الفهرس 
AIM OF WORKOnly 14 pages are availabe for public view
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Abstract
Knee osteoarthritis (KOA) is a progressive joint disease that often involves intra- and periarticular structures and is considered pathology characterized by articular cartilage lesions, synovitis, subchondral sclerosis, and osteophytes.In addition, KOA is one of the most common causes of joint pain and loss of motor function among middle-aged and elderly people in the United States.Despite advances in medical technology, no drug or surgical intervention is currently available for delaying the development of KOA.
Oral anti-inflammatory drugs, physiotherapy, topical anti-inflammatory gels, and intra-articular injections are currently routine treatments for patients with symptomatic KOA. Nonsurgical treatments, such as exercise and weight loss, are recommended because surgical treatment may lead to increased symptoms and poor functional outcomes
However, compliance with nonsurgical treatment is lower in KOA, and medications, such as simple analgesics and nonsteroidal anti-inflammatory drugs, are often associated with adverse events. Many studies have reported that hyaluronic acid (HA) has visco-induction properties and can increase intra-articular lubrication; therefore, intra-articular HA injection is widely used to treat KOA.However, although intra-articular drug therapy is often associated with reduced pain and increased joint function in patients, it is not effective in patients with KOA.
In the past decade, the use of autologous growth factors to treat knee osteoarthritis, such as intra-articular injection of platelet-rich plasma (PRP), has received increasing attention.Recent studies have demonstrated that growth factors and other cytokines released by platelets during injury can
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modulate the inflammatory process and help maintain or regenerate tissue structure. The subchondral bone contributes to the cartilage repair process and KOA.
PRP is an autologous blood product containing a high concentration of platelets, and it has become an emerging treatment for ligament, tendon, cartilage, and bone injuries in orthopedics and sports medicine. The intra-articular injection of PRP as a minimally invasive treatment has been widely used in the treatment of clinically related diseases. Sanchez et al. reported that a new technique for the delivery of PRP is intraosseous infiltration combined with intra-articular injections to treat severe KOA; moreover, no adverse reactions occurred in their study.
Many clinical studies have reported good clinical efficacy of PRP injections, and some previously published systematic reviews and meta-analyses have also suggested that PRP is a safe and effective orthopedic treatment compared with other intra-articular injections.
However, these reviews did not reach a consensus in terms of the effects of PRP on pain relief and functional recovery and concluded that more high-quality randomized controlled trials (RCTs) are still needed. Previous reviews either included non-RCTs or only analyzed a small number of RCTs (<10), and additional randomized trials have since been published. Therefore, further systematic reviews and meta-analyses are needed to fully investigate the effects of PRP on knee pain relief and functional improvement.
In the current study the aim of the work is to evaluate the results of non surgical treatment of early OA of the knee, we conclude 45 cases with knee osteoarthritis divided into three groups according treatment PRP group,hyaluronic acid group and medical treatment group
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In the current study we found that there were insignificant differences between study groups as regard demographic data
In the current study we found that there were insignificant differences between study groups as regard Kellgren-Lawrence grade
In the current study we found that there was insignificant differences between study groups as regard VAS baseline but after 3 months there was significant decrease in medical group than other groups.And PRP group shows lower VAS than HA group
There was insignificant differences between study groups as regard Knee society score baseline but after 3 months there was significant improvement in all groups after treatment and medical group had better score than others but difference not reach significance
There were insignificant differences between study groups as regard Oxford score baseline but after 3 months there was significant improvement in all groups after treatment with significant differences in medical group versus others.