Ultrasound Guided Platelet Rich Plasma Injection in Post Traumatic Knee Meniscus Lesion
Mona Helal Omara
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Amr Mohamed El-Badry
Department of Diagnostic Radiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Amal Mohamed El-Barbary
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Hanan Mohamed El-Saadany
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
Elham Mohamed Kassem
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Orthobiologics have gained a lot of attention as a potential meniscal injury therapy option in recent years. There are several techniques for biologically enhancing meniscal healing, such as the use of platelet-rich plasma (PRP), cytokines, growth factors, and fibrin clots. The aim of this study was to evaluate the efficacy of PRP injection guided by ultrasound on functional and clinical improvement in patients with post traumatic knee meniscal injury grade 2.
Methods: This study was carried out on forty patients with evidence of post traumatic knee intramural meniscal lesion grade 2 on magnetic resonance imaging (MRI). Patients were treated with three injections, two weeks apart of 4 ml of autologous PRP injected at the site of knee meniscal lesion under continuous ultrasound guidance.
Results: There were significant improvement as regard pain assessed by Visual Analogue Scale (VAS), active range of motion (ROM), knee joint line tenderness grading 4 months after treatment compared to before treatment. There was significant improvement as regard symptoms, Activities of daily living (ADL), pain, sport and recreation function and knee related quality of life (QOL) subscales of KOOS 4 months after treatment compared to before treatment.
Conclusions: Peri-meniscal PRP injection under ultrasound guidance in patients with post traumatic knee meniscal lesions grade 2 with persistent pain appears to be an effective method for pain relief. Peri-meniscal PRP injection is able to achieve improvement in clinical and functional scores after 4 months follow up. Musculoskeletal ultrasonography is a fundamental tool for peri-meniscal areas injections to guarantee its accuracy and maximizes its benefits.
Keywords: Ultrasound, platelet rich plasma, post traumatic knee, meniscus tear