PRP Versus Local Steroid Injections in Management of Sacroiliac Joint Inflammation

Abstract
Background: Low back pain is common and originates in the Sacroiliac (SI) joint in 15%-30% of cases. Traditional SI joint disruption/de generative sacroiliitis treatments include non operative care or open SI joint fusion.
Aim of Study: We aim to evaluate and compare the use-fulness, side effects and complication of use platelet Rich Plasma (PRP) versus the more commonly used local steroid injection in treatment of sacroiliitis.
Patient and Methods: These study include 18 patient were divided into two group:
•Group (A): 30 patients received image guided local inter-articular steroid injection of 2ml methylprednisolone (Depo-Medrol) plus 1ml lidocaine.
•Group (B): 16 patients received image guided local interar-ticular injection of 3ml PRP plus 0.5ml lidocaine.
The median follow-up 6-12 weeks, evaluating improve-ment, the need for repeat injection and complication. The extent of pain improvement was evaluated using the visual analogue pain scale (VAS).
Result: Group (A) 24 patient (80%) had complete resolving of symptom while 8 patient in Group (B) had resolution (50%).
Group (A) had one case of sever painful injection site, one case with supreficial infection and two cases who com-plained of systemic effects of steroids including hiccups and elevated blood sugar levels that improved after one week, while Group (B) had two cases with acute aching pain follow-ing the injection and improved the following three days and one case where the procedure had to be redone under CT guidance.
Conclusion: Local steroid for treatment of sacroiliitis more effective in management when compare two local PRP injection but the complication rate is higher and there is more risk in certain groups who do not tolerate steroids like diabetics, hypertensive and old age.
PRP administration is inferior to steroid in management of sacroiliitis in terms of immediate pain relief but is much safer, has less complication and can be repeated safely.