Safety and Efficacy of Autologous Intra-articular Platelet Lysates in Early and Intermediate Knee Osteoarthrosis in Humans: A Prospective Open-Label Study.
OBJECTIVE
To explore the safety and benefit from intra-articular autologous platelet lysate (PL) injection in early and intermediate knee osteoarthritis.


METHODS
Open-label prospective study.


METHODS
Laboratory.


METHODS
Adult patients, aged 35 to 70 years, with a history of chronic pain or swelling on one or both knees and imaging findings (radiograph or magnetic resonance imaging) of degenerative changes in the joint of grade I or II on the Kellgren scale were included.


METHODS
Autologous PL was given in the knee joint by percutaneous intra-articular route every 3 weeks for a total of 3 injections.


METHODS
Response was evaluated by nonnormalized Knee Osteoarthritis and Disability Outcome Score (KOOS).


RESULTS
There was a significant improvement in the 5 aspects evaluated at weeks 32 and 52 compared with baseline. Symptoms score significantly improved at weeks 32 and 52 from a mean of 11.1 at baseline to 9.0 (P < 0.0001) and 8.7 (P < 0.0001). Stiffness score significantly improved at weeks 32 and 52 from 2.2 at baseline to 1.7 (P < 0.022) and 1.6 (P < 0.016). Pain score improved at 32 weeks and at 52 weeks from a baseline of 14.2 to 9.8 (P < 0.0001) and 9.2 (P < 0.0001). Daily Living score improved from 25.0 to 18.7 at 32 weeks (P < 0.0001) and to 15.6 at 52 weeks (P < 0.0001). Sport score improved from 10.7 to 8.4 at 32 weeks (P < 0.0001) and to 8.1 at 52 weeks (P < 0.0001).


CONCLUSIONS
Intra-articular PL significantly improved score of all aspects evaluated by KOOS. Platelet lysate seems to be a safe product.


CONCLUSIONS
To the best of our knowledge, this is the first clinical study addressing the use of autologous PL as a treatment measure for knee osteoarthrosis (KOA). There are no studies published regarding the treatment of KOA by intra-articular injections of PL. The previous studies were on the use of platelet-rich plasma (PRP) treatment for KOA. Platelet-rich plasma use has been in place for several years, however, a standardized protocol has not yet been established. Platelet lysate represents a safe, economical, easy to prepare, and easy to apply source of growth factors in the treatment of KOA. A head-to-head study is needed to compare PRP with PL in KOA.
*Department of Orthopedic Surgery, Jordan University Hospital, University of Jordan, Amman, Jordan; †Department of Medicine, Thrombosis Haemostasis Laboratory, University of Jordan, Amman, Jordan; ‡Faculty of Medicine, Cell Therapy Center, University of Jordan, Amman, Jordan; §Department of Radiology, Jordan University Hospital, University of Jordan, Amman, Jordan; ¶Faculty of Medicine, University of Jordan, Amman, Jordan; ‖Department of Medical Statistics & Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar; and #Department of Public Health, Weill Cornell Medical College in Qatar, Doha, Qatar.
Jihad
J
Al-Ajlouni
Abdalla
A
Awidi
Osama
O
Samara
Mahasan
M
Al-Najar
Emad
E
Tarwanah
Mohannad
M
Saleh
Mohammad
M
Awidi
Freh Abu
FA
Hassan
Mohammad
M
Samih
Abdulbari
A
Bener
Manar
M
Dweik
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000628:therapy*; D017713:Platelet Transfusion / Q000009:adverse effects; D011446:Prospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome