For all cases, before treatment PL treatment initiation the duration of the disease