PRP vs Corticosteroids for Basal Joint Osteoarthritis
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Kettering Health Network
Must not be taking: Corticosteroids
Disqualifiers: Stage 4 arthritis, Fibromyalgia, others
Trial Summary
What is the purpose of this trial?Single blinded PRP vs. Corticosteroid vs. Placebo (normal saline) intra-articular injection for basal joint arthritis.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment for basal joint osteoarthritis?
Research shows that both corticosteroids and platelet-rich plasma (PRP) are effective in reducing pain and improving function in conditions like knee osteoarthritis and shoulder periarthritis. PRP may offer better long-term outcomes, while corticosteroids provide quicker short-term relief.
12345Is it safe to use PRP and corticosteroid injections in humans?
Both PRP and corticosteroid injections are generally safe for treating various conditions like shoulder pain, knee osteoarthritis, and lumbar spondylosis. Studies have shown no major complications and similar minor complication rates for both treatments.
12356How does the treatment of PRP compare to corticosteroids for osteoarthritis?
PRP (Platelet-Rich Plasma) injections may offer longer-lasting relief compared to corticosteroid injections for osteoarthritis, as they are suggested to be more effective over time, although both treatments are effective in reducing pain and improving function in the short term.
35678Eligibility Criteria
This trial is for people with early to moderate osteoarthritis in the basal joint of the thumb. It's not suitable for those with fibromyalgia, inflammatory diseases, bone tumors, certain wrist conditions like DeQuervain's tenosynovitis recently treated or advanced arthritis as per Eaton stage 4. Pregnant or terminally ill patients and those who've had a corticosteroid injection in the past year at the affected site are also excluded.Inclusion Criteria
My arthritis in the thumb joint is at an early to moderate stage.
Exclusion Criteria
My thumb joint arthritis is severe (Stage 4).
I have Pressier disease, Kienbock's, or avascular necrosis of the scaphoid.
You are pregnant or have a terminal illness.
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive intra-articular injections of either PRP, corticosteroid, or placebo for basal joint arthritis
6-8 weeks
Follow-up
Participants are monitored for safety and effectiveness after treatment
1 year
Participant Groups
The study tests three treatments: platelet concentrate (PRP), corticosteroid injections, and placebo (normal saline) injected into the joint. Participants won't know which treatment they're getting but will be randomly assigned to one of these options to compare effectiveness.
3Treatment groups
Experimental Treatment
Active Control
Placebo Group
Group I: PRPExperimental Treatment1 Intervention
Intra-articular injection of platelet rich plasma.
Group II: CorticosteroidActive Control1 Intervention
Intra-articular injection of kenalog.
Group III: Normal SalinePlacebo Group1 Intervention
Intra-articular injection of normal saline
Corticosteroid injection is already approved in United States, European Union, Canada for the following indications:
🇺🇸 Approved in United States as Corticosteroids for:
- Allergic reactions
- Asthma
- COPD
- Rheumatoid arthritis
- Osteoarthritis
- Bursitis
- Tendonitis
- Skin conditions
- Eye conditions
- Gastrointestinal disorders
🇪🇺 Approved in European Union as Corticosteroids for:
- Allergic reactions
- Asthma
- COPD
- Rheumatoid arthritis
- Osteoarthritis
- Bursitis
- Tendonitis
- Skin conditions
- Eye conditions
- Gastrointestinal disorders
🇨🇦 Approved in Canada as Corticosteroids for:
- Allergic reactions
- Asthma
- COPD
- Rheumatoid arthritis
- Osteoarthritis
- Bursitis
- Tendonitis
- Skin conditions
- Eye conditions
- Gastrointestinal disorders
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Orthopedic Associates of Southwest OhioCenterville, OH
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Who Is Running the Clinical Trial?
Kettering Health NetworkLead Sponsor
References
Effects of corticosteroids and platelet-rich plasma on synoviocytes in IL-1ß-induced inflammatory condition. [2022]Corticosteroid injections are used to treat shoulder pain. Platelet-rich plasma (PRP) is known to have anti-inflammatory and anabolic effects, as well as cytoprotective effects against corticosteroids. Thus, this study was to investigate the effects of co-treatment of corticosteroid and PRP on anti-inflammatory and matrix homeostasis of synoviocytes in IL-1ß-induced inflammatory conditions.
