scholarly journals Conservative Treatment of Ankle Osteoarthritis

2021 ◽  
Vol 10 (19) ◽  
pp. 4561
Author(s):  
Sergio Tejero ◽  
Estefanía Prada-Chamorro ◽  
David González-Martín ◽  
Antonio García-Guirao ◽  
Ahmed Galhoum ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Clinical Studies ◽  
Platelet Rich Plasma ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Pharmacological Treatments ◽  
Ankle Osteoarthritis ◽  
Knee Oa ◽  
Plasma Injection ◽  
Inflammatory Drugs

Despite the disabling nature of ankle osteoarthritis (OA), there is poor scientific evidence for a conservative treatment compared to the hip and knee OA. In this regard, most of the treatment options in use are not based on clinical studies of the ankle, and they are extracted from evidence obtained from clinical studies of other lower limb joints. However, this does not seem to be a good idea, since the aetiology of ankle OA is quite different from that of the hip or knee. Nonpharmacological and pharmacological treatments such as nonsteroidal anti-inflammatory drugs, hyaluronic acid, corticosteroid, platelet-rich plasma injection and mesenchymal stem cells injections have been reported. However, further research is required in this field to obtain a specific clinical practice guideline for the conservative treatment of ankle OA.

scholarly journals Platelet-Rich plasma Injection Management for Ankle osteoarthritis study (PRIMA): protocol of a Dutch multicentre, stratified, block-randomised, double-blind, placebo-controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030961
Author(s):  
LDA Paget ◽  
SMA Bierma-Zeinstra ◽  
S Goedegebuure ◽  
GMMJ Kerkhoffs ◽  
R Krips ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
The Netherlands ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Foot And Ankle ◽  
Ankle Osteoarthritis ◽  
Knee Oa ◽  
Plasma Injection ◽  
Pain Subscale ◽  
Randomised Controlled

IntroductionPlatelet-rich plasma (PRP) is a potentially efficacious treatment for ankle osteoarthritis (OA), but its use has not been examined in high-quality studies. Systematic reviews show that PRP injections significantly decrease pain and improve function in patients with knee OA. Ankle OA is more common than hip or knee OA in the young active population; with a prevalence of 3.4%.PRP injections in ankle OA are shown to be safe and improve quality of life over time, but no randomised controlled trial has been conducted. Our randomised controlled trial will evaluate the efficacy of PRP injections for symptom reduction and functional improvement, compared with placebo, in the treatment of ankle (talocrural) OA.Methods and analysisWe will conduct the Platelet-Rich plasma Injection Management for Ankle OA study: a multicentre, randomised, placebo-controlled trial. One hundred patients suffering from ankle OA will be randomised into two treatment groups: PRP injection or placebo (saline) injection. Both groups will receive two injections of PRP or placebo at an interval of 6 weeks. Primary outcome is the American Orthopaedic Foot and Ankle Society score at 26 weeks. Secondary outcomes determined at several follow-up moments up to 5 years, include Ankle Osteoarthritis Score, Foot and Ankle Outcome Score, pain subscale of (0–40), Visual Analogue Scale score (0–100), Ankle Activity Score (0–10), subjective patient satisfaction Short Form Health Survey-36, Global Attainment Scaling and the EuroQol-5 dimensions-3 levels utility score. A cost-effectiveness analysis will be performed at 1 year.Ethics and disseminationThe study is approved by the Medical Ethics Review Committee Amsterdam Medical Center, the Netherlands (ABR 2018–042, approved 23 July 2018) and registered in the Netherlands trial register (NTR7261). Results and new knowledge will be disseminated through the Dutch Arthritis Association (ReumaNederland), Dutch patient federation, conferences and published in a scientific peer-reviewed journal.Trial registration numberNTR7261.

PLATELET-RICH PLASMA INJECTION IN EARLY OSTEOARTHRITIS KNEE FOLLOW-UP 1 YEAR

2021 ◽  
pp. 6-8
Author(s):  
Abdul Hassan Khan ◽  
Prasanta Kumar Pujari ◽  
Bikramjit Gayen ◽  
Dipak Kumar Jha ◽  
Debarshi Jana
Keyword(s):  
Conservative Treatment ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Repair Process ◽  
Plasma Injection ◽  
Osteoarthritis Knee ◽  
The One ◽  
Tissue Recovery ◽  
Natural Healing ◽  
Better Than

