Comparative Study between Platelet Rich Plasma (PRP) Injection versus Radiofrequency for Treatment of Patients with Chronic Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis (OA) is considered as one of the main causes of functional disability. The patient with OA is suffering not only from the persistent pain, stiffness and limited mobility. Treatment of knee OA is platelet-rich plasma (PRP). Although PRP is one of the options in the management of knee OA, its effectiveness and wide application is still controversial. On the other hand, the use of radiofrequency ablation (RFA) procedures to treat chronic knee pain has surged in the past decade. Accepted targets for RF treatment now include most neural structures to include major nerves and ganglia.
Objective: To compare the pain-relieving effect of radiofrequency of genicular nerve versus PRP if injected in the intra-articular osteoarthritic knee joint.
Patients and methods: The present prospective, comparative, randomized study was conducted at Aswan university hospital. Fifty patients with knee osteoarthritis were included during 6-month period. Studied populations were divided into 2 groups: Group I: Which included 25 patients who received a single intraarticular injection of PRP only. The mean age of the included patients was 53.23 ± 8.03 years and the majority of them were females (80%). The mean BMI was 28.43 ± 2.11 Kg/m2, and Group II: Which included 25 patients who received a single session of conventional radiofrequency of genicular nerves. The mean age of the included patients was 56.04 ± 7.58 years and the majority of them were females (76%). The mean BMI was 29.61 ± 1.64 Kg/m2
Results: Our analysis showed that the PRP did not significantly improve the VAS score (p =0.28). Regarding the effect of  radiofrequency of genicular nerve on study outcomes, we found that radiofrequency of genicular nerve significantly improved the VAS score (p =0.09). In terms of comparison analysis, we found that there were statistically significant differences between the
included groups in terms of VAS score (p =0.63), at the end of follow-up. The radiofrequency of genicular nerve group showed statistically significant lower values than the PRP alone group.
Conclusion: Radiofrequency of genicular nerve is an effective modality in reducing the pain and improving the mobility of the knee in patients with knee osteoarthritis in patients who are no responder to pharmacological treatment.