J Appl Biomed 18:41-45, 2020 | DOI: 10.32725/jab.2020.012

Clinical comparison of platelet-rich plasma injection and daily celecoxib administration in the treatment of early knee osteoarthritis: A randomized clinical trial

Rubén Reyes-Sosa1,#, Agustin Lugo-Radillo2,# *,Maria del Rocio Ruiz-Olivera 1, Lizzet Cruz-Santiago1, Celia Rubí García-Cruz1, Oliver Mendoza-Cano3
1 Instituto Mexicano del Seguro Social, Hospital General de Zona No. 1, Oaxaca, Mexico
2 CONACYT - Universidad Autónoma Benito Juárez de Oaxaca, Faculty of Medicine and Surgery, Oaxaca, Mexico
3 Universidad de Colima, Faculty of Civil Engineering, Colima, Mexico

Background: Oral and topical nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics and intra-articular corticosteroid injections are the recommended first line of treatment for knee osteoarthritis (OA); however, they have serious side effects. Platelet-rich plasma (PRP) has been posited as an effective and safer alternative treatment for knee OA. Hitherto, there is only one study comparing the effectiveness of PRP against an NSAID. Aim of the study: The aim of this study was to determine the effectiveness of PRP against celecoxib in the treatment of early knee OA.

Methods: 60 patients with knee OA grade II and III were randomly alocated in two groups. Group 1 received one injection of autologous PRP in each affected knee, with a reinjection after 15 days; Group 2 received 200 mg of oral celecoxib each 24 h for a year. Visual Analogue Scale (VAS), total Western Ontario and McMaster Universities Arthritis Index (WOMAC) and WOMAC subscales for pain, stiffness and function were measured at baseline and at 1, 3, 6 and 12 months after the start of the treatment.

Results: At the end of the study PRP was significantly better than celecoxib (p < 0.05) in improving VAS (40.40%), total WOMAC (58.95%) and WOMAC subscales of pain (50.60%), stiffness (34.13%) and function (51.90%). Significant differences remained after adjusting for age, sex or knee OA grade II or III.

Conclusions: Intra-articular PRP is significantly better than celecoxib in improving pain, function and stiffness in early knee OA. This significant difference is independent of age, sex or knee OA grade II or III.

Keywords: Celecoxib; Inflammation; Knee; Osteoarthritis; Platelet-Rich Plasma
Conflicts of interest:

The authors have no conflict of interests to declare.

Received: January 21, 2019; Revised: August 14, 2020; Accepted: August 18, 2020; Prepublished online: August 20, 2020; Published: August 27, 2020  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Reyes-Sosa R, Lugo-Radillo A, Cruz-Santiago L, García-Cruz CR, Mendoza-Cano O. Clinical comparison of platelet-rich plasma injection and daily celecoxib administration in the treatment of early knee osteoarthritis: A randomized clinical trial. J Appl Biomed. 2020;18(2-3):41-45. doi: 10.32725/jab.2020.012. PubMed PMID: 34907724.
Download citation

