1.The Multiple Dosing Effects of Platelet-Rich Plasma on Cartilage Regeneration in Knee Osteoarthritis: Randomised, Placebo-Controlled Trial
Saraf A ; Hussain A ; Mahipal V ; Agarwal T ; Kush A
Malaysian Orthopaedic Journal 2025;19(No. 1):11-20
Introduction: The purpose of this study was to evaluate
clinical and biochemical efficacy of autologous intraarticular (IA) platelet rich plasma (PRP) compared to saline
and to measure effectiveness of single and multiple doses
given at monthly intervals for Kellgren-Lawrence (K-L)
grade II, III knee osteoarthritis (KOA).
Materials and methods: A total of 130 patients were
randomised into 4 groups; PRP-1 (n=36), PRP-2 (n=34),
PRP-3 (n=32) and saline (NS) (n=28), after approval from
institute ethics committee (reference number: TMU/IEC/20-
21/091) and was conducted in accordance with Helsinki
declaration. Groups PRP-1, PRP-2, PRP-3 received single,
double and triple injections of PRP whereas NS group
received single saline (0.9%) injection. Assessment of
outcome scores (visual analogue scale [VAS] and Western
Ontario and McMaster Universities Arthritis Index
[WOMAC]) was done at baseline and three, six, nine months
post intervention. Serum collagen 2-1 (Coll2-1) estimation at
baseline and nine months post-therapy was used for
biochemical assessment.
Results: Improvement in VAS and WOMAC was
statistically significant and clinically meaningful (Minimal
clinically important change [MCIC]; >12% of baseline and
≥2cm difference in mean for WOMAC and VAS,
respectively) for groups PRP-1, PRP-2 and PRP-3 in
comparison to saline (P<0.05), at every follow-up. PRP
groups also exhibited a significant decrease in serum Coll2-
1 at 9 months (P<0.05). On comparison among the PRP
groups, multiple doses (groups PRP-2 and PRP-3) produced
significantly better clinical results than single dose (group
PRP-1) (P<0.05), whereas the difference in Coll2-1 levels
was significant for group PRP-1 vs PRP-3 only (P<0.05).
Conclusion: PRP results in clinically significant
amelioration of functional and pain scores as well as
significant reduction in serum levels of Coll2-1 in K-L grade
II, III KOA over nine months. These benefits can be
accentuated by multiple doses given one month apart.


Result Analysis
Print
Save
E-mail