Platelet-rich plasma versus oral paracetamol for treatment of early knee osteoarthritis. Preliminary study

Background: In the treatment of early osteoarthrosis, analgesics and nonsteroidal anti-inflammatory drugs are frequently used to relieve pain. Currently, platelet-rich plasma is used as an alternative treatment for osteoarthrosis. The aim of this study was to evaluate the effect of platelet-rich plasma compared to paracetamol as treatment for patients with grade I knee osteoarthrosis. Methods: We evaluated 42 patients who were randomized into two groups. Group one was treated with 5 ml of platelet-rich plasma in two applications, whereas group two was treated with 1 g of oral paracetamol every 8 h for 30 days. Both patient groups received supervised physical rehabilitation during the 6-month observation period. Peripheral blood samples were taken to measure plasma IL-1 beta, TNF-alpha and TGF-beta 1 levels at day 0 and at 6 months post-treatment. Clinical evaluation was conducted using the Knee injury and Osteoarthritis Outcome Score (KOOS) at the start of the study and for every subsequent month during the study period. Results: The KOOS for group one at treatment initiation was measured at 30.1 points, whereas at the end it was measured at 48.2 points, showing 60% clinical improvement. There were no statistically significant differences in IL-1 beta and TNF-alpha levels between groups treated either with platelet-rich plasma or paracetamol. Conclusions: Patients treated with platelet-rich plasma showed a statistically significant increase in serum levels of TGF-beta 1, which was associated with an improvement in the clinical evaluation used (KOOS).