Commentary - Journal of Orthopedic Surgery and Rehabilitation (2017) Volume 1, Issue 3

Human amniotic allograft tissue matrix with platelet rich plasma injections and prolotherapy to treat chronic knee pain and severe osteoarthritis

*Corresponding Author:

Jeffrey Xue
Center for Pain Management and Rehabilitation Midwest Joint Pain Institute Peoria, IL USA
Tel: 309 689 8888
E-mail: janetlyb@yahoo.com

Accepted date: December 28, 2017

Citation: Jeffrey Xue, Yibing Li, Aswathy Krishnakumar, et al. Human amniotic allograft tissue matrix with platelet rich plasma injections and prolotherapy to treat chronic knee pain and severe osteoarthritis. J Orthop Surg Rehabil. 2017;1(3):5.

Abstract

Osteoarthritis (OA) originates from ligament laxity, tendinopathy, cartilage degeneration, and previous joint injuries and can result in functional limitations and chronic pain. Treatment include a mixture of human amniotic allograft tissue and plasma rich plasma (PRP) alongside dextrose prolotherapy. The human amniotic allograft tissue is extracted from a healthy, living donor and contains protein collagens, growth factors, and receptor antagonists. PRP contains additional growth factors, and dextrose prolotherapy is used to stimulate the body for regeneration of the tissue. This study is to assess the clinical outcome of the human amniotic tissue and PRP alongside prolotherapy on the pain and function of the patients.

Description

Osteoarthritis (OA) originates from ligament laxity,
tendinopathy, cartilage degeneration, and previous joint injuries
and can result in functional limitations and chronic pain.
Treatment include a mixture of human amniotic allograft tissue
and plasma rich plasma (PRP) alongside dextrose prolotherapy.
The human amniotic allograft tissue is extracted from a healthy,
living donor and contains protein collagens, growth factors, and
receptor antagonists. PRP contains additional growth factors,
and dextrose prolotherapy is used to stimulate the body for
regeneration of the tissue. This study is to assess the clinical
outcome of the human amniotic tissue and PRP alongside
prolotherapy on the pain and function of the patients.

102 patients were treated for degenerative joint disease/OA
and were selected from September 2015-Novermber 2017.
Patients were of 38-92 years, 56 males and 44 females, and
severe degenerative joint disease/OA was confirmed via X-ray.
Treatments include the mix of human amniotic allograft tissue
and PRP with prolotherapy under ultrasound guidance to the
patellar tendon, Medial collateral ligament, Lateral Collateral
Ligament, and the knee joints. Results were shown on the VAS
pain scale: (1-10) with 10 being the greatest pain and 0 being
no pain, and the lower extremity 80-point functional scale: (the
larger the number, the more function the patient has). Data was gathered before treatment and 2 months after during followup.
Statistical significance was calculated for the difference
shown for both scales using a paired-t test at a significance of
(alpha=0.05).

For the pain scale, a sample size of 99 was used due to lack
of follow up information necessary. There was a mean of 1.91
decrease of pain after the treatment with a standard deviation
of 2.02 for the differences between the before and after. With a
t-score of 9.42359, the null hypothesis was rejected, so sufficient
evidence to conclude the treatment does decrease the pain
caused by DJD/OA at alpha of 0.05. For the lower extremity
80-point functional scale, a sample size of 98 was used due
to same reason for the pain scale. There was a mean of 8.14
increase in functions seen in the patients after the treatment with
a standard deviation of 13.95. Comparing the t-score of 5.77796
to the alpha of 0.05, there is sufficient evidence to conclude
that the treatment does indeed increase the functionality for the
patients with DJD/OA at the knee(s).

Comprehensive regenerative therapies as above are safe,
effective, non–invasive treatment options for patients with
chronic knee pain from severe osteoarthritis. They are potentially
served as alternatives to the total knee replacement surgeries for
patients who failed other conservative care. Further treatments
are recommended to some patients and continuous clinical
studies are warranted to evaluate the long-term benefits.