SLR - August 2012 - Greg Iwaasa
Reference: Mei-Dan O, Carmount MR, Laver L, Mann G, Maffulli N, and Nyska M, Am J Sports Med, 20 (10): 1-8, 2012
Scientific Literature Review
Reviewed by: Greg Iwaasa, DPM
Residency Program: Pinnacle Health System, Harrisburg PA
Podiatric Relevance:
Osteochondral lesions (OCLs) are a common injury seen by foot and ankle surgeons. Platelet-rich plasma provides a non-surgical option for treating patients with symptomatic OCLs.
Methods:
A total of twenty-nine patients with thirty OCLs were divided into 2 different groups. The first group consisted of Hyaluronic acid (HA) injections in the ankle joint at one-week intervals for a total of three injections. The second group consisted of patients who received platelet-rich plasma (PRP) injections at a two week intervals for a total of three injections. Immediately after each of the injections, the patient’s ankle was put through passive range of motion to distribute the fluid. Patients were seen at four, 12, and 28 weeks after injection to assess function, range of motion, and adverse events. Symptoms were also evaluated at this time as well. Efficacy measures were determined using the Visual Analog Scale (VAS) and modified Ankle-Hindfoot Scale (AHFS)
Results:
The HA group consisted of 15 patients with 15 OCLs. The PRP group consisted of 14 patients with 15 OCLs. Both groups AHFS scores improved over 28 weeks. The HA group improved from 66 to 78 whereas the PRP group improved from 68 to 92. All patients had improvement of symptoms, but Group Two patients had a significantly greater improvement than Group One. Group Two also had statistically significant improvement from Group One with regards to VAS stiffness and function, but not pain.
Conclusions:
PRP is an effective non-surgical option for the treatment of OCLs for up to six months. In this report, PRP yielded more improvement in stiffness and function than HA.