Background: Osteoarthritis (OA) knee is one of the most prevalent musculoskeletal disorders in elderly population. It has got various treatment options but most are unsatisfactory. In recent years Platelet-rich plasma (PRP) is emerged as a promising treatment modality and classied as “Orthobiologics”. PRPenhances tissue recovery, by catalysing the body's natural healing response and tissue repair process. Aim And Objectives:Tocompare the efcacies oftreatmentwithPRPinjectionandconservative treatmentwithNSAIDSandexercise inOAknee. Materials And Methods:This was a observational study in which comparisons of different outcomes were made on the efcacies of the treatments with PRPinjection and compared to conservative treatment with NSAIDS and exercise in OAknee. The study was conducted in the Department of Orthopedics in Ramkrishna Mission SevaPratisthan. Atotal number of 60 patients with power 80% were randomly selected from the patients with OA attended OPD during the period from June 2019 to June 2021. The patients were divided into two groups of 30 patients in each group. The patients of the one group were treated with intra-articular PRPinjection and the patients of another group were treated conservatively with NSAIDS and exercise. After the completion of treatment, the patients were followed-up for 1 year and the outcomes of the treatments were assessed by WOMAC (The Western Ontario and McMaster Universities Osteoarthritis Index) knee assessment scoring system. Results:At 1 year the completion of treatments it was found that both clinical and functional improvements of the patients were signicantly better than the initiation of treatments (p<0.0001). However, the improvements of the patients treated with PRPinjection were signicantly better than the patients treated conservatively with NSAIDS and exercise (p<0.001). Conclusion: From the results of the study it may be concluded that PRP injection is better than conservative treatment with NSAIDS and exercise to treat OAknee

scholarly journals The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis

2021 ◽  
Vol 22 (11) ◽  
pp. 5492
Author(s):  
Dawid Szwedowski ◽  
Joanna Szczepanek ◽  
Łukasz Paczesny ◽  
Jan Zabrzyński ◽  
Maciej Gagat ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Operative Treatment ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Treatment Protocols ◽  
Metabolic Functions ◽  
Inflammatory Drugs ◽  
Positive Effect

Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on chondrogenesis and proliferation of mesenchymal stem cells (MSC) is still highly controversial. Recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, significant progress has been made in understanding the mechanism of PRP action. In this review, we will discuss mechanisms related to inflammation and chondrogenesis in cartilage repair and regenerative processes after PRP administration in in vitro and animal studies. Furthermore, we review clinical trials of PRP efficiency in changing the OA biomarkers in knee joint.

scholarly journals Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 854
Author(s):  
Dragan Primorac ◽  
Vilim Molnar ◽  
Eduard Rod ◽  
Željko Jeleč ◽  
Fabijan Čukelj ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Stromal Vascular Fraction ◽  
Disease Stage ◽  
Knee Oa ◽  
Marrow Mesenchymal Stem Cells ◽  
The Moment ◽  
And Function ◽  
Orthopedic Patients

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

scholarly journals Injections in the osteoarthritic knee: a review of current treatment options

2021 ◽  
Vol 6 (6) ◽  
pp. 501-509
Author(s):  
Gerardo Fusco ◽  
Francesco M. Gambaro ◽  
Berardo Di Matteo ◽  
Elizaveta Kon
Keyword(s):  
Platelet Rich Plasma ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Cartilage Degradation ◽  
Current Treatment ◽  
Biologic Agents ◽  
Knee Oa ◽  
Molecular Approaches

Knee osteoarthritis is a degenerative condition characterized by progressive cartilage degradation, subchondral damage, and bone remodelling. Among the approaches implemented to achieve symptomatic and functional improvements, injection treatments have gained increasing attention due to the possibility of intra-articular delivery with reduced side effects compared to systemic therapies. In addition to well-established treatment options such as hyaluronic acid (HA), cortico-steroids (CS) and oxygen-ozone therapy, many other promising products have been employed in the last decades such as polydeoxyribonucleotide (PDRN) and biologic agents such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Moreover, ultrasound-guided intra-meniscal injection and X-ray-guided subchondral injection techniques have been introduced into clinical practice. Even when not supported by high evidence consensus, intra-articular CS and HA injections have gained precise indications for symptomatic relief and clinical improvement in OA. Biological products are strongly supported by in vitro evidence but there is still a lack of robust clinical evidence. PRP and MSCs seem to relieve OA symptoms through a regulation of the joint homeostasis, even if their capability to restore articular cartilage is still to be proved in vivo. Due to increasing interest in the subchondral bone pathology, subchondral injections have been developed with promising results in delaying joint replacement. Nevertheless, due to their recent development and the heterogeneity of the injected products (biologic agents or calcium phosphate), this approach still lacks strong enough evidence to be fully endorsed. Combined biological treatments, nano-molecular approaches, monoclonal antibodies and ‘personalized’ target therapies are currently under development or under investigation with the aim of expanding our armamentarium against knee OA. Cite this article: EFORT Open Rev 2021;6:501-509. DOI: 10.1302/2058-5241.6.210026

scholarly journals Medikamentozno zdravljenje endometrioze: pregled stanja in nove možnosti zdravljenja

2016 ◽  
Vol 85 (7-8) ◽  
Author(s):  
Maja Jakič ◽  
Andrej Vogler ◽  
Tea Lanišnik Rižner
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Uterine Cavity ◽  
Pharmacological Treatments ◽  
Gynecological Examination ◽  
Combination Studies ◽  
Hormonal System ◽  
Gynecological Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.

