Comparison of the effects of a physiotherapy protocol and platelet-rich plasma treatment on pain, functionality, and kinesiophobia in women with medial compartment osteoarthritis of the knee
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Golhisar Vocational School of Health Services, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
Department of Anatomy, Faculty of Medicine, Başkent University, Ankara, Turkey
Submission date: 2020-11-27
Acceptance date: 2021-01-05
Publication date: 2023-03-21
Physiother Quart. 2023;31(1):39-45
Although the popularity of platelet-rich plasma treatments has recently increased, physiotherapy is still one of the recommended methods of gonarthrosis treatment. The aim of the study was to examine the preferability of lower-cost physiotherapy compared with high-cost platelet-rich plasma treatment for gonarthrosis and the effects of both treatments on pain, functionality, and kinesiophobia.

Overall, 61 women participated in this randomized controlled study. The first group (physiotherapy) received conservative physiotherapy treatment (hot pack, ultrasound, transcutaneous electrical nerve stimulation, manual therapy) and home exercises. The second group (platelet-rich plasma) underwent only a home exercise program. An isometric knee exercise, an isotonic knee exercise, and dynamic step exercises for the quadriceps femoris muscle were planned for the home exercises. Exercise program compliance was monitored by exercise diary and telephone calls every day. The patients were evaluated in terms of pain levels, physical limitations (WOMAC and Lysholm scales), and kinesiophobia (Tampa Scale for Kinesiophobia). Data were collected 4 times (before treatment and in the 4th, 8th, and 12th week).

The patients’ average age was 60.92 ± 10.67 years. In both groups, there was a decrease in pain and WOMAC and Tampa scores, and an increase in Lysholm scores compared with the pre-treatment outcomes (p < 0.05). No between-group difference in these parameters was observed (p > 0.05).

The scarce difference in the indirect comparisons of the groups in terms of pain, functionality, and kinesiophobia scores may indicate that the two treatment methods may be equally recommended.

