title: Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis.
abstract: BACKGROUND
  Knee osteoarthritis (OA) is a degenerative and progressive articular cartilage disease. Infiltration of autologous platelet-rich plasma (PRP) has been proposed as a therapeutic alternative due to the content of biologically active cytokines in PRP. We aimed to compare the clinical response of acetaminophen and intra-articular leukocyte-poor PRP (LP-PRP) in early knee OA.
  
  
  METHODS
  A total of 65 patients with clinically and radiographically documented knee OA (grade 1-2) were analyzed. Patients were randomized into two groups: 32 were treated with acetaminophen (500 mg/8 h) over 6 weeks, and 33 received three intra-articular injections of autologous LP-PRP (once every 2 weeks). All patients were evaluated by the Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities (WOMAC) score, and the SF-12 health survey at baseline and 6, 12, and 24 weeks of follow-up. All LP-PRP preparations were analyzed for the platelet, leukocyte, IL-1ra, and TGF-β concentrations.
  
  
  RESULTS
  The decrease in the VAS pain level in the LP-PRP group was greater than that in the acetaminophen group (p < 0.05). Patients treated with LP-PRP showed a sustained improvement in knee function at week 24 (p < 0.01). The SF-12 results only indicated an improvement in quality-of-life in the LP-PRP group at 6, 12, and 24 weeks of follow-up (p < 0.01). Both IL-1ra and TGF-β were detected in the LP-PRP samples (313.8 ± 231.6 and 21,183.8 ± 8556.3 pg/mL, respectively).
  
  
  CONCLUSIONS
  Treatment with LP-PRP injections resulted in a significantly better clinical outcome than did treatment with acetaminophen, with sustained lower EVA and WOMAC scores and improvement in quality-of-life (higher SF-12 score). Therapy with LP-PRP may positively modify the inflammatory joint environment by counteracting IL-1β action.
authors: Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León (UANL), Ave Francisco I. Madero and Eduardo Aguirre Pequeño S/N, Colonia Mitras Centro, C.P. 64460, Monterrey, NL, México.
authors: Mario
authors: M
authors: Simental-Mendía
authors: Department of Orthopaedics and Traumatology, University Hospital, UANL, Monterrey, NL, México.
authors: José F
authors: JF
authors: Vílchez-Cavazos
authors: Department of Orthopaedics and Traumatology, University Hospital, UANL, Monterrey, NL, México.
authors: Víctor M
authors: VM
authors: Peña-Martínez
authors: Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León (UANL), Ave Francisco I. Madero and Eduardo Aguirre Pequeño S/N, Colonia Mitras Centro, C.P. 64460, Monterrey, NL, México.
authors: Salvador
authors: S
authors: Said-Fernández
authors: Department of Orthopaedics and Traumatology, University Hospital, UANL, Monterrey, NL, México.
authors: Jorge
authors: J
authors: Lara-Arias
authors: Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León (UANL), Ave Francisco I. Madero and Eduardo Aguirre Pequeño S/N, Colonia Mitras Centro, C.P. 64460, Monterrey, NL, México. herminia.martinezrd@uanl.edu.mx.
authors: Herminia Guadalupe
authors: HG
authors: Martínez-Rodríguez
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: Acetaminophen; Intra-articular infiltration; Leukocyte-poor platelet-rich plasma; Osteoarthritis