Cell and Organ Transplantology. 2020; 8(2):131-138.
DOI: 10.22494/cot.v8i2.112
Analysis of quality of life in patients with knee osteoarthritis after application of autologous leukocyte-rich and leukocyte-poor platelet-rich plasma
Goliuk Ye.¹, Pschenychny T.¹, Ostapenko T.², Yavorovska V.¹, Magomedov O.¹
- ¹State Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
- ²Ukrainian Scientific Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of Ministry of Health of Ukraine, Kyiv, Ukraine
Abstract
In recent years, there is a growing interest in the application of regenerative medicine methods in the treatment of degenerative injuries of the musculoskeletal system. Knee osteoarthritis (gonarthrosis) is one of the most common reasons for visiting orthopedic surgeons to patients.
The purpose of the study was to evaluate the quality of life in patients with different stages of gonarthrosis after application of leukocyte-rich platelet-rich plasma (LR-PRP) and leukocyte-poor platelet-rich plasma (LP-PRP).
Materials and methods. The results of the treatment of 48 patients with gonarthrosis grades 1-3 according to Kellgren-Lawrence after intra-articular injection of LR-PRP or LP-PRP were compared. The quality of life questionnaires were used: visual analogue scale, Lysholm Knee Score and Oxford Knee Score before treatment, after the first injection, every 2 weeks before the end of treatment and every 3 months for 1 year.
Results. Evaluation of the treatment results obtained at stages 1 and 2 of knee osteoarthritis showed a positive result for both groups of patients during 12 months of follow-up and at stage 3 a significant improvement was achieved for up to 6 months. There was no significant difference between the results of LR-PRP and LP-PRP injections for 9-12 months. After using LP-PRP treatment, the dynamics of quality of life during the year was stepless and more steady, without periods of regression while for LR-PRP injections was a clear significant short-term reduction in the treatment effect for about 6 months, compared to both baseline and values of the previous period at 1 and 2 stages gonarthrosis with further improvement and a stable positive effect for up to 12 months.
Conclusions. The application of platelet-rich plasma improved the quality of life for 12 months in patients with stage 1-2 gonarthrosis and for 6 months at stage 3. The obtained positive results substantiate the need for further research to determine the prospects for the application of platelet-rich plasma in the complex treatment of knee osteoarthritis compared to other methods.
Key words: regenerative medicine; platelet-rich plasma; knee osteoarthritis; quality of life
Full Text PDF (eng) Full Text PDF (ua)1. Assirelli E., Filardo G. Effect of two different preparations of platelet-rich plasma on synoviocytes. Knee Surg. Sports. Traumatol. Arthrosc. 2015;23(6):2690-2703. doi: 10.1007/s00167-014-3113-3 https://doi.org/10.1007/s00167-014-3113-3 PMid:24942296 PMCid:PMC4541703 |
||||
2. Borregaard N. Neutrophils, from marrow to microbes. Immunity. 2010;33(5):657-70. doi: 10.1016/j.immuni.2010.11.011. PMID: 21094463. https://doi.org/10.1016/j.immuni.2010.11.011 PMid:21094463 |
||||
