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Recruiting NCT07339137

NCT07339137 The Effects of Intra-articular and Peri-articular Platelet-rich Plasma (PRP) Injections ın Chronic Knee Osteoarthritis

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Clinical Trial Summary
NCT ID NCT07339137
Status Recruiting
Phase
Sponsor Ankara City Hospital Bilkent
Condition Platelet Rich Plasma Injection
Study Type INTERVENTIONAL
Enrollment 42 participants
Start Date 2025-08-01
Primary Completion 2026-02-01

Eligibility & Interventions

Sex All sexes
Min Age 40 Years
Max Age 65 Years
Study Type INTERVENTIONAL
Interventions
Conservative TherapyIntra-Articular PRPPeri-Articular PRP

Eligibility Fast-Check

Enter your details for a quick preliminary check. This does not replace medical advice.

What to Expect as a Participant

You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.

This trial targets 42 participants in total. It began in 2025-08-01 with a primary completion date of 2026-02-01.

⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.

Brief Summary

The primary objective of this study is to evaluate and compare the effectiveness of ultrasound-guided combined intra-articular and peri-articular platelet-rich plasma (PRP) injections with intra-articular PRP injections alone in patients with chronic knee osteoarthritis (OA). The study specifically examines the effects of these treatment approaches on pain, physical function, activities of daily living, and structural parameters, including medial collateral ligament (MCL) thickness and distal femoral cartilage thickness. Osteoarthritis is a degenerative joint disease characterized by progressive cartilage erosion, osteophyte formation, and subchondral sclerosis, leading to pain, stiffness, and functional disability. It is the most common form of arthritis and a leading cause of disability worldwide, affecting approximately 300 million individuals. Although the knee is the most frequently involved joint, OA is now recognized as a whole-joint disease, involving not only cartilage degeneration but also pathological changes in subchondral bone, synovium, and surrounding extra-articular structures. Platelet-rich plasma is an autologous concentration of platelets suspended in a small volume of plasma and contains a variety of bioactive growth factors, such as transforming growth factor-beta (TGF-β), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF). These factors play a crucial role in promoting cell proliferation, angiogenesis, and tissue repair. In knee OA, PRP has been shown to reduce matrix metalloproteinase (MMP) activity, particularly MMP-13, enhance endogenous hyaluronic acid production, and support chondrogenesis. Although intra-articular PRP injections are widely accepted as a safe and effective treatment and have demonstrated superiority over placebo and hyaluronic acid in long-term follow-up studies, most existing research has focused exclusively on intra-articular applications. Knee OA is a multifactorial condition frequently associated with extra-articular pathologies, including ligament laxity, peri-articular edema, and soft tissue inflammation. Limiting treatment to the intra-articular space alone may therefore overlook these important contributors to pain and functional impairment. Emerging evidence suggests that a combined treatment approach targeting both intra-articular and peri-articular structures may provide superior outcomes in terms of pain reduction and functional improvement. This prospective randomized controlled trial will include 42 patients aged 40-65 years with chronic knee OA classified as Kellgren-Lawrence grade 2 or 3. Participants will be randomly assigned to one of three groups: a control group receiving conservative treatment only (exercise therapy and lifestyle modifications), a group receiving conservative treatment plus ultrasound-guided intra-articular PRP injections, and a third group receiving conservative treatment plus combined ultrasound-guided intra-articular and peri-articular PRP injections targeting the MCL and pes anserinus regions. Clinical outcomes will be assessed using validated instruments, including the Visual Analog Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 (SF-36) Quality of Life Scale. In addition, ultrasonographic measurements of MCL thickness and distal femoral cartilage thickness will be performed to evaluate structural changes. By investigating the additional value of peri-articular PRP injections, this study aims to contribute to the development of more comprehensive and effective injection protocols for the management of chronic knee osteoarthritis.

Eligibility Criteria

Inclusion Criteria * Age between 40 and 65 years. * Patients with significant medial knee pain who have not responded to conservative treatment for at least 3 months. * Patients diagnosed with knee osteoarthritis according to the American College of Rheumatology (ACR) criteria and with Kellgren-Lawrence grade 2 or 3 radiographic osteoarthritis. * Intact cognitive function. * Willingness to participate in the study and provide signed informed consent. * Visual Analog Scale (VAS) score of 4 or higher. Exclusion Criteria * History of previous knee trauma or surgery. * Physical therapy, intra-articular steroid, or hyaluronic acid injections in the knee within the last 3 months. * Active oncological diseases. * Local infection, sepsis, wounds, or scars in the injection area. * Systemic infections, hepatitis, or immunosuppression. * Bleeding diathesis or irregular International Normalized Ratio (INR) due to oral warfarin use. * Inflammatory arthropathies. * Uncontrolled hypertension, uncontrolled diabetes mellitus, decompensated heart failure, coronary artery disease, or asthma. * Suspected or confirmed pregnancy. * Use of corticosteroids or opioids. * Anemia. * Body mass index (BMI) greater than 35. * Allergy to citrate. * Use of nonsteroidal anti-inflammatory drugs (NSAIDs) within the last week that may affect platelet function analyzer-100 (PFA-100) activity. * Physical examination findings suggestive of patellar retinaculum, meniscus, or cruciate ligament injury. * General health impairment or lack of cooperation. * Refusal to participate in the study.

Contact & Investigator

Central Contact

Rıdvan E ÇELİK

✉ ridvancelik94@gmail.com

📞 +905078414386

Principal Investigator

Emre ADIGÜZEL, Prof. Dr.

STUDY DIRECTOR

Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital

Frequently Asked Questions

Who can join the NCT07339137 clinical trial?

This trial is open to participants of all sexes, aged 40 Years or older, up to 65 Years, studying Platelet Rich Plasma Injection. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.

Is NCT07339137 currently recruiting?

Yes, NCT07339137 is actively recruiting participants. Contact the research team at ridvancelik94@gmail.com for enrollment information.

Where is the NCT07339137 trial being conducted?

This trial is being conducted at Ankara, Turkey (Türkiye).

Who is sponsoring the NCT07339137 clinical trial?

NCT07339137 is sponsored by Ankara City Hospital Bilkent. The principal investigator is Emre ADIGÜZEL, Prof. Dr. at Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital. The trial plans to enroll 42 participants.

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