Background: There is a controversy regarding the efficacy of arthroscopic treatment of osteoarthritis of the knee. Intra-articular injection of hyaluronic acid or platelet rich plasma (PRP) may add benefit after arthroscopic debridement and lavage of osteoarthritic knees. The aim of this study was to compare the outcome of arthroscopic debridement of the knee whether done alone or if combined with hyaluronic acid or platelet rich plasma.
Material and Methods: This prospective study involved 69 patients with grade 1, 2, or 3 knee osteoarthritis (according to the Kellgren and Lawrence grading scale). All patients underwent arthroscopic debridement. Twenty one cases were treated by arthroscopic debridement alone (first or control group) and 48 cases received in addition an intra-articular injection by either autologous PRP (second group) included 23 cases, and the third group included 25 patients were injected with three intra-articular injection of high molecular weight hyaluronic acid (HA). All patients were evaluated before intervention, 6 weeks, 6 and 12 months after the treatment by VAS, IKDC, and WOMAC scores.
Results: No major adverse effects were detected after arthroscopic debridement, or intra-articular injection. At the end of the study, the three groups showed improvement in pain and function. However, the improvement achieved at the early follow up period was marked in the HA group than the other two groups. When comparing the effect of injection in the second and third groups, there is a significant higher post injection pain reduction in PRP group. At the early follow up (6 weeks), the clinical outcomes were better in the HA group, but at the late follow up (52 weeks), the clinical outcomes were better in the PRP group.
Conclusion: Arthroscopic debridement increases the better results for PRP and HA for treatment of early grades of knee osteoarthritis up to one years of follow up. The PRP injection group achieved a significant better clinical result than did HA injection group for treatment of knee osteoarthritis. |
