Clinical and functional outcomes following platelet rich plasma in the management of knee osteoarthritis: A case series in a tertiary care hospital.

OBJECTIVE: To clinically assess the efficacy of Platelet rich Plasma (PRP) in improving the functional movement in knee osteoarthritis. METHODS: This prospective case series, on 89 patients, was studied in Sindh Rangers Hospital, Karachi, Pakistan from 1st October 2018 to 31st March 2019. The analysis involved all patients aged 30-65 years diagnosed with grade 1, 2 and 3 arthritis. PRP was administered in three doses one month apart, and patients were evaluated for outcome measures after the third month of the third dose of PRP. To measure functional improvement in knee osteoarthritis, the range of motion (ROM), McMaster University Osteoarthritis index (WOMAC), Western Ontario, and Visual analogue scale (VAS) were used. RESULTS: PRP was infused into 89 patients, with a mean age of 61.24±8.92 years. The average pre-treatment WOMAC score was 37.0 ±2.9, and it was lowered to 18.8± 5.2 after PRP (p<0.02). The pre-treatment VAS was 8.42 ±0.84, and it was reduced to 4.91±2.12, indicating mild to moderate pain. Our PRP therapy was appreciated by 63 (70.07%) patients, while 17 (19.1%) were only partly satisfied. However, 9 (10.1%) patients were dissatisfied. CONCLUSIONS: The results of this case series showed that the use of PRP injections for treating osteoarthritis (grade 1 to 3) proved to be successful in terms of improving functional outcomes and reducing pain intensity.

Comparison of titanium elastic nails versus Thomas splint traction for treatment of pediatric femur shaft fracture.

OBJECTIVE: To compare titanium elastic nails with Thomas splint traction treatment for femur shaft fracture in children. METHODS: The descriptive randomised study was conducted at Abbasi Shaheed Hospital, Karachi, from January 2013 to December 2014, and comprised children aged 6-12 years with simple femur shaft fractures. The patients were randomised into two equal groups. Group A patients were treated with titanium elastic nail and group B patients with Thomas splint traction. Patients were mobilised without weight-bearing on the 5th to 7th postoperative day. In group B, traction was maintained for about 8 to 10 weeks. After splint removal, patients were referred to physical therapy. Patients were available for one-year follow-up. RESULTS: There were 30 patients; 15(50%) in each of the two groups. Those group A had full weight-bearing at 4-6 weeks and early return to routine activities compared to group B patients who took 8-12 weeks. The results were Excellent in 12(80%) patients in group A and 6(40%) patients in group B Postoperative superficial infection occurred in 3(10%) patients. CONCLUSIONS: Titanium elastic nailing is an effective treatment of femur shaft fractures in children.