References

  1. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. (1986). Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29(8): 1039-1049. DOI: 10.1002/art.1780290816. Go to original source... Go to PubMed...
  2. Anitua Aldecoa E, Andía Ortiz I (2000). Un nuevo enfoque en la regeneración ósea. Plasma rico en factores de crecimiento (PRGF). Vitoria-España: Puesta al Día Publicaciones.
  3. Barber-Westin SD, Noyes FR (2017). Rating of Athletic and Daily Functional Activities: Knee-Specific Scales and Global Outcome Instruments. In: Barber-Westin SD, Noyes FR (Eds). Noyes' Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes (pp. 1211-1221). Philadelphia: Saunders. Go to original source...
  4. Bottegoni C, Dei Giudici L, Salvemini S, Chiurazzi E, Bencivenga R, Gigante A (2016). Homologous platelet-rich plasma for the treatment of knee osteoarthritis in selected elderly patients: an open-label, uncontrolled, pilot study. Ther Adv Musculoskelet Dis 8(2): 35-41. DOI: 10.1177/1759720X16631188. Go to original source... Go to PubMed...
  5. Buendia-Lopez D, Medina-Quiros M, Fernandez-Villacanas Marin MA (2018). Clinical and radiographic comparison of a single LP-PRP injection, a single hyaluronic acid injection and daily NSAID administration with a 52-week follow-up: a randomized controlled trial. J Orthop Traumatol 19(1): 3. DOI: 10.1186/s10195-018-0501-3. Go to original source... Go to PubMed...
  6. Hochberg MC, Altman RD, Toupin April K, Benkhalti M, Guyatt G, McGowan J, et al. (2012). American College of Rheumatology 2012 Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee. Arthrit Care Res 64(4): 465-474. DOI: 10.1002/acr.21596. Go to original source... Go to PubMed...
  7. Kavadar G, Demircioglu DT, Celik MY, Emre TY (2015). Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. J Phys Ther Sci 27(12): 3863-3867. DOI: 10.1589/jpts.27.3863. Go to original source... Go to PubMed...
  8. Kilincoglu V, Yeter A, Servet E, Kangal M, Yildirim M (2015). Short term results comparison of intraarticular platelet-rich plasma (prp) and hyaluronic acid (ha) applications in early stage of knee osteoarthritis. Int J Clin Exp Med 8(10): 18807-18812.
  9. Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, et al. (2010). Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4): 472-479. DOI: 10.1007/s00167-009-0940-8. Go to original source... Go to PubMed...
  10. Laudy ABM, Bakker EWP, Rekers M, Moen MH (2015). Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med 49(10): 657-672. DOI: 10.1136/bjsports-2014-094036. Go to original source... Go to PubMed...
  11. Law TY, Nguyen C, Frank RM, Rosas S, McCormick F (2015). Current concepts on the use of corticosteroid injections for knee osteoarthritis. Phys Sportsmed 43(3): 269-273. DOI: 10.1080/00913847.2015.1017440. Go to original source... Go to PubMed...
  12. Lee T, Lu N, Felson DT, Hyon KC, Dalal DS, Zhang Y, Dubreuil M (2016). Use of non-steroidal anti-inflammatory drugs correlates with the risk of venous thromboembolism in knee osteoarthritis patients: a UK population-based case-control study. Rheumatology (Oxford) 55(6): 1099-1105. DOI: 10.1093/rheumatology/kew036. Go to original source... Go to PubMed...
  13. Montanez-Heredia E, Irizar S, Huertas PJ, Otero E, Del Valle M, Prat I, et al. (2016). Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in the Treatment of Osteoarthritic Knee Pain: A Randomized Clinical Trial in the Context of the Spanish National Health Care System. Int J Mol Sci 17(7): 1064. DOI: 10.3390/ijms17071064. Go to original source... Go to PubMed...
  14. Mundy L (2016). Platelet-rich plasma: a case study for the identification of disinvestment opportunities using horizon scanning. Aust Health Rev 41(1). DOI: 10.1071/AH15075. Go to original source... Go to PubMed...
  15. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A (2013). Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis. A Prospective, Double-Blind, Randomized Trial. Am J Sports Med 41(2): 356-364. DOI: 10.1177/0363546512471299. Go to original source... Go to PubMed...
  16. Pourcho AM, Smith J, Wisniewski SJ, Sellon JL (2014). Intraarticular platelet-rich plasma injection in the treatment of knee osteoarthritis: review and recommendations. Am J Phys Med Rehabil 93(11 Suppl. 3): S108-121. DOI: 10.1097/PHM.0000000000000115. Go to original source... Go to PubMed...
  17. Sakata R, McNary SM, Miyatake K, Lee CA, Van den Bogaerde JM, Marder RA, Reddi AH (2015). Stimulation of the superficial zone protein and lubrication in the articular cartilage by human platelet-rich plasma. Am J Sports Med 43(6): 1467-1473. DOI: 10.1177/0363546515575023. Go to original source... Go to PubMed...
  18. Sanchez M, Fiz N, Azofra J, Usabiaga J, Aduriz Recalde E, Garcia Gutierrez A, et al. (2012). A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy 28(8): 1070-1078. DOI: 10.1016/j.arthro.2012.05.011. Go to original source... Go to PubMed...
  19. Say F, Gürier D, Yener K, Bülbül M, Maikoç M (2013). Platelet-Rich Plasma Injection Is More Effective than Hyaluronic Acid in the Treatment of Knee Osteoarthritis. Acta Chir Orthop Traumatol Cech 80(4): 278-283. Go to original source... Go to PubMed...
  20. Simon LS (2013). Nonsteroidal anti-inflammatory drugs and their risk: a story still in development. Arthritis Res Ther 15(Suppl. 3): S1. DOI: 10.1186/ar4173. Go to original source... Go to PubMed...
  21. Solomon DH, Husni ME, Libby PA, Yeomans ND, Lincoff AM, Lupsilonscher TF (2017). The Risk of Major NSAID Toxicity with Celecoxib, Ibuprofen, or Naproxen: A Secondary Analysis of the PRECISION Trial. Am J Med 130(12): 1415-1422.e4. DOI: 10.1016/j.amjmed.2017.06.028. Go to original source... Go to PubMed...
  22. Spakova T, Rosocha J, Lacko M, Harvanova D, Gharaibeh A (2012). Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil 91(5): 411-417. DOI: 10.1097/PHM.0b013e3182aab72. Go to original source... Go to PubMed...
  23. Sundman EA, Cole BJ, Karas V, Della Valle C, Tetreault MW, Mohammed HO, Fortier LA (2014). The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med 42(1): 35-41. DOI: 10.1177/0363546513507766. Go to original source... Go to PubMed...
  24. Vaquerizo V, Plasencia MA, Arribas I, Seijas R, Padilla S, Orive G, Anitua E (2013). Comparison of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) versus Durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy 29(10): 1635-1643. DOI: 10.1016/j.arthro.2013.07.264. Go to original source... Go to PubMed...
  25. Wang CC, Lee CH, Peng YJ, Salter DM, Lee HS (2015). Platelet-Rich Plasma Attenuates 30-kDa Fibronectin Fragment-Induced Chemokine and Matrix Metalloproteinase Expression by Meniscocytes and Articular Chondrocytes. Am J Sports Med 43(10): 2481-2489. DOI: 10.1177/0363546515597489. Go to original source... Go to PubMed...
  26. Yin WJ, Xu HT, Sheng JG, An ZQ, Guo SC, Xie XT, Zhang CQ (2016). Advantages of Pure Platelet-Rich Plasma Compared with Leukocyte- and Platelet-Rich Plasma in Treating Rabbit Knee Osteoarthritis. Med Sci Monit 22: 1280-1290. DOI: 10.12659/msm.898218. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.