Intra Articular Injections With Platelet Rich Plasma in Patients With Juvenile Osteochondritis Dissecans of the Knee
Osteochondritis Dissecans
About this trial
This is an interventional treatment trial for Osteochondritis Dissecans
Eligibility Criteria
Inclusion Criteria:
- Male or female age 10 - 17 inclusive with open physis confirmed by MRI
- Documented symptomatic stable juvenile osteochondritis dissecans of the knee based on MRI without changes of osteoarthritis and no prior history of knee surgery.
- The patient must be able to hold still without sedation for approximately 1 hour and must pass MRI screening evaluation for retained metal.
- Patients with Di Paola stage 1 or 2 lesions
Exclusion Criteria:
- Patients with polyarticular disease.
- Patients with blood disorders (Blood disorders (thrombopathy, thrombocytopenia, anemia with hemoglobin <9g/dL). Only those patients with a positive history of blood disorders will have a Complete Blood Count (CBC) performed a week prior to inclusion in the study.
- Patients who had intra-articular treatment with steroids within 3 months
- Patients who are pregnant or nursing at the time of consent.
- Patients with inflammatory arthritic conditions (e.g. rheumatoid arthritis)
- Non-English speaking patients. (Scores used for evaluation have not been validated in Spanish)
- Patients who had previous knee surgery
- Additional disabilities in any of the lower limbs that would interfere with any of the clinical assessments.
- Chronic use of NSAID (defined as taking non-steroidal anti-inflammatory drug) regularly every week for the last 6 months), steroids or chemotherapy drugs
- Treatment with NSAIDs within 15 days prior to randomization in this study
- Patients with a BMI over 30. Due to the fact that this study utilizes an injection technique which may be inaccurate in obese subjects.
- Patients with a prolongation of bleeding time, e.g. those receiving anticoagulant drug therapy
- Patients with a contraindication to MRI including: patients with cardiac pacemaker or non-approved intracranial vascular clip, and those with orthopedic hardware as the resulting artifact can complicate interpretation
- Patients with acute or chronic renal failure
- Patients with a previous anaphylactic reaction to gadolinium enhanced MRI.
- Patients with Di Paola stage 3 or 4 lesions
Sites / Locations
- Children's Hospital Colorado
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Platelet rich plasma (PRP)
Conventional therapy
Patients will receive three PRP injections into the symptomatic knee; they will also be fitted with a hinged brace locked in extension, with weight bearing as tolerated and crutches for those with pain upon weight bear, complete rest from impact activities with progression to weight bearing as tolerated for 6 weeks, and then followed according to the Sports Medicine department's protocol for OCD.
Patients will be fitted with a hinged brace locked in extension, with weight bearing as tolerated and crutches for those with pain upon weight bear, complete rest from impact activities with progression to weight bearing as tolerated for 6 weeks, and then followed according to the Sports Medicine department's protocol for OCD.