Clinical efficacy of Platelet-Rich Plasma versus local Methylprednisolone Injection in Lateral Epicondylitis. [2023]To compare the results of local administration of platelet-rich plasma (PRP) with methylprednisolone in the treatment of tennis elbow.
Double-Blind Randomized Controlled Trial Comparing Platelet-Rich Plasma With Intra-Articular Corticosteroid Injections in Patients With Bilateral Knee Osteoarthritis. [2022]Introduction Platelet-rich plasma (PRP) intra-articular injections have gained popularity and are suggested to be more effective and longer lasting than corticosteroid or visco-supplementation therapy. There are few studies comparing PRP with corticosteroid injections and none comparing PRP in patients with bilateral knee osteoarthritis with the patient acting as their own control. Methods We performed a double-blind randomized controlled trial including 29 patients (58 knees) with radiologically confirmed mild-to-moderate bilateral knee osteoarthritis. They were randomized to receive an intra-articular PRP injection into one knee and a methylprednisolone injection with a local anesthetic into the contralateral knee. The primary outcome was measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) before the treatment and at six weeks, three months, and six months. Secondary outcome was measured pain with the visual numerical pain rating scale (VNS). Results Corticosteroids and PRP were both effective in improving pain, stiffness, and function at all time points, with maximal improvements at six weeks and three months. PRP scored slightly better than steroid injections at six months; nevertheless, there was no statistically significant difference between corticosteroids and PRP injections (F2,139=0.173, p=0.84). The secondary outcome also delivered the same result with improvement at all time points but no statistically significant difference (F2,139=0.168, p=0.85). Conclusions Both corticosteroids and PRP interventions are effective in improving pain, stiffness, and function in patients with bilateral knee osteoarthritis up to six months with no statistically significant difference between the two.
Comparison of Clinical and Functional Outcomes after Platelet-Rich Plasma Injection and Corticosteroid Injection for the Treatment of de Quervain's Tenosynovitis. [2023]Background  Platelet-rich plasma (PRP) has local anti-inflammatory actions, which is being used as a treatment in various tendinopathies. Purpose  The aim of the study is to compare the clinical results of PRP injection and corticosteroid injection in the management of de Quervain's tenosynovitis (DQTSV). Patients and Methods  In this prospective study, 60 patients of DQTSV, fulfilling the predefined inclusion and exclusion criteria, were randomised into two groups. In group 1 ( n  = 30), patients received a single injection of autologous PRP and in group 2 ( n  = 30) they received a single injection of corticosteroid (methylprednisolone). All patients were followed up at 1 month, 3 months, 6 months, and 1 year for evaluation by Finkelstein test, visual analogue scale (VAS), DASH (Disabilities of the Arm, Shoulder and Hand) score, and Modified Mayo Wrist score (MMWS). Results  In both the groups improvement occurred in Finkelstein test, VAS score, DASH score, and MMWS which were found to be statistically significant at all points of follow-ups when compared to the pre-intervention values. Comparison of scores between the two groups did not show any statistical significance. No complications were reported in PRP group. Statistically significant complications ( p -value = 0.026) like subcutaneous fat atrophy, depigmentation, and temporary increase in pain were seen in eight patients in the corticosteroid group with an overall complication rate of 26.67%. Conclusion  Both the modalities are equally effective in the management of DQTSV remittance. PRP is equally effective as corticosteroid in reducing symptoms of first dorsal compartment stenosing tenosynovitis. PRP may have a lower complication profile, however, this benefit should be weighed against the slight increase in cost and time of PRP preparation and injection. Level of Evidence  Level 2, prospective comparative study.
