Tirtosuharto H, Wiratnaya IGE, Astawa P. Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis. World J Orthop 2022; 13(10): 911-920 [PMID: 36312525 DOI: 10.5312/wjo.v13.i10.911]
Corresponding Author of This Article
I Gede Eka Wiratnaya, Doctor, Consultant Physician-Scientist, Department of Orthopaedic and Traumatology, Faculty of Medicine Udayana University/ Sanglah Hospital, Jalan Diponegoro, Dauh Puri Klod, Denpasar 80113, Bali, Indonesia. igewiratnaya@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Oct 18, 2022; 13(10): 911-920 Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.911
Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis
Henry Tirtosuharto, I Gede Eka Wiratnaya, Putu Astawa
Henry Tirtosuharto, I Gede Eka Wiratnaya, Putu Astawa, Department of Orthopaedic and Traumatology, Faculty of Medicine Udayana University/Sanglah Hospital, Denpasar 80113, Bali, Indonesia
Author contributions: Tirtosuharto H designed and conceived the study, collected the data, conducted the data analyses, and drafted the manuscript; Wiratnaya IGE and Astawa P designed and conceived the study, and revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Faculty of Medicine Udayana University/Sanglah Hospital (Ethical Clearance No. 1847/UN14.2.2.VII.14/LT/2021).
Informed consent statement: Informed consent was not required due to the retrospective nature of the study and anonymized nature of the data.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The data supporting the findings of this study are not available to be shared publicly due to legal/ethical restrictions.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: I Gede Eka Wiratnaya, Doctor, Consultant Physician-Scientist, Department of Orthopaedic and Traumatology, Faculty of Medicine Udayana University/ Sanglah Hospital, Jalan Diponegoro, Dauh Puri Klod, Denpasar 80113, Bali, Indonesia. igewiratnaya@gmail.com
Received: June 7, 2022 Peer-review started: June 7, 2022 First decision: August 4, 2022 Revised: August 18, 2022 Accepted: September 12, 2022 Article in press: September 12, 2022 Published online: October 18, 2022 Processing time: 132 Days and 4.2 Hours
ARTICLE HIGHLIGHTS
Research background
The current management for knee osteoarthritis (OA) is not able to stop disease progression, particularly in Kellgren-Lawrence (KL) grade 3 and 4 OA. Thus, alternative therapeutic options are needed to prevent the progression of joint damage in OA and delay the need for knee arthroplasty.
Research motivation
Alternative therapies for knee OA are needed that can prevent disease progression. Such treatment is expected to increase quality of life and prevent or delay the need for arthroplasty.
Research objectives
To investigate whether adjunctive treatment with platelet-rich plasma (PRP) and hyaluronic acid (HA) after arthroscopic debridement provides better outcomes then arthroscopic debridement alone.
Research methods
This was a retrospective cohort study using medical record data. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and its sub-scores was used as the outcome parameter. The data were analyzed using the paired t-test, one-way analysis of variance, and post hoc least significant difference test.
Research results
Adjunctive PRP or HA after arthroscopic debridement was not superior to arthroscopic debridement alone in improving knee OA symptoms. However, adjunctive PRP resulted in improvement of pain symptoms. A longer evaluation period is needed to assess the long-term outcome.
Research conclusions
Adjunctive PRP or HA after arthroscopic debridement was not superior to arthroscopic debridement alone in improving knee OA symptoms. Adjunctive PRP after arthroscopic debridement was more beneficial in reducing pain.
Research perspectives
The results of this study are expected to provide clinicians with an alternative treatment for KL grade 3 and 4 knee OA. Future research with a prospective cohort and longer follow-up period is needed.
