Treatment with intraosseous and intra-articular ozonated PRP in patellar chondropathy in young patients

Abstract

Introduction: Anterior knee pain produces a declination of the quality of life. One of the possible pathologies causing this symptom is chondromalacia patellae. Although patellar chondropathy is used to describe the softening of patellar articular cartilage, it remains a general descriptive term as it cannot be associated with a specific pathophysiologic mechanism. The objective of this study is to investigate the effect of intraosseous and intra articular ozone-PRP infiltrations on patients with anterior knee pain in absence of altered patellofemoral joint anatomy.

Methods: For this purpose, 36 patients of the affected population were recruited to participate in this non-randomized, prospective, unmasked, non-controlled with placebo. All patients received three intraosseous and intra articular ozone-PRP injections (0, 7º and 14º day). Patients between the ages of 13 to 31 years with anterior knee pain and positive physical exploration were eligible for inclusion. Strict exclusion criteria were proposed. Patient related measures in the form of WOMAC questionnaire were the main outcome of interest. All outcomes were measured at baseline, and after 6 months.

Results: A statistically significant difference (P<0,005) was observed in WOMAC questionnaire in all patients after 3 intraosseous and intra articular ozone-PRP infiltrations, with a notable improvement in symptoms. The superiority of the therapeutic modality under investigation was observed at 6 months after the initial diagnosis was made. Furthermore, the results of this study revealed a significant improvement at 6 months when compared to baseline measures. The analysis of the patients age showed a negative correlation when baseline values were compared to measures at 6 months, meaning younger patients had more benefit from the treatment.

Conclusion: The main results of this study affirm the positive effects of ozone-PRP for the treatment of anterior knee pain, described by previous research and the subsequent improvement of the quality of life. Relatively little information was found in the literature search regarding the therapeutic effects of ozone-PRP on anterior knee pain by patellar chondropathy. No studies have been previously conducted on intraosseus and intra articular ozone-PRP infiltrations in patellar chondropathy. This study found a benefit when comparing PROMs between patient groups. Therefore, further studies will be needed in order to increase our knowledge of intra-articular and intra-osseous infiltrations of ozone-PRP.