Treatments for Knee Cartilage Injuries in Athletes Using PRP and Hyaluronic Acid: A Retrospective Analysis
Öz
Aim: This retrospective study seeks to evaluate the clinical outcomes and imaging findings in athletes with knee cartilage injuries treated using autologous platelet-rich plasma (PRP) and hyaluronic acid (HA) injections.
Material and Method: Sixty athletes participated in this investigation, with 30 individuals in the PRP group and 30 in the HA group. PRP was administered via ultrasound-guided intra-articular injections over three sessions, spaced at three-week intervals. Similarly, HA was injected using high molecular weight hyaluronic acid following the same schedule. Clinical evaluation was performed using the Visual Analog Scale (VAS) for pain assessment and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for functional evaluation. Radiological changes were assessed through magnetic resonance imaging (MRI).
Results: Both VAS and KOOS scores demonstrated a greater improvement in the PRP group compared to the HA group (p<0.05). MRI findings revealed more pronounced cartilage regeneration in the PRP group (p<0.05). No statistically significant differences were found between the two groups regarding age, gender, or career duration (p>0.05).
Conclusion: For sportsmen with knee cartilage problems, PRP therapy has been found to be a more successful treatment alternative than HA. PRP offers better outcomes for cartilage regeneration, pain management, and functional enhancement. The long-term effectiveness of these results may be further assessed in prospective randomized studies in the future.
Anahtar Kelimeler
Platelet-rich plasma hyaluronic acid knee cartilage injuries biological therapy clinical outcomes
Etik Beyan
The study adhered to the principles outlined in the Declaration of Helsinki and was approved by Dicle University Medical Faculty Ethics Committee for Noninterventional Studies (Approval No: 2023/16-42) before data collection began (Date: 14.03.2023).
Kaynakça
- Mandelbaum BR, ElAttrache NS. Articular cartilage repair techniques. Sports Med Arthrosc Rev. 2016;24:43.
- Brittberg, M. New frontiers for cartilage repair, joint preservation and prevention. Journal of Cartilage & Joint Preservation. 2022;2:100060.
- Filardo G, Kon E, Di Martino A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:229.
- Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am. 2009;91:1778-90.
- Kon E, Filardo G, Drobnic M, et al. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2012;20:436-49.
- Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-72.
- Anitua E, Sánchez M, Orive G, Andía I. The potential impact of the preparation rich in growth factors (PRGF) in different medical fields. Biomaterials. 2007;28:4551-60.
- Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-64.
- Slattery C, Kweon CY. Classifications in brief: outerbridge classification of chondral lesions. Clin Orthop Relat Res. 2018;476:2101-4.
- Retzky JS, Fletcher C, Rizy M, et al. Magnetic resonance observation of cartilage repair tissue (MOCART) scores > 55 at 6 months postoperative predict ability to achieve patient acceptable symptomatic state at minimum 1 year postoperative following autologous chondrocyte implantation for grade IV chondral defects about the patellofemoral joint. Cartilage. 2025;16:17-23.
- Migliorini F, Eschweiler J, Maffulli N, et al. Management of patellar chondral defects with autologous matrix induced chondrogenesis (AMIC) compared to microfractures: a four years follow-up clinical trial. Life (Basel). 2021;11:141.
- Fletcher C, Rizy M, Gomoll A, Strickland S. Treatment of patellar chondral lesions with concomitant matrix-induced autologous chondrocyte implantation, medial patellofemoral ligament reconstruction, and tibial tubercle osteotomy. Arthroscopy Techniques. 2024;13:103059.
- Burger D, Feucht M, Muench LN, et al. Good clinical outcomes after patellar cartilage repair with no evidence for inferior results in complex cases with the need for additional patellofemoral realignment procedures: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2022;30:1752-68.
- Migliorini F, Eschweiler J, Maffulli N, et al. Autologous matrix-induced chondrogenesis (AMIC) and microfractures for focal chondral defects of the knee: a medium-term comparative study. Life (Basel). 2021;11:183.
- Volz M, Schaumburger J, Frick H, et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop. 2017;41:797-804.
- Faiz KW. VAS--visuell analog skala [VAS--visual analog scale]. Tidsskr Nor Laegeforen. 2014;134:323.
- Roos EM. 30 years with the Knee injury and Osteoarthritis Outcome Score (KOOS). Osteoarthritis Cartilage. 2024;32:421-9.
- Reed ME, Villacis DC, Hatch GF 3rd, et al. 3.0-Tesla MRI and arthroscopy for assessment of knee articular cartilage lesions. Orthopedics. 2013;36:e1060-4.
- Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141:2-18.
- Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
- Nouri F, Babaee M, Peydayesh P, et al. Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial. BMC Musculoskelet Disord. 2022;23:856.
