To assess the clinical efficacy and safety of a treatment based on one cycle versus two cycles of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) on patients with knee osteoarthritis (OA).
Ninety patients with knee OA were included and evaluated. A total of 48 patients received one cycle (OC group) (3 injections on a weekly basis), while 42 patients received two cycles of PRGF-Endoret (TC group) spaced 6 months between them. Patients were evaluated with LEQUESNE and WOMAC scores before treatment and after 48 weeks. Safety assessment was also performed.
A significant reduction of all assessed outcome measures was shown for both groups at 48 weeks compared with baseline values (P < 0.001). Patients of TCs group showed a significantly higher reduction (P < 0.05) in WOMAC stiffness subscales. Regarding LEQUESNE INDEX, a significantly higher reduction was observed in the TC group in all subscales except in pain score. In the maximum walking distance subscale (MCD), the improvement rate was 31.8% higher for the TCs group compared with the OC group (P < 0.01). In addition, the TC group showed a significant improvement in LEQUESNE activities of daily living (ADV) and global subscales of 14.7 and 11.8% (P < 0.05) higher, respectively, than the OC group.
Treatment with two cycles of PRGF did not show a significantly higher pain reduction compared with one cycle treatment. However, two cycles of PRGF showed a significant improvement in WOMAC stiffness, LEQUESNE MCD, LEQUESNE ADV and LEQUESNE global subscales. Therefore, patients treated with two cycles present an improvement in quality of life.
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We would like to thank Verónica Moreno and Esther Montes for their contribution to the paper. Authors wish to thank BTI Biotechnology Institute for their active contribution.
Conflict of interest
Vaquerizo V. and Aguirre JJ. declares that have no conflict of interest. Anitua E. is the Scientific Director and GO, SP and LB are scientists at BTI Biotechnology Institute, a dental implant company that investigates in the fields of oral implantology and PRGF-Endoret technology.
This work was supported by the Biomedical Research Foundation of Principe de Asturias University Hospital.
This study was performed in accordance with current law regulatory rules, and the international guidelines for Good Clinical Practice. The study protocol was previously reviewed and approved by the institutional review board (EC11-026).
Informed consent was obtained from all individual participants included in the study.
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Vaquerizo, V., Padilla, S., Aguirre, J.J. et al. Two cycles of plasma rich in growth factors (PRGF-Endoret) intra-articular injections improve stiffness and activities of daily living but not pain compared to one cycle on patients with symptomatic knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 26, 2615–2621 (2018). https://doi.org/10.1007/s00167-017-4565-z
- Growth factors