Comparison of the Efficacy of Platelet-Rich Plasma (PRP) and Local Corticosteroid Injection in Periarthritis Shoulder: A Prospective, Randomized, Open, Blinded End-Point (PROBE) Study. [2022]Background Periarthritis or frozen shoulder, also called adhesive capsulitis, is characterized by stiffness and pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy, short-wave therapy, ultrasonic therapy, transcutaneous electrical nerve stimulation, hydrotherapy, analgesics, intra-articular injections, manipulation under general anesthesia (MUA), and surgical management. The application of intra-articular steroid injection has been a common and efficacious option in rapidly diminishing shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP) injections in frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of intra-articular injections of PRP and triamcinolone in patients of shoulder periarthritis in a population from the eastern region of India Methodology A total of 60 patients with periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of triamcinolone (40 mg/mL) intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis. Results The mean VAS score in the PRP and triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both pain and disability scores in the PRP group after 24 weeks. Conclusions The triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing pain and disability scores in terms of VAS and DASH scores.
Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies. [2023]This systematic review compares clinical outcomes between platelet-rich plasma (PRP) and corticosteroid injections for the treatment of lumbar spondylosis and sacroiliac arthropathy. A systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Pubmed, SCOPUS, and Ovid MEDLINE databases. All level I-III evidence comparative studies published in the English language investigating the clinical outcomes between PRP and corticosteroid injections for the treatment of lumbar spondylosis and sacroiliac arthropathy were included. Five studies (242 patients, 114 PRP, 128 corticosteroid) were analyzed. One randomized study was level I evidence, two randomized studies were level II, and two non-randomized studies were level III. Final follow-up ranged from six weeks to six months. Four studies found that both PRP and corticosteroid treatment led to a statistically significant reduction in the visual analog scale (VAS). One found that only the PRP group led to a statistically significant reduction in VAS. Three studies found more significant improvements in one or more clinical outcome scores among PRP patients as compared with corticosteroid patients at the three- to six-month follow-up. Two studies found no difference in outcome score improvements between the two groups at six- to 12-week follow-up. There were no reports of major complications. There were no significant differences in minor complication rates between the two groups. In conclusion, both PRP and corticosteroid injections are safe and effective options for the treatment of lumbar spondylosis and sacroiliac arthropathy. There is some evidence that PRP injection is a more effective option at long-term follow-up compared with corticosteroid injection. Further randomized controlled trials with longer-term follow-up are necessary to compare its long-term efficacy.
Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. [2021]Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee osteoarthritis (OA), particularly in the UK. IA platelet-rich plasma (PRP) injections are a promising alternative, but no systematic reviews to date have compared them to the current standard of care, IA CS injections. We aim to investigate the effect of IA PRP injections versus IA corticosteroid injections for the symptomatic management of knee OA.
Intra-Articular Injection of Platelet-Rich Plasma Is More Effective than Hyaluronic Acid or Steroid Injection in the Treatment of Mild to Moderate Knee Osteoarthritis: A Prospective, Randomized, Triple-Parallel Clinical Trial. [2023]Purpose: To prospectively compare the efficacy and safety of intra-articular injections of platelet-rich plasma (PRP) with hyaluronic acid (HA) and glucocorticosteroid (CS) control groups for knee osteoarthritis (KOA) in a randomized, triple-parallel, single-center clinical trial. Methods: A total of 75 patients were randomly assigned to one of three groups receiving a single injection of either leukocyte-poor platelet-rich plasma (25 knees), hyaluronic acid (25 knees), or glucocorticosteroid (25 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was collected at baseline and 6, 12, and 26 weeks after treatment. Results: After 6 weeks of PRP administration, a decrease in the mean WOMAC value was observed in all three study groups. Three months after administration, the greatest decrease in the mean WOMAC value was obtained in the PRP group. The results in the HA and CS groups were similar (p = 0.681). In the one-way analysis of variance and post hoc analysis using the HSD Tukey test, a significantly greater improvement was shown by comparing the PRP and CS groups (p = 0.001), and the PRP and HA groups (p = 0.010). After intra-articular injection of CS, the reduction in pain was greatest 6 weeks after administration, and the mean value was the lowest among all groups. During subsequent visits, the value of the pain subscale increased, and after 6 months, it was the highest among the studied groups. Using the Wilcoxon paired test, no PRP effect was found to reduce stiffness at the 6-month follow-up (p = 0.908). Functional improvement was achieved in all groups, i.e., a decrease in the value of this subscale 6 months after administration. The largest decrease was seen in the group that received PRP (p