The effectiveness of Ozone activated Platelet Rich Plasma intra articular injection in pain management of anterior cruciate ligament tear

Authors

  • Abdullah Ahmed Mohammad Department of Family Medicine, AL Mansor Primary Health Center, Kirkuk, Iraq. https://orcid.org/0000-0002-8576-8259
  • Hayder Ghali Wadi Algawwam National TB Control Program, Iraq. https://orcid.org/0000-0002-9469-4861
  • Nuha Abdulwahab Muhammed Ali Department of Rheumatology & Medical Rehabilitation, Azadi Teaching Hospital, Kirkuk, Iraq.
  • Huda Ihsan KhairuAllah Department of Rheumatology & Medical Rehabilitation, Azadi Teaching Hospital, Kirkuk, Iraq.
  • Safwat Abbas Ali Department of anesthesia and intensive care, medicana international hospital, Istanbul, Turkey.

DOI:

https://doi.org/10.22317/imj.v7i1.1226

Keywords:

ACL tear, Pain Management, Platelets Rich Plasma, Ozone, Iraq

Abstract

Objectives: The anterior cruciate ligament (ACL) is one of the most common injured knee ligaments and it is one of the most frequent injuries seen in orthopedic practice

Methods: This is a retrospective study of 20 patients (14 female and 6 male) with ACL tear managed by intra articular activated PRP injection in the first author private clinic in Kirkuk over 2 years period (August 1, 2017–July 31, 2019). A detailed history was taken according to a questionnaire and a complete physical and radiological (MRI) examination was done. A sample of patient’s own blood was used to prepare PRP by a process of two repeated centrifugation. Longevity resources EXT50 Ozone Generator with oxygen tank and CGA870 Oxygen Regulator were used for activation of PRP. The clinical notes were reviewed to ascertain the clinical presentations and response of patients to PRP therapy.

Results: The mean age was 55±10.38years. The age groups affected with ACL were 50-59 and 60-69 years (n: 7, 35%) for each, while (n:5,25%) from age group 40-49 years and (n: 1, 5%) was from age group 20-29. Although 19 patient (95%) have at least one co-morbid condition, all the patient (n:20, 100%) show good response.7 patient (35%) received three doses of PRP and 13 patient (65%) received four doses to get good response.

Conclusion: Even though PRP and Ozone are not expensive therapies, they seem to be safe and effective in pain management of ACL tear.

References

Vaishya R, Hasija R (2013). Joint hypermobility and anterior cruciate ligament injury. J OrthopSurg (Hong Kong) 21(2):182–184

Shultz SJ, Schmitz RJ, Benjaminse A, Chaudhari AM, Collins M, Padua DA (2012). ACL research retreat VI: an update on ACL injury risk and prevention. J Athl Train 47(5):591–603

Evans S, Shaginaw J, Bartolozzi A (2014).Acl reconstruction - it’s all about timing. Int J Sports PhysTher 9(2):268–273

Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS (2010). A randomized trial of treatment for acute anterior Crut tears. New Engl J Med 363(4):331–342

Brophy RH, Silvers HJ, Mandelbaum BR (2010). Anterior cruciate ligament injuries: etiology and prevention. Sports Med Arthrosc 18(1):2–11.

Lohmander LS, Englund PM, Dahl LD, Roos EM (2007). The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 35:1756–1769

Alazzawi S, Sukeik M, Ibrahim M, Haddad FS (2016). Management of anterior cruciate ligament injury: pathophysiology and treatment. Br J Hosp Med 77(4):222–225

K.S. Lee, J.J. Wilson, D.P. Rabago, G.S. Baer, J.A. Jacobson, C.G. Borrero (2011). Musculoskeletal applications of platelet-rich plasma: fad or future? American Journal of Roentgenology, 196; 628-636.

Smith PA (2016), Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee osteoarthritis, AmJ sport 44(4):884-9.

Sanchez-Gonzalez DJ., Mendez-Bolania E., Trejo-BahenaNI(2012), PRP peptides key for regeneration, International Journal of Peptides, 202.doi: 10.1155/2012/532519.

Elvis, A M, and J S Ekta. “Ozone therapy: A clinical review.” Journal of natural science, biology, and medicine vol. 2,1 (2011): 66-70. doi:10.4103/0976-9668.

A.A Mohammad. Clinical applications of ozone: a review of 94 cases from Iraq.

Iraq Med J: 2018.2.10-14.

Bhattacharya V, Hansrani M, Wyatt MG, Lambert D and Jones DN (2003). Outcome following surgery for thoracic outlet syndrome. Eur J VascEndovasc Surg. 26:170–175.

Zelman DC; Dukes E; Brandenburg N; Bostrom A And Gore M (2005). Identification of cut-points for mild, moderate and severe pain due to diabetic peripheral neuropathy. Pain. 115: 29–36.

Mussano F, Genova T, Munaron L (2011). Cytokine, chemokine, and growth factor profile -of platelet-rich plasma. Platelets 27: 467-471.

Andia I, Abate M (2013). Platelet-rich plasma: Underlying biology and clinical correlates. Regenerative Medicine 8: 645-658.

Oh JH, Kim WOO, Park KU (2015). Comparison of the cellular composition and cytokine-release kinetics of various platelet rich plasma preparations. Am J Sports Med 43: 3062-3070.

Okuda K, Kawase T, Momose M (2003). Platelet-Rich Plasma Contains High Levels of Platelet-Derived Growth Factor and Transforming Growth Factor-β and Modulates the Proliferation of Periodontally Related Cells In Vitro. J Periodontol 74: 849-857.

Zhang J, Wang JHC (2010). Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med 38: 2477-2486.

Yeprem L, Ellialtioglu A, Baeza-Noci J. The efficacy of intra-articular PRP, Ozone and Ozone+PRP injections in patients with osteoarthritis.. J Ozone Ther. 2018:2(3) doi: 10.7203/jo3t.2.3.2018.10904.

Cakir R (2014). Ozone therapy & combined PRP applications, oncothermia journal 10:35-39.

S. A. Raeissadat, P. Ghazi Hosseini, M. H. Bahrami, R. Salman Roghani, M. Fathi, A. GharooeeAhangar, M. Darvish(2021). The comparsion effects of intra-articular injection of platelet rich plasma (PRP), plasma rich in growth facrors (PRGF), hyaluronic acid (HA) &ozone in knee osteoarthritis; a one year randomized clinical trail, BNC musculoskelet disord.22:134.

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Published

2023-03-26

How to Cite

Ahmed Mohammad, A. ., Ghali Wadi Algawwam, H. ., Abdulwahab Muhammed Ali, N. ., Ihsan KhairuAllah, H. ., & Abbas Ali, S. . (2023). The effectiveness of Ozone activated Platelet Rich Plasma intra articular injection in pain management of anterior cruciate ligament tear. Iraq Medical Journal, 7(1), 20–23. https://doi.org/10.22317/imj.v7i1.1226

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