Platelet rich plasma and exercise for pain relief in end stage knee osteoarthritis

Objective: To evaluate the efficacy of exercise and intra-articular ozonized platelet rich plasma (IA-OPRP) injections as management for sever grad IV knee osteoarthritis (KOA). Methods: Over 18-month period (January 1, 2018– July 31, 2019), 33 patients (21 females and 12 males) with 58 grade IV osteoarthritic knees were retrospectively studied. Severity of KOA was assessed according to the clinical features and Kellgren &Lawrencegrading scale. All patients underwent 8-weeks simple exercises followed by 4 sessions of IA-OPRP.OPRP was prepared by centrifuging patients’ own blood and activated by passing 1 ml of ozone for each 1 ml of platelet rich plasma. A questionnaire was used to categorize the pain severity into mild, moderate, and severe and the response to therapy was graded as excellent, good, fair, and poor. Results: The mean age was 63.7 years. The top co-morbid condition were overweight and obesity (n=28, 84.8%) whereas diabetes and hypertension ranked second (n=15 each, 45.4%). All patients had severe pain of grad IV knee OA. Overall, exercise and four IA-OPRP injections yielded good-excellent results in (72.4%) of the treated joints (p˂0.01) with no significant sex-related difference in pain response (p>0.01). Conclusion: Exercise and IA-OPRP seems to be a safe, effective and cheap method for relieving the chronic pain of severeknee OA.