3. Caplan A., Correa D. PDGF in bone formation and regeneration: New Insights into a Novel Mechanism Involving MSCs. J. Orthop. Res. 2011:1795-1803. DOI: 10.1002/jor.21462 https://doi.org/10.1002/jor.21462 PMid:21618276 |
||||
4. Chubinskaya S, Kuettner KE, Cole AA. Expression of matrix metalloproteinases in normal and damaged articular cartilage from human knee and ankle joints. Lab Invest. 1999;79(12):1669-77. | ||||
5. DeLong J. M., Russell R. P., Mazzocca A. D.. Platelet-rich plasma: the PAW classification system. Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2012. 28(7), 998-1009. DOI:10.1016/j.arthro.2012.04.148 https://doi.org/10.1016/j.arthro.2012.04.148 PMid:22738751 |
||||
6. Dohan Ehrenfest D. M., Rasmusson L., Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends in biotechnology. 2009; 27(3):158-167. DOI:10.1016/j.tibtech.2008.11.009 https://doi.org/10.1016/j.tibtech.2008.11.009 PMid:19187989 |
||||
7. Duif C., Vogel T., Topcuoglu F., Spyrou G., von Schulze Pellengahr C., Lahner M. Does intraoperative application of leukocyte-poor platelet-rich plasma during arthroscopy for knee degeneration affect postoperative pain, function and quality of life? A 12-month randomized controlled double-blind trial. Archives of orthopaedic and trauma surgery. 2015. 135(7):971-977. DOI: 10.1007/s00402-015-2227-5) https://doi.org/10.1007/s00402-015-2227-5 PMid:25957981 |
||||
8. Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114(6):1502-1508. DOI:10.1097/01.prs.0000138251.07040.51 https://doi.org/10.1097/01.PRS.0000138251.07040.51 PMid:15509939 |
||||
9. Filardo G, Kon E, DI Matteo B, DI Marino A, Sessa A, Merli ML, Marcacci M. Leukocyte-poor PRP application for the treatment of knee osteoarthritis. Joints. 2014;1(3):112-20. DOI:10.11138/jts/2013.1.3.112 https://doi.org/10.11138/jts/2013.1.3.112 PMid:25606520 |
||||
10. Filardo G., Previtali D., Napoli F., Candrian C., Zaffagnini S., Grassi A. (2020). PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials. Cartilage, 1947603520931170. DOI: 10.1177/1947603520931170) https://doi.org/10.1177/1947603520931170 PMid:32551947 |
||||
11. Fitzpatrick J., Bulsara M. K., McCrory P. R., Richardson M. D., Zheng M. H. Analysis of Platelet-Rich Plasma Extraction: Variations in Platelet and Blood Components Between 4 Common Commercial Kits. Orthopaedic journal of sports medicine. 2017;5(1). DOI:10.1177/2325967116675272 https://doi.org/10.1177/2325967116675272 PMid:28210651 PMCid:PMC5302100 |
||||
12. Furman M.I., Barnard M.R., Krueger L.A., Fox M.L., Shilale E.A., Lessard D.M. et al. Circulating Monocyte-platelet aggregates are an early marker of acute myocardial infarction.. J. Am. Coll. Cardiol. 2001;38:1002-6. DOI: 10.1016/s0735-1097(01)01485-1 https://doi.org/10.1016/S0735-1097(01)01485-1 |
||||
13. Htun P., Fateh-Moghadam S., Tomandl B., Klinger K., Stellos K., Garlichs C. et al. Course of platelet activation and platelet-leukocyte interaction in cerebrovascular ischemia.. Stroke. 2006;37:2283-7. DOI: 10.1161/01.STR.0000236638.75591.61 https://doi.org/10.1161/01.STR.0000236638.75591.61 PMid:16888273 |
||||
14. Joseph J.E., Harrison P., Mackie I.J., Isenberg D.A. Increased circulating plateletleucocyte complexes and platelet activation in patients with antiphospholipid syndrome, systemic lupus erythematosus and rheumatoid arthritis. Brithsh J. Haematol. 2001;115:451-9. DOI: 10.1046/j.1365-2141.2001.03101. https://doi.org/10.1046/j.1365-2141.2001.03101.x PMid:11703349 |