- Huang HY, Hsu CW, Lin GC, et al. Comparing efficacy of a single intraarticular injection of platelet-rich plasma (PRP) combined with different hyaluronans for knee osteoarthritis: a randomized-controlled clinical trial. BMC Musculoskelet Disord. 2022;23:954.
- Dhillon J, Decilveo AP, Kraeutler MJ, et al. Third-generation autologous chondrocyte implantation (cells cultured within collagen membrane) is superior to microfracture for focal chondral defects of the knee joint: systematic review and meta-analysis. Arthroscopy. 2022;38:2579-86.
- Bosco F, Giai Via R, Giustra F, et al. Platelet-rich plasma for jumper's knee: a comprehensive review of efficacy, protocols, and future directions. Eur J Orthop Surg Traumatol. 2024;34:91-6.
Öz
Kaynakça
- Mandelbaum BR, ElAttrache NS. Articular cartilage repair techniques. Sports Med Arthrosc Rev. 2016;24:43.
- Brittberg, M. New frontiers for cartilage repair, joint preservation and prevention. Journal of Cartilage & Joint Preservation. 2022;2:100060.
- Filardo G, Kon E, Di Martino A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:229.
- Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am. 2009;91:1778-90.
- Kon E, Filardo G, Drobnic M, et al. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2012;20:436-49.
- Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-72.
- Anitua E, Sánchez M, Orive G, Andía I. The potential impact of the preparation rich in growth factors (PRGF) in different medical fields. Biomaterials. 2007;28:4551-60.
- Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356-64.
- Slattery C, Kweon CY. Classifications in brief: outerbridge classification of chondral lesions. Clin Orthop Relat Res. 2018;476:2101-4.
- Retzky JS, Fletcher C, Rizy M, et al. Magnetic resonance observation of cartilage repair tissue (MOCART) scores > 55 at 6 months postoperative predict ability to achieve patient acceptable symptomatic state at minimum 1 year postoperative following autologous chondrocyte implantation for grade IV chondral defects about the patellofemoral joint. Cartilage. 2025;16:17-23.
- Migliorini F, Eschweiler J, Maffulli N, et al. Management of patellar chondral defects with autologous matrix induced chondrogenesis (AMIC) compared to microfractures: a four years follow-up clinical trial. Life (Basel). 2021;11:141.
- Fletcher C, Rizy M, Gomoll A, Strickland S. Treatment of patellar chondral lesions with concomitant matrix-induced autologous chondrocyte implantation, medial patellofemoral ligament reconstruction, and tibial tubercle osteotomy. Arthroscopy Techniques. 2024;13:103059.
- Burger D, Feucht M, Muench LN, et al. Good clinical outcomes after patellar cartilage repair with no evidence for inferior results in complex cases with the need for additional patellofemoral realignment procedures: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2022;30:1752-68.
- Migliorini F, Eschweiler J, Maffulli N, et al. Autologous matrix-induced chondrogenesis (AMIC) and microfractures for focal chondral defects of the knee: a medium-term comparative study. Life (Basel). 2021;11:183.
- Volz M, Schaumburger J, Frick H, et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop. 2017;41:797-804.
- Faiz KW. VAS--visuell analog skala [VAS--visual analog scale]. Tidsskr Nor Laegeforen. 2014;134:323.
- Roos EM. 30 years with the Knee injury and Osteoarthritis Outcome Score (KOOS). Osteoarthritis Cartilage. 2024;32:421-9.
- Reed ME, Villacis DC, Hatch GF 3rd, et al. 3.0-Tesla MRI and arthroscopy for assessment of knee articular cartilage lesions. Orthopedics. 2013;36:e1060-4.
- Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141:2-18.
- Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
- Nouri F, Babaee M, Peydayesh P, et al. Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial. BMC Musculoskelet Disord. 2022;23:856.
- Huang HY, Hsu CW, Lin GC, et al. Comparing efficacy of a single intraarticular injection of platelet-rich plasma (PRP) combined with different hyaluronans for knee osteoarthritis: a randomized-controlled clinical trial. BMC Musculoskelet Disord. 2022;23:954.
- Dhillon J, Decilveo AP, Kraeutler MJ, et al. Third-generation autologous chondrocyte implantation (cells cultured within collagen membrane) is superior to microfracture for focal chondral defects of the knee joint: systematic review and meta-analysis. Arthroscopy. 2022;38:2579-86.
- Bosco F, Giai Via R, Giustra F, et al. Platelet-rich plasma for jumper's knee: a comprehensive review of efficacy, protocols, and future directions. Eur J Orthop Surg Traumatol. 2024;34:91-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ortopedi |
| Bölüm | Özgün Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 9 Mayıs 2025 |
| Gönderilme Tarihi | 19 Aralık 2024 |
| Kabul Tarihi | 25 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 7 Sayı: 2 |
Chief Editors
Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey
Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey
Editors
Assoc. Prof. Serkan Öner
İzmir Bakırçay University, Department of Radiology, İzmir, Türkiye
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