scholarly journals Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions

Medicine ◽  
2021 ◽  
Vol 100 (7) ◽  
pp. e24680 ◽  
Author(s):  
Chenglong Wang ◽  
Zhuo Zhang ◽  
Yihang Ma ◽  
Xiangji Liu ◽  
Qingsan Zhu
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Plasma Injection ◽  
Rotator Cuff Lesions

scholarly journals Plantar Fasciitis—A Comparison of Treatment with Intralesional Steroids versus Platelet-Rich Plasma

2017 ◽  
Vol 107 (6) ◽  
pp. 490-496 ◽  
Author(s):  
Carlos Acosta-Olivo ◽  
Jorge Elizondo-Rodriguez ◽  
Ricardo Lopez-Cavazos ◽  
Felix Vilchez-Cavazos ◽  
Mario Simental-Mendia ◽  
...  
Keyword(s):  
Treatment Group ◽  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Treatment Method ◽  
Great Success ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Intralesional Steroids

Background: Many treatment options for plantar fasciitis currently exist, some with great success in pain relief. The objective of our study was to compare the use of intralesional steroids with platelet-rich plasma (PRP), using pain scales and functional evaluation, in patients with plantar fasciitis who did not respond to conservative treatment. Methods: A controlled, randomized, blinded clinical assay was performed. Patients were assigned to one of the two groups by selecting a sealed envelope. The steroid treatment group received 8 mg of dexamethasone plus 2 mL of lidocaine as a local anesthetic. The PRP treatment group received 3 mL of PRP activated with 0.45 mL of 10% calcium gluconate. All of the patients were evaluated at the beginning of the study, and at 2, 4, 8, 12, and 16 weeks post-treatment with the Visual Analog Scale (VAS), Foot and Ankle Disability Index (FADI), and American Orthopedic Foot and Ankle Society (AOFAS) scale. Results: The right foot was the most frequently affected foot (63%). The average age of the patients was 44.8 years (range, 24–61 years). All scales used (VAS, FADI and AOFAS) showed that the difference was not statistically significant between the two groups. Conclusions: We can conclude that the use of PRP is an effective treatment method for patients with plantar fasciitis who do not respond to conservative treatment because PRP demonstrates an efficacy equal to that of steroids. However, the cost and the time for preparation the PRP are two of the disadvantages of this treatment.

Does Intra-Articular Injection of Platelet-Rich Plasma Have an Effect on Cartilage Thickness in Patients with Primary Knee Osteoarthritis?

2021 ◽  
Vol 17 ◽  
Author(s):  
Noha M Abdel Baki ◽  
Zeinab O. Nawito ◽  
Nehal M. S. Abdelsalam ◽  
Dina Sabry ◽  
Hossam Elashmawy ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Womac Score ◽  
Cartilage Thickness ◽  
Condylar Cartilage ◽  
Knee Oa ◽  
Group I ◽  
Grading Scale ◽  
Inflammatory Drugs ◽  
Group Ii

Objectives: To determine the effect of intra-articular injection of platelet-rich plasma (PRP) in patients with primary knee osteoarthritis (OA) by clinical evaluation and ultrasonographic (US) assessment of cartilage thickness. Patients and Methods: A total of 100 patients with mild to severe primary knee OA using the Kellgren-Lawrence (K-L) grading scale were included and divided into two groups. Group I included 50 patients who were given two intra-articular knee injections of PRP, 1 week apart; Group II included 50 patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and chondroprotective drugs. Functional assessment of all OA patients done using the basal WOMAC score, at 2 and 6 months.US assessment of femoral condylar cartilage thickness was conducted basally and at 6 months. Results: Improvement of WOMAC score was observed at 2 and 6 months in Group I following PRP injection compared to Group II (p values < 0.001), The improvement of WOMAC in Group I occurred in all severity degrees of OA (p < 0.001). Moreover, a significant increase in cartilage thickness at the intercondylar area (ICA) at 6 months relative to baseline assessment by US in Group I (p = 0.041) was found. Conclusion: Treatment with PRP injections can reduce pain and improve knee function in patients with various degrees of articular degeneration. Further studies are needed to clarify the anabolic effect of PRP on the articular cartilage.

Conservative Treatment of Ankle Osteoarthritis: Can Platelet-Rich Plasma Effectively Postpone Surgery?

2017 ◽  
Vol 56 (2) ◽  
pp. 362-365 ◽  
Author(s):  
Ilaria Repetto ◽  
Besmir Biti ◽  
Paola Cerruti ◽  
Roberto Trentini ◽  
Lamberto Felli
Keyword(s):  
Conservative Treatment ◽  
Platelet Rich Plasma ◽  
Ankle Osteoarthritis
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