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To Evaluate the Optimum Dose of Platelet Rich Plasma in Knee Osteoarthritis and Compare Efficacy With Hyaluronic Acid

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ClinicalTrials.gov Identifier: NCT04198467
Recruitment Status : Completed
First Posted : December 13, 2019
Last Update Posted : December 13, 2019
Information provided by (Responsible Party):
Dr. Himanshu Bansal Foundation

Brief Summary:
Randomized, Double-blind, 12-month, placebo-controlled study was conducted on 100 outpatients . Intervention platelet rich plasma( PRP) prepared from 60 ml of blood by adding novel step of filtration to manual centrifuge step to achieve 7 times concentration. the efficacy was compared with administration of hyaluronic acid. Subjective Womac scores ,6 min pain free walking distance as well objective assessments MRI ,synovial fluid assessments were made out .Absolute counts of platelets as dose was evaluated to be effective in alleviating symptoms in early knee OA.

Condition or disease Intervention/treatment Phase
Knee Osteoarthritis Biological: Platelet rich plasma Drug: Hyaluronic Acid Phase 2

Detailed Description:

Osteoarthritis (OA) causes substantial physical disability that limits a person ability to indulge in daily activities. OA related disability has been affecting millions of older adults throughout the world, and the number has almost doubled in 2019.

Though the process of OA could not be reversed, efficient management strategies could help in minimizing primary pain with physical exercises, surgical procedures, and medications.

Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been dramatically associated with mild to severe side effects, limiting its continuous use. Chondro-protective agents (CPAs) have been proven to provide only minimal symptomatic benefit. Platelet-rich plasma (PRP) has emerged as a supreme therapy in OA knee however exact dose ,preparation and duration of benefit still remains unclear.

Study was undertaken to demonstrate the potential of leukocyte depleted PRP in cartilage repair of knee OA using WOMAC scores as subjective assessment tool.

Our research also evaluated objective criteria ing joint space width (JSW),cartilage thickness on MRI, Ultrasound that would improve knee joint function in patients with knee OA.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:

182 patients screened, 100 were considered eligible for the study and were randomized. The most common reason for exclusion was either the lack of radio graphic evidence of knee OA or the presence of severe disease with JSW less than 2 mm at the narrowest point.

Out of the 100 randomized patients, roughly equal numbers, six patients in PRP and 7 in placebo, did not complete the study. Reasons for withdrawal were personal,inefficacy, or adverse event as an increase in pain.

Masking: Double (Participant, Investigator)
Masking Description: Hyaluronic acid as placebo both patient and investigator blinded
Primary Purpose: Treatment
Official Title: Randomized Controlled Study to Compare Safety and Efficacy of Intra Articular Administration of Platelet Rich Plasma Versus Hyaluronic Acid as Placebo in Patients With Osteoarthritis of Knee
Actual Study Start Date : October 21, 2014
Actual Primary Completion Date : April 15, 2016
Actual Study Completion Date : July 10, 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: PRP (100billion platelets)
platelet rich plasma having 100 billion platelets in 10 ml plasma prepared from 60 ml blood
Biological: Platelet rich plasma
Platelet rich plasma : 100 billion platelets in 10 ml of plasma(PRP) administered intra-articular
Other Name: PRP

Placebo Comparator: hyaluronic acid
Four ml of high-molecular-weight hyaluronic acid (HMWHA) with a concentration of 22mg/ml
Drug: Hyaluronic Acid
Hyaluronic acid :Four ml of high-molecular-weight hyaluronic acid with a concentration of 22mg/ml injected intra-articular
Other Name: SYNVISC

Primary Outcome Measures :
  1. changes in womac score [ Time Frame: baseline,1 month,3 months,6 months, and 1year ]
    WOMAC, a widely used measure to assess patients' pain, joint mobility, and physical disability evaluates three dimensions, pain, stiffness, and physical function, with 5, 2, and 17 questions, respectively. The total maximum score is 96 and minimum, 0

  2. changes in cartilage thickness as assessed on 1.5 T MRI [ Time Frame: baseline and at one year ]
    Using the 1.5-T field strength with standard MRI acquisition protocols, MRI was performed of each joint individually in coronal, sagittal, and transverse planes. The maximum thickness of the cartilage at posterior,meniscal and patellar level measured at the midsagittal plane through the medial condyle was considered. The medial femoral cartilage of the affected knee was chosen for measurement.

Secondary Outcome Measures :
  1. changes in joint space width [ Time Frame: baseline and at 12months ]
    Patients were radiographed in a weight-bearing position, joints fully extended, standing at 1 m from the X-ray source20. The width was measured at the narrowest point of the Joint (JSW)

  2. changes in cartilage thickness as assessed by ultrasonically. [ Time Frame: baseline ,6 months and at 12 months ]
    Having the patients sit with flexed knees,The articular cartilage of the medial femoral condyle was evaluated with a starting point at the level of intercondylar notch to the medial border of the medial condyle by an ultrasound.

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Ages Eligible for Study:   25 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Outpatients who fulfilled the clinical and radiological criteria set by the American College of Rheumatology for the diagnosis of symptomatic primary knee OA, with pain Visual Analogue Scale (VAS) score of >3 in the previous month. In cases where both the knees were symptomatic, the knee which was comparatively more painful was considered.

Exclusion Criteria:

  1. Evidence of secondary knee OA because of injury, inflammatory or metabolic rheumatic disease, or osteonecrosis;
  2. Prior intra-articular injection of hyaluronic acid (HA), including lavage and corticosteroids within the previous three months;
  3. Severe knee OA, with JSW <1 mm, or surgery required on the evaluated knee in the year
  4. Patients with clinically significant systemic disease.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04198467

Sponsors and Collaborators
Dr. Himanshu Bansal Foundation
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Principal Investigator: himanshu bansal, ms anupam hospital rudrapur uttrakhand
Publications of Results:
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Responsible Party: Dr. Himanshu Bansal Foundation
ClinicalTrials.gov Identifier: NCT04198467    
Other Study ID Numbers: HimanshuBansalF
First Posted: December 13, 2019    Key Record Dates
Last Update Posted: December 13, 2019
Last Verified: December 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Anyone interested, Researcher ,Patient or Institute can contact and we would gladly assist him with all information. Nothing is hidden
Supporting Materials: Study Protocol
Informed Consent Form (ICF)
Clinical Study Report (CSR)
Time Frame: Data will be always available to anyone interested
Access Criteria: Anyone interested, Researcher ,Patient or Institute can access data anytime.
URL: http://www.drhbf.org

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Dr. Himanshu Bansal Foundation:
Platelet rich plasma
Additional relevant MeSH terms:
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Osteoarthritis, Knee
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Hyaluronic Acid
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Protective Agents