||||
15. Kikuchi N., Yoshioka T., Taniguchi Y. et al. Optimization of leukocyte-poor platelet-rich plasma preparation: a validation study of leukocyte-poor platelet-rich plasma obtained using different preparer, storage, and activation methods. J Exp Ortop. 2019;6(24). DOI:10.1186/s40634-019-0190-8 https://doi.org/10.1186/s40634-019-0190-8 PMid:31161535 PMCid:PMC6546777 |
||||
16. Kobayashi Y., Saita Y., Nishio H. Leukocyte concentration and composition in platelet-rich plasma (PRP) influences the growth factor and protease concentrations. J Orthop Sci. 2016;21(5):683-689. DOI: 10.1016/j.jos.2016.07.009 https://doi.org/10.1016/j.jos.2016.07.009 PMid:27503185 |
||||
17. Kennedy M.I., Whitney K., Evans T., LaPrade R.F. Platelet-rich plasma and cartilage repair. Curr Rev Musculoskelet Med.- 2018;11(4):573-582. DOI: 10.1007/s12178-018-9516 https://doi.org/10.1007/s12178-018-9516-x PMid:30203333 PMCid:PMC6220001 |
||||
18. Lana J. F., Huber S. C., Purita J., Tambeli C. H., Santos G. S., Paulus C., Annichino-Bizzacchi J. M. Leukocyte-rich PRP versus leukocyte-poor PRP – The role of monocyte/macrophage function in the healing cascade. J Clin Orthop Trauma. 2019;Suppl 1:S7-S12. https://doi.org/10.1016/j.jcot.2019.05.008 https://doi.org/10.1016/j.jcot.2019.05.008 PMid:31700202 PMCid:PMC6823808 |
||||
19. Leonidou A., Lepetsos P., Mintzas M., Kenanidis E. Inducible nitric oxide synthase as a target for osteoarthritis treatment. Expert Opin Ther Targets. 2018;22(4):299-318. DOI: 10.1080/14728222.2018.1448062 https://doi.org/10.1080/14728222.2018.1448062 PMid:29504411 |
||||
20. Lucarelli E., Beccheroni A., Donati D., Sangiorgi L., et al. Platelet-derived growth factors enhance proliferation of human stromal stem cells. Biomaterials. 2003. 24(18):3095-3100. https://doi.org/10.1016/s0142-9612(03)00114-5). https://doi.org/10.1016/S0142-9612(03)00114-5 |
||||
21. Meeson R., Sanghani-Keri A., Coathup M. VEGF with AMD3100 endogenously mobilizes mesenchymal stem cells and improves fracture healing. J Orthop Res. 2019;37(6):1294-1302. DOI: 10.1002/jor.24164 https://doi.org/10.1002/jor.24164 PMid:30345545 PMCid:PMC6563072 |
||||
22. Mickelson J.K., Lakkis N.M., Villarreal-Levy G., Hughes B.J., Smith C.W. Leukocyte activation with platelet adhesion after coronary angioplasty: a mechanism for recurrent disease?. J Am Coll Cardiol. 1996;28:345-53. DOI: 10.1016/0735-1097(96)00164-7 https://doi.org/10.1016/0735-1097(96)00164-7 |
||||
23. Oltulu I., Korkmaz O., Isyar M., Kara A., Bulbul A. M., Mahirogulları M. Does the Difference in Leukocyte Concentration of PRP Affect the Short-Term Follow-Up Results in Cases Diagnosed with Early Stage Knee Osteoarthritis? Serbian Journal of Experimental and Clinical Research. 2019. DOI:10.2478/sjecr-2019-0010). https://doi.org/10.2478/sjecr-2019-0010 |
||||
24. Ott I., Neumann F.J., Gawaz M., Schmitt M., Schomig A. Increased neutrophil-platelet adhesion in patients with unstable angina. Circulation J. 1996;94:1239-46. DOI: 10.1161/01.cir.94.6.1239 https://doi.org/10.1161/01.CIR.94.6.1239 PMid:8822975 |
||||
