Kellgren-Lawrence grade I ~ III
  • More than 40 out of 100-mm VAS scale for pain at screening and baseline
  • Participant is willing and able to give informed consent for participation in the study
Exclusion Criteria
  • Patients with Hb values < 10 g/dl and platelet values < 100,000/ul
  • Patients with a current or medical history of autoimmune disease
  • Recent fever ( within 2 weeks) or serious illness
  • Local infection at the site of the procedure
  • Corticosteroid injection at treatment site within 1 month
  • Systematic use of corticosteroids within 2 weeks
  • Female participants who are pregnant, lactating or planning pregnancy during the course of the study
  • Patients who have been administered with immunosuppressants within the past 6 weeks
  • Patients who are enrolled in any other clinical trials within 4 weeks
  • Patients who the principal investigator considers inappropriate for participation in the clinical trial for reasons other than those listed above

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PRP groupPRPPatients randomized to this group of treatment will receive 1 blinded knee intra-articular injections of autologous Platelet-Rich Plasma (3ml).
Hyaloronan groupHyaluronic acidPatients randomized to this group of treatment will receive 1 blinded knee intra-articular injections of hyaluronic acid (3ml)
Primary Outcome Measures
NameTimeMethod
Change from baseline in International Knee Documentation Committee subjective score at week 24Baseline, Week 24

International Knee Documentation Committee subjective score for both groups

Secondary Outcome Measures
NameTimeMethod
Change from baseline in VAS (Visual Analogue scale) for pain during walkingBaseline, Week 6, Week 12, Week 24

VAS (Visual Analogue scale) for pain during walking for both groups of treatment

Change from baseline in Western Ontario and McMaster Universities Arthritis IndexBaseline, Week 6, Week 12, Week 24

Western Ontario and McMaster Universities Arthritis Index variation for both groups

Subscale analysis of pain, stiffness, function also contain

Number of Participants with Adverse EventsWeek 6, Week 12, Week 24

All adverse events included

Change from baseline in Samsung Medical Center Patellofemoral score (SMC patellofemoral score)Baseline, Week 6, Week 12, Week 24

Samsung Medical Center Patellofemoral score for both groups of treatment

Patient global assessmentWeek 6, Week 12, Week 24

Patient global assessment was evaluated for improvement of symptoms using 100mm VAS.

Change from baseline in International Knee Documentation Committee subjective score at week 6, week 12Baseline, Week 6, Week 12

International Knee Documentation Committee subjective score for both groups

Trial Locations

Locations (1)

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

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