Cabinet de Traumatologie et Médecine du Sport à Pau (64) – Dr Marc BOUVARD

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6eme étude de haut niveau de preuve sur PRP/cartilage

Publié le 9 avril 2015

Une 6ème étude (en accès libre ) mesurant l’efficacité de 2 injections de PRP(n=87) versus 3 injections d’acide hyaluronique(n=73) vient de paraitre. Elle compare chez des patients atteint d’arthrose (Kellgren 1-4) plusieurs scores fonctionnels dont le WOMAC avec un an de recul. Les deux traitements apportent une amélioration mais avec une supériorité à nouveau des PRP. A noter que les résultats sont meilleurs chez les patients Kellgren 2.

Clin Med Insights Arthritis Musculoskelet Disord. 2015 Jan 7;8:1-8. doi: 10.4137/CMAMD.S17894

Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial).

Raeissadat SA1, Rayegani SM2, Hassanabadi H3, Fathi M4, Ghorbani E5, Babaee M5, Azma K6.

INTRODUCTION: Knee osteoarthritis (OA) is the most common articular disease. Different methods are used to alleviate the symptoms of patients with knee OA, including analgesics, physical therapy, exercise prescription, and intra-articular injections (glucocorticoids, hyaluronic acid [HA], etc). New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage, including the use of platelet-rich plasma (PRP) as a complex of growth factors. Due to the high incidence of OA and its consequences, we decided to study the long-term effect of intraarticular injection of PRP and HA on clinical outcome and quality of life of patients with knee OA.

METHOD: This non-placebo-controlled randomized clinical trial involved 160 patients affected by knee OA, grade 1-4 of Kellgren-Lawrence scale. In the PRP group (n = 87), two intra-articular injections at 4-week interval were applied, and in the HA group (n = 73), three doses of intra-articular injection at 1-week interval were applied. All patients were prospectively evaluated before and at 12 months after the treatment by Western Ontario and McMaster Universities Arthritis Index (WOMAC) and SF-36 questionnaires. The results were analyzed using SPSS 16.1 software (RCT code: IRCT2014012113442N5).

RESULTS: At the 12-month follow-up, WOMAC pain score and bodily pain significantly improved in both groups; however, better results were determined in the PRP group compared to the HA group (P < 0.001). Other WOMAC and SF-36 parameters improved only in the PRP group. More improvement (but not statistically significant) was achieved in patients with grade 2 OA in both the groups.

CONCLUSION: This study suggests that PRP injection is more efficacious than HA injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee OA who have not responded to conventional treatment.

Free PMC Article

Malgré cela la communauté rhumatologique reste très septique et dubitative : Quelle place pour les PRP (plasma riche en plaquettes) dans l’arthrose ? Paul Ornetti et coll. Revue du rhumatisme 81 (2014) 466–471. Le débat scientifique continue.

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