Project Details
Abstract
Osteoarthritis (OA) of the knees is a common degenerative disorder seen in a rehabilitation outpatient clinic. It is characterized by structural changes in the articular cartilage and the surrounding tissues. Studies have shown that the injection of autologous platelet rich plasma (PRP) is effective in treating patients with early stages of knee OA. However, the effect of PRP in treating patients with moderate to severe degrees of knee OA is still controversial. Synovial fluid (SF) is in contact with the primary tissues affected by OA (cartilage and synovium). As a result, using proteomics to determine the changes in the SF protein (biomarker) concentrations can provide us with important information regarding the treatment effectiveness of PRP. PRP is blood plasma rich in autologous platelets. When activated, platelets release growth factors that can stimulate the healing of soft tissue structures. However, the number of platelets in the human blood is not concentrated. As a result, centrifugation is needed to concentrate the platelets. The human knee cartilage has scarce blood supply. When injured, growth factors can hardly reach this area to repair the cartilage. Therefore, it is why PRP injection can be effective in treating OA as platelets are directly introduced into the knee joints. Studies have stated that the effect of PRP is superior to that of hyaluronic acid (HA) in treating knee OA. Our previous study has documented that optimum PRP treatment can be achieved when PRP is injected into the knee joint and to the pes anserinus complex when treating patients with moderate to severe degrees of knee OA. The turnover rate of proteins in the knee joint SF is about 1 hour. Particles with higher molecular weight such as hyaluronic acid has a turnover rate of approximately 13 hours. As a result, there are doubts as to whether the injected liquid form PRP can really sustain its treatment effectiveness for a certain period of time. In this two-year proposal, we plan to introduce a PRP injectant product that is more viscous, able to release growth factors continuously, and can be contained in the knee joint for a longer period of time. This viscous PRP injectant has a viscosity similar to that of an anti-cough syrup. The best centrifugation speed to generate the highest number of platelets will be discovered. The most suitable oscillation speed and heating temperature to yield this viscous PRP product that can release the greatest number of growth factors will also be discovered. Patients with moderate to severe degrees of knee OA will be recruited. Pain scales, proteomics, and isokinetic evaluations will be performed to examine the treatment effectiveness. We hypothesize that the injection of viscous autologous PRP will result in more obvious improvements in knee pain and functional status as compared with the liquid-form PRP. Upon the completion of this study, we will be able to gather adequate scientific evidences as to which physical form of PRP injectant is a better option in treating patients with moderate to severe degrees of knee OA.
Project IDs
Project ID:PC10907-1106
External Project ID:MOST109-2314-B182-028-MY2
External Project ID:MOST109-2314-B182-028-MY2
Status | Finished |
---|---|
Effective start/end date | 01/08/20 → 31/07/21 |
Keywords
- Osteoarthritis
- Proteomics
- Isokinetic
- Functional Scale
- Synovial fluid
- Autologous Platelet Rich Plasma
- Viscosity
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