25. Pifer M.A., Maerz T., Baker K.C., Anderson K. Matrix metalloproteinase content and activity in low-platelet, low-leukocyte and high-platelet, high-leukocyte platelet rich plasma (PRP) and the biologic response to PRP by human ligament fibroblasts. Am J Sports Med. 2014; 42(5):1211-1218. DOI:10.1177/0363546514524710. https://doi.org/10.1177/0363546514524710 PMid:24627579 |
||||
26. Singh M.V., Davidson D.C., Kiebala M., Maggirwar S.B. Detection of circulating platelet-monocyte complexes in persons infected with human immunodeficiency virus type-1. J. Virol. Methods. 2012; 181(2):170-6. doi: 10.1016/j.jviromet.2012.02.005 https://doi.org/10.1016/j.jviromet.2012.02.005 PMid:22387340 PMCid:PMC3322263 |
||||
27. Stark MA, Huo Y, Burcin TL, Morris MA, Olson TS, Ley K. Phagocytosis of apoptotic neutrophils regulates granulopoiesis via IL-23 and IL-17. Immunity. 2005;22(3):285-94. doi: 10.1016/j.immuni.2005.01.011. PMID: 15780986. https://doi.org/10.1016/j.immuni.2005.01.011 PMid:15780986 |
||||
28. Xie X., Zhang C., Tuan R.S. Biology of platelet-rich plasma and its clinicalapplication in cartilage repair. Arthritis Res Ther. 2014;16(1):204. DOI: 10.1186/ar4493 https://doi.org/10.1186/ar4493 PMid:25164150 PMCid:PMC3978832 |
||||
29. Yin W.J., Xu H.T., Sheng J.G. Advantages of pure platelet-rich plasma compared with leukocyte- and platelet-rich plasma in treating rabbit knee osteoarthritis. Med Sci Monit.- 2016;22):1280-90. doi: 10.12659/msm.898218. https://doi.org/10.12659/MSM.898218 PMid:27086145 PMCid:PMC4837928 |
||||
30. Yin W., Xin Q., Zhang Y. Advantages of pure platelet rich plasma compared with leukocyte and platelet richplasma in promoting repair of bone defects. J Transl Med. 2016;14:73. DOI: 10.1186/s12967-016-0825-9 https://doi.org/10.1186/s12967-016-0825-9 PMid:26980293 PMCid:PMC4792107 |
||||
31. Yoshida R., Murray M. M. Peripheral blood mononuclear cells enhance the anabolic effects of platelet-rich plasma on anterior cruciate ligament fibroblasts. J Orthop Res. 2013;31(1):29-34. https://doi.org/10.1002/jor.22183 https://doi.org/10.1002/jor.22183 PMid:22767425 PMCid:PMC3469725 |
||||
32. Wang S.Z., Fan W.M., Jia J. Is exclusion of leukocytes from platelet-rich plasma (PRP) a better choice for early intervertebral disc regeneration?. Stem Cell Res Ther. 2018;9(1):199. DOI: 10.1186/s13287-018-0937-7 https://doi.org/10.1186/s13287-018-0937-7 PMid:30021649 PMCid:PMC6052621 |
||||
33. Wojdasiewicz P., Poniatowski Ł.A., Szukiewicz D. The Role of inflammatory and anti-inflammatory cytokines in the pathogenesis of osteoarthrit is mediators. Inflamm. 2014;2014:561459. DOI: 10.1155/2014/561459 https://doi.org/10.1155/2014/561459 PMid:24876674 PMCid:PMC4021678 |
||||
34. Wong V.W., Wan D.C., Gurtner G.C., Longaker M.T. Regenerative surgery: tissue engineering in general surgical practice. World Journal of Surgery. 2012;36(10):2288-2299. DOI:10.1007/s00268-012-1710-1. https://doi.org/10.1007/s00268-012-1710-1 PMid:22777416 |
Goliuk Ye, Pschenychny T, Ostapenko T, Yavorovska V, Magomedov O. Analysis of quality of life in patients with knee osteoarthritis after application of autologous leukocyte-rich and leukocyte-poor platelet-rich plasma. Cell Organ Transpl. 2020; 8(2):131-138. doi:10.22494/cot.v8i2.112
Is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.