Plasma Rich in Growth Factors (PRGF) Versus Saline Intraosseous Infiltrations Combined with Intra-Articular PRGF in Severe Knee Osteoarthritis: A Prospective Double-Blind Multicentric Randomized Controlled Trial with 1-Year Follow-Up.
OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
J Clin Med. 2025 01-Nov;():. 10.3390/jcm14228075What this means for my practice?
Combined intraosseous and intra-articular PRGF provides superior improvements in pain, function, and quality of life compared with intra-articular PRGF alone in severe knee osteoarthritis. Clinically, targeting subchondral bone may enhance regenerative treatment effectiveness and delay need for surgical intervention. Limitations include lack of imaging outcomes, limited generalizability due to BMI and age restrictions, and absence of a true placebo group without intraosseous intervention.
Study Summary
Eighty-five patients with severe knee osteoarthritis were randomized to receive intraosseous PRGF (n=43) or intraosseous saline (n=43), both combined with three intra-articular PRGF injections. The primary outcome of interest was the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 months. Secondary outcomes included WOMAC pain, stiffness, physical function, quality of life, and minimum clinically important improvement (MCII). Outcomes were assessed at baseline, 3, 6, and 12 months. Overall, the results of the study revealed that both groups experienced significant improvements in KOOS and WOMAC scores, but the intraosseous PRGF group demonstrated significantly greater improvements in pain, symptoms, function, and quality of life across most timepoints (p<0.05). These findings suggest that targeting subchondral bone with PRGF provides additional clinical benefit in severe knee osteoarthritis.
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