The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

ALEMDAROĞLU, Kadir Bahadır; Öztürk, Alper; Aydogan, Nevres Hurriyet; ÖZMERİÇ, Ahmet; Gul, Deniz; KARA, Talip; İLTAR, Serkan

The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

Nevres Hürriyet AYDOĞAN, (Muğla Sıtkı Koçman Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Muğla, Türkiye)

Deniz GÜL, (Tokat Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Tokat, Türkiye)

Serkan İLTAR, (Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Ahmet ÖZMERİÇ, (Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Talip KARA, (Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Alper ÖZTÜRK, (Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Kadir Bahadır ALEMDAROĞLU (Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Journal of Clinical and Analytical Medicine

4 1

Yıl: 2016 Cilt: 7 Sayı: 6 Sayfa Aralığı: 767 - 771 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

Öz:

Amaç: Trombositten zengin plazma'nın (TZP) eklem içi uygulaması, diz osteoartriti tedavisinde alternatif bir yöntem olabilir. Bu çalışmanın amacı, eklem içine uygulanmadan önce trombositten zengin plazmanın aktivasyon yöntemlerinin karşılaştırılmasıdır. Gereç ve Yöntem: 51 hasta (76 diz) rastgele iki gruba ayrıldı. 1. grupta TZP aktivasyonu kalsiyum klorid (CaCl) eklenerek sağlandı. 2. grupta ise TZP aktivasyonu, hazırlandıktan sonra -70 derecede 24 saat bekletilip, tamamen çözülmesi için 37o suda 5 dakika bekletilerek eklem içine uygulandı. Hastalar VAS ve WOMAC ağrı skorları ile başvuru anında, ikinci, altıncı ve onikinci aylarda değerlendirildiler. Bulgular: VAS ve WOMAC skorları başvuru anında; 2., 6., ve 12. aya göre kıyaslandığında istatistiksel olarak anlamlı derecede yüksekti (p=0.06). 2., 6., 12. aylarda gruplar arasında istatistiksel anlamlı fark saptanmasa da 2., 6., ve 12. aylarda her iki skorda kademeli olarak düşme eğilimi olduğu görüldü. Tartışma: Hastalar her iki aktivasyon yönteminden de oldukça fazla klinik fayda gördüler. Klinik faydaları açısından TZP'nın CaCl veya -70 derecede aktivasyonu arasında anlamlı fark yoktur. Bu nedenle -70 derecede aktivasyon CaCl gibi ilave malzeme ihtiyacını ortadan kaldıracağından öncelikli tercih edilebilir.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Farklı Aktivasyon Yöntemleriyle Hazırlanan Trombositten Zengin Plazma'nın Diz Osteoartritli Hastalardaki Klinik Etkisi

Öz:

Aim: Intra-articular application of platelet rich plasma (PRP) can be an alternative treatment method for knee osteoarthritis. The objective of this study was to compare the activation methods of platelet rich plasma before intraarticular application. Material and Method: A total 51 patients (76 knees) was randomly selected into two groups. In group 1, activation of PRP was managed by adding calcium chloride (CaCl). In group 2, activation of PRP was managed by keeping the solution at -70° degrees for 24 hours after preparation and immersed in water at 37oC for a period of 5 minutes for complete dissolution. Then PRP was applied. The patients were assessed with VAS and WOMAC pain scores both baseline and after 2nd, 6th and 12th months of the treatment. Results: VAS and WOMAC pain scores were significantly higher at baseline compared to the results obtained at the 2nd, 6th and 12th months (p=0.06). Following 2nd, 6th and 12th months a gradual downward tendency was seen in both scores, even though no significant difference was found between the groups after 2nd, 6th and 12th months. Discussion: Patients.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Pereira D, Peleteiro B, Arauio J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic re- view. Osteoarthr Cartil 2011;19:1270-85
Aslan A, Aydogan NH, İlhan M, Özerdemoğlu RA, Altuntaş İ, Yorgancıgil H. The effect of different intraarticular drug applications to the antioxidan system and lipid peroxidation in gonarthrosis. Gaziantep Med J 2012;18(1):1-6.
Bhatia D, Bejarano T, Novo M. Current Interventions in the management of knee osteoarthritis. J Pharm Bio Allied 2013;5:30-8.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis. Osteoarthr Cartil 2008;16:137-62.
Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician 2012;85:49-56.
Aslan A, Kırdemir V, Atay T, Baykal YB, Aytekin Ö, Aydoğan FC. The Efficacy of Intra-Articular Injection of Hyaluronic Acid With Supplemental Peroral Vita- min E Following Arthroscopic Debridement in the Treatment of Knee Osteoar- thritis: A Prospective, Randomized, Controlled Study. Türk Fiz Tıp Rehab Derg 2012;58(3):199-203.
Longo UG, Petrillo S, Franceschetti E, Berton A, Maffuli N, Denaro V. Stem cells and gene therapy for cartilage repair. Stem Cells Int 2012; DOI: 10.1155/2012/168385.
Chevalier X, Eymard F, Richette P. Biologic agents in osteoarthritis: hopes and disappointments. Nat Rev Rheumatol 2013;2:44.
Lopez-Vidriero E, Goulding KA, Simon DA, Sanchez M, Johnson DH. The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy 2010;26:269-78
Anitua E, Andia I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, et al. Autologous preparation srich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 2005;23:281-6.
Kon E, Buda R, Filardo G, DiMartino A, Timoncini A, Cenacchi A, et al. Platelet- rich plasma: intra-articular knee injections produced favorable results on degen- erative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010;18:472-9.
Filardo G, Kon E, Buda R, Timoncini A, DiMartino A, Cenacchi A, et al. Plate- let-rich plasma intra-articular knee injections for the treatment of degenera- tive cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011;19:528-35.
Smyth NA, Murawski CD, Fortier LA, Cole BJ, Kennedy JG. Platelet-Rich plasma in the pathologic processes of cartilage: review of basic science evidence. Ar- throscopy 2013;29:1399-409.
Lee JW, Kwon OH, Kim TK, Cho YK, Choi KY, Chung HY et al. Platelet-rich plas- ma: quantitative assessment of growth factor levels and comparative analysis of activated and inactivated groups. Arch Plast Surg 2013;40:530-5.
Moon KH. New view on the initial development site and radiographic clas- sification system of osteoarthritis of the knee based on radiographic analysis. Int J Biomed Sci 2012;8:233-43.
Ediz L, Tekeoğlu İ. Symptom modifying effect of colchicine in patients with knee osteoarthritis. J Clin Anal Med 2012;3(1):63-7.
Milano G , Sanna E , Deriu L , Careddu G , Manunta L , A. Manunta A , et al. The effect of platelet rich plasma combined with microfractures on the treatment of chondral defects: an experimental study in a sheep model. Osteoarthr Cartil 2010;18: 971-80.
Varga-Szabo D, Pleines I, Nieswandt B. Cell adhesion mechanisms in platelets. Arterioscler Thromb Vasc Biol 2008;28:403-12.
O'Keefe RJ, Crabb ID, Puzas JE, Rosier RN. Effects of transforming growth factor-beta 1 and fibroblast growth factor on DNA synthesis in growth plate chon- drocytes are enhanced by insulin-likegrowth factor-I. J Orthop Res 1994;12:299- 310.
Zimmermann R, Arnold D, Strasser E, Ringwald J, Schlegel A, Wiltfang& R. Eck- steinJ. Sample preparation technique and white cell content influence the detect- able levels of growth factors in platelet concentrates. Vox Sang 2003;85:283-9.
Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 2006;34:1774-8.
Kon E, Filardo G, Delcogliano M, Presti ML, Russo A, Bondi A, et al. Platelet- rich plasma: new clinical applicatio: a pilot study for treatment of jumper's knee. İnjury 2009;40:598-603.
Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of plateletrich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil 2010;89:961-9.
Torrero JI, Aroles F, Ferrer D. Treatment of knee chondropathy with platelet rich plasma. Preliminary results at 6 months of follow-up with only one injection. J Biol Regul Homeost Agents 2012;26:71-8.
Jang SJ, Kim JD, Cha SS. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. Eur J Orthop Surg Travmatol 2013;23:573-80.

APA	Aydogan N, Gul D, İLTAR S, ÖZMERİÇ A, KARA T, Öztürk A, ALEMDAROĞLU K (2016). The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. , 767 - 771.
Chicago	Aydogan Nevres Hurriyet,Gul Deniz,İLTAR Serkan,ÖZMERİÇ Ahmet,KARA Talip,Öztürk Alper,ALEMDAROĞLU Kadir Bahadır The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. (2016): 767 - 771.
MLA	Aydogan Nevres Hurriyet,Gul Deniz,İLTAR Serkan,ÖZMERİÇ Ahmet,KARA Talip,Öztürk Alper,ALEMDAROĞLU Kadir Bahadır The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. , 2016, ss.767 - 771.
AMA	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. . 2016; 767 - 771.
Vancouver	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. . 2016; 767 - 771.
IEEE	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K "The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis." , ss.767 - 771, 2016.
ISNAD	Aydogan, Nevres Hurriyet vd. "The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis". (2016), 767-771.

APA	Aydogan N, Gul D, İLTAR S, ÖZMERİÇ A, KARA T, Öztürk A, ALEMDAROĞLU K (2016). The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. Journal of Clinical and Analytical Medicine, 7(6), 767 - 771.
Chicago	Aydogan Nevres Hurriyet,Gul Deniz,İLTAR Serkan,ÖZMERİÇ Ahmet,KARA Talip,Öztürk Alper,ALEMDAROĞLU Kadir Bahadır The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. Journal of Clinical and Analytical Medicine 7, no.6 (2016): 767 - 771.
MLA	Aydogan Nevres Hurriyet,Gul Deniz,İLTAR Serkan,ÖZMERİÇ Ahmet,KARA Talip,Öztürk Alper,ALEMDAROĞLU Kadir Bahadır The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. Journal of Clinical and Analytical Medicine, vol.7, no.6, 2016, ss.767 - 771.
AMA	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. Journal of Clinical and Analytical Medicine. 2016; 7(6): 767 - 771.
Vancouver	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis. Journal of Clinical and Analytical Medicine. 2016; 7(6): 767 - 771.
IEEE	Aydogan N,Gul D,İLTAR S,ÖZMERİÇ A,KARA T,Öztürk A,ALEMDAROĞLU K "The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis." Journal of Clinical and Analytical Medicine, 7, ss.767 - 771, 2016.
ISNAD	Aydogan, Nevres Hurriyet vd. "The Clinical Effect of Platelet-Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis". Journal of Clinical and Analytical Medicine 7/6 (2016), 767-771.