PRP, Visco Or Physiotherapy? Choosing The Right Treatment For OA Knee
Knee pain is the disabling and common condition in elderly people. Degenerative changes occur naturally as an ageing process. A chronic ailment that affects the bones and joints i.e. osteoarthritis has a major negative influence on mobility as well as quality of life, especially in older adults. Joint inflammation, subchondral bone alterations, and cartilage loss are its defining features. Osteoarthritis of the knee is especially common and can cause discomfort, instability in the joint, and restrictions in function. It can be managed by various treatment protocols. Knee pain can vary from mild to moderate and moderate to severe. According to that one should plan a treatment.
Visco-supplementation:
Mechanism: Visco-supplementation involves the intra-articular injection of Hyaluronic Acid (HA) into the knee joint. HA is a naturally occurring polysaccharide that is a key component of synovial fluid, which serves as a lubricant and shock absorber in joints. By introducing HA to the joint space, the treatment aims to restore the viscoelastic properties of the synovial fluid, providing both lubrication and cushioning for the articular surfaces. This restoration is particularly beneficial in osteoarthritis (OA), where the natural concentration of HA is diminished.
Benefits: The primary objective of visco-supplementation is to alleviate the symptoms associated with knee arthritis, such as pain and stiffness. This treatment is particularly suitable for patients with mild to moderate OA, as it is less invasive than surgical options. By improving joint lubrication and reducing friction during movement, patients often experience enhanced mobility and improved comfort during activities of daily living. Studies have shown that visco-supplementation can lead to short- to mid-term pain relief and functional improvement, though results may vary among individuals.
Platelet Rich Plasma:
Mechanism: Platelet Rich Plasma (PRP) therapy involves the extraction and concentration of platelets from the patient’s own blood. Once processed, the PRP, which contains growth factors and cytokines, is injected into the affected joint or tissue. The growth factors present in PRP stimulate cellular processes that promote tissue regeneration, inflammation reduction, and healing. Additionally, PRP can enhance collagen synthesis and improve blood flow to the area, further facilitating the healing process.
Benefits: PRP may provide more substantial pain relief and functional improvement than visco-supplementation, particularly in patients experiencing moderate to severe knee pain from OA. The potential for longer-lasting effects is attributed to its regenerative properties, which can lead to improved joint function and reduced reliance on analgesics. Clinical studies have shown promising outcomes with PRP, demonstrating its effectiveness in improving knee function and alleviating pain symptoms.
Physiotherapy:
Mechanism: Physiotherapy encompasses various therapeutic modalities, including targeted exercises, manual therapy, and adjunctive treatments such as thermotherapy (heat and ice), electrical stimulation, and massage. The exercises prescribed aim to enhance muscle strength, flexibility, and range of motion in the knee joint, which subsequently aids in improving overall functional capacity. Physiotherapy also promotes neuromuscular coordination, which is crucial for joint stability and balance.
Benefits: As the first line of treatment for knee pain, physiotherapy is essential for managing pain, particularly in conjunction with other interventions. It allows for personalized care, focusing on the individual’s specific needs and rehabilitation goals. Through consistent physical therapy, patients can achieve long-term pain management, improve joint mechanics, and increase physical activity levels, thereby enhancing their overall quality of life.
While physiotherapy is typically the first line of treatment for most cases of knee pain, PRP (Platelet-Rich Plasma), Visco supplementation (Visco) may be the best options for moderate to severe osteoarthritis. Visco injection can be considered for Mild to moderate osteoarthritic knee changes and PRP can be considered for moderate to severe type of osteoarthritic changes.
Ultimately, the choice of treatment should be guided by a thorough assessment of the patient's condition, taking into account the severity of osteoarthritis, the presence of comorbidities, and personal preferences. A multidisciplinary approach that integrates physiotherapy with biological therapies like PRP or visco-supplementation can offer the best outcomes for individuals suffering from knee osteoarthritis.
