Analysis of Pooled Data from Two Pivotal Controlled Trials on the Efficacy of Intra-osseous Injection of Platelet-rich Plasma in the Treatment of Osteoarthritis Knee

Research Objectives: To evaluate the additional efficacy of intraosseous injection (IO) of platelet-rich palsma (PRP) over intra-articular (IA) injection in terms of pain-relief and knee-activity scores in persons with Osteoarthritis (OA) Knee.

Design: A pooled analysis of two clinical trials

Setting: A tertiary care teaching hospital, India

Participants: Persons with OA Knee (K&L grade III)

Interventions: The pooled intent-to-treat population included 114 patients receiving either single IO+IA injection with 18ml PRP or single IA injection with 8ml PRP solution at the target knee joint.

Main Outcome Measures: The primary outcome was pain relief, assessed by VAS knee pain score. The secondary outcome was the knee activity scores, assessed with the KOOS scale. Persons were assessed at baseline, at six weeks, and at 12 weeks.

Results: Compared to IA-PRP injection, persons who received IO+IA-PRP injection reported significant pain relief [mean difference= -0.40; (95%CI: -0.72 to-0.08)] in VAS pain and KOOS-Pain [MD= -0.40; (95%CI:-0.72, -0.08] scores at 12 weeks. However, IO+IA-PRP injection failed to demonstrate significant improvements in other KOOS parameter sub-scores (symptoms, ADL, Sports/ Recreation, QoL) at 12 weeks. Persons who received IO+IA-PRP injections reported significant pain, stiffness, and swelling due to interventions (intra-osseous procedures) compared to persons who received only IA-PRP injections.

Conclusions: Compared to IA-PRP injection, IO+IA-PRP injection provided significant pain relief in VAS- and KOOS- pain scores at 12 weeks. However, during knee activities, a single episode of IO+IA-PRP injection did not provide additional benefits in other KOOS parameter scores. Compared to IA-PRP injection, IO+IA-PRP injection was more painful.

Author(s) Disclosures: Nil