title: Conservative Treatment of Ankle Osteoarthritis: Can Platelet-Rich Plasma Effectively Postpone Surgery?
abstract: Osteoarthritis is the most common and disabling of the orthopedic diseases. Currently, the conservative treatment of osteoarthritis is limited to symptomatic treatment, whose goal is to improve function and pain control. Ankle osteoarthritis is relatively uncommon, in contrast to osteoarthritis of the hip and knee, and the therapeutic options (both pharmacologic and surgical) are limited, with surgery providing poorer and less predictable results. The effectiveness of platelet-rich plasma injections for osteoarthritis is still controversial, especially so for ankle arthritis, owing to the lack of evidence in the present data. We retrospectively evaluated the mid- to long-term clinical results (mean follow-up of 17.7 months) for platelet-rich plasma injections in 20 patients (20 ankles) with ankle osteoarthritis. We evaluated the presence of pain using the visual analog scale, function using the Foot and Ankle Disability Index, and subjective satisfaction. The pre- and post-treatment scores, obtained from the clinical records and from telephone interviews during the follow-up period, were compared using the Student t test. We found a strong positive effect for 4 platelet-rich plasma injections (injected once a week) on pain (p = .0001) and function (p = .001), with 80% of patients very satisfied and satisfied, and only 2 patients (10%) required surgery because of early treatment failure. These results suggest that the use of platelet-rich plasma injection is a valid and safe alternative to postpone the need for surgery.
authors.affiliation: Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy. Electronic address: ilariarepetto86@gmail.com.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Repetto
authors.affiliation: Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
authors.forename: Besmir
authors.initials: B
authors.lastname: Biti
authors.affiliation: Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cerruti
authors.affiliation: Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Trentini
authors.affiliation: Professor, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
authors.forename: Lamberto
authors.initials: L
authors.lastname: Felli
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D000072700:Conservative Treatment; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D064232:Visual Analog Scale
keywords: ankle chondropathy; ankle osteoarthritis; conservative treatment; functional outcome; growth factors; intra-articular ankle injections; platelet-rich plasma