Bilge A, Ulusoy RG, Üstebay S, Öztürk Ö. Osteoarthritis [in Turkish]. Kafkas J Med Sci. 2018;8:133–142; doi: 10.5505/kjms.2016.82653.
Dikici A, Ulaşlı AM, Çevik H, Eroğlu S, Solak Ö, Dündar Ü. The use of complementary and alternative medicine in patients with degenerative osteoarthritis [in Turkish]. Euras J Fam Med. 2015;4(3):126–130.
Sen R, Hurley JA. Osteoarthritis. StatPearls Publishing; 2020. Available 09.02.2023 from: https://www.ncbi.nlm.nih.gov/b....
Baysal E, Budak M, Atılgan E, Tarakcı D. Comparison of different rehabilitation approaches effectiveness in individuals with knee osteoarthritis [in Turkish]. J Exerc Ther Rehabil. 2019;6(1):32–41.
Turhan B, Usgu G, Usgu S, Çınar MA, Dinler E, Koca­maz D. Investigation of kinesiophobia, state and trait anxiety levels in patients with lower extremity ligament injury or fracture history [in Turkish]. Turk J Sports Med. 2019;54(3):175–182; doi: 10.5152/tjsm.2019.130.
Altaş EU, Demirdal Ü. The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: a single-blind, prospective, randomized-controlled study. Turk J Phys Med Rehabil. 2020;66(1):73–83; doi: 10.5606/tftrd.2020.3089.
Özkılıç R, Kuru T, İpek S, Keskin E, Işık C, Kaya YE. Comparison of the effects of intra-articular hyaluronic acid and tenoxicam on pain and knee joint functions in knee osteoarthritis [in Turkish]. Acta Med Alanya. 2018;2(3):149–158; doi: 10.30565/medalanya.419286.
Kan HS, Chan PK, Chiu KY, Yan CH, Yeung SS, Ng YL, et al. Non-surgical treatment of knee osteoarthritis. Hong Kong Med J. 2019;25(2):127–133; doi: 10.12809/hkmj187600.
The public health services price schedule. Ankara: Health Services General Directorate, Social Security Practices Department; 2020.
Mangone G, Orioli A, Pinna A, Pasquetti P. Infiltrative treatment with platelet rich plasma (PRP) in gonarthrosis. Clin Cases Miner Bone Metab. 2014;11(1):67–72; doi: 10.11138/ccmbm/2014.11.1.067.
Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45–56; doi: 10.1016/0304-3959(83)90126-4.
Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005;13(1):28–33; doi: 10.1016/j.joca.2004.10.010.
Celik D, Coşkunsu D, Kılıçoğlu Ö. Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res. 2013;471(8):2602–2610; doi: 10.1007/s11999-013-3046-z.
Tunca Yılmaz ÖT, Yakut Y, Uygur F, Uluğ N. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability [in Turkish]. Fizyoter Rehabil. 2011;22(1):44–49.
Vázquez-Morales E, Verdugo-Meza RA, Godínez-Alvarado M, Chávez-Covarrubias G. Efficacy of viscosupplementation with high and medium molecular weight hyaluronic acid in patients with symptomatic gonarthrosis grades II–III [in Spanish]. Acta Ortop Mex. 2019;33(3):166–168.
Uslu Güvendi E, Aşkın A, Güvendi G, Koçyiğit H. Comparison of efficiency between corticosteroid and platelet rich plasma injection therapies in patients with knee osteoarthritis. Arch Rheumatol. 2018;33(3):273–281; doi: 10.5606/ArchRheumatol.2018.6608.
Öz B, Karataş A, Akar ZA, Koca SS. Obesity and musculoskeletal system [in Turkish]. Firat Med J. 2018;23(Suppl.):42–47.
Raud B, Gay C, Guiguet-Auclair C, Bonnin A, Gerbaud L, Pereira B, et al. Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis. Sci Rep. 2020;10(1):3601; doi: 10.1038/s41598-020-60587-1.
Wu Y, Zhu S, Lv Z, Kan S, Wu Q, Song W, et al. Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil. 2019;33(12):1863–1875; doi: 10.1177/0269215519866494.
Mumtaz SN, Shah SH. Role of ultrasound therapy in osteoarthritis knee. Pak Armed Forces Med J. 2018;68(4):914–918.
Kalaiselvi K, Mahendran P, Makaju S. A comparative analysis of electrical stimulation, versus TENS with isometric and isotonic exercise of quadriceps for the chronic osteoarthritis knee patients. J Chalmeda Anand Rao Inst Med Sci. 2017;14(2):61–66.
Shimoura K, Iijima H, Suzuki Y, Aoyama T. Immediate effects of transcutaneous electrical nerve stimulation on pain and physical performance in individuals with preradiographic knee osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil. 2019;100(2):300–306.e1; doi: 10.1016/j.apmr.2018.08.189.
Lin M-T, Wei K-C, Wu C-H. Effectiveness of platelet-rich plasma injection in rotator cuff tendinopathy: a systematic review and meta-analysis of randomized controlled trials. Diagnostics. 2020;10(4):189; doi: 10.3390/diagnostics10040189.
Pasin T, Ataoğlu S, Pasin Ö, Ankarali H. Comparison of the effectiveness of platelet-rich plasma, corticosteroid, and physical therapy in subacromial impingement syndrome. Arch Rheumatol. 2019;34(3):308–316; doi: 10.5606/ArchRheumatol.2019.7225.
Van Ark M, van den Akker-Scheek I, Meijer LTB, Zwer­ver J. An exercise-based physical therapy program for patients with patellar tendinopathy after platelet-rich plasma injection. Phys Ther Sport. 2013;14(2):124–130; doi: 10.1016/j.ptsp.2012.05.002.
Filardo G, Kon E, Della Villa S, Vincentelli F, Fornasari PM, Marcacci M. Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop. 2010;34(6):909–915; doi: 10.1007/s00264-009-0845-7.
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