Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach.
OBJECTIVE
To compare the safety and efficacy of two different approaches of platelet-rich plasma (PRP) production methods as intra-articular injection treatment for knee cartilage degenerative lesions and osteoarthritis (OA).


METHODS
The study involved 144 symptomatic patients affected by cartilage degenerative lesions and OA. Seventy-two patients were treated with 3 injections of platelet concentrate prepared with a single-spinning procedure (PRGF), the other 72 with 3 injections of PRP obtained with a double-spinning approach. The patients were evaluated prospectively at the enrollment and at 2, 6, and 12 months' follow-up with IKDC, EQ-VAS and Tegner scores; adverse events and patient satisfaction were also recorded.


RESULTS
Both treatment groups presented a statistically significant improvement in all the scores evaluated at all the follow-up times. Better results were achieved in both groups in younger patients with a lower degree of cartilage degeneration. The comparative analysis showed similar improvements with the two procedures: in particular, IKDC subjective evaluation increased from 45.0 ± 10.1 to 59.0 ± 16.2, 61.3 ± 16.3, and 61.6 ± 16.2 at 2, 6, and 12 months in the PRGF group, and from 42.1 ± 13.5 to 60.8 ± 16.6, 62.5 ± 19.9, and 59.9 ± 20.0 at 2, 6, and 12 months in the PRP group, respectively. Concerning adverse events, more swelling (P = 0.03) and pain reaction (P = 0.0005), were found after PRP injections.


CONCLUSIONS
Although PRP injections produced more pain and swelling reaction with respect to that produced by PRGF, similar results were found at the follow-up times, with a significant clinical improvement with respect to the basal level. Better results were achieved in younger patients with a low degree of cartilage degeneration.


METHODS
II.
Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136, Bologna, Italy.
Giuseppe
G
Filardo
Elizaveta
E
Kon
Maria Teresa
MT
Pereira Ruiz
Franca
F
Vaccaro
Rita
R
Guitaldi
Alessandro
A
Di Martino
Annarita
A
Cenacchi
Pier Maria
PM
Fornasari
Maurilio
M
Marcacci
D000328:Adult; D000368:Aged; D002357:Cartilage Diseases / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000628:therapy*; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016896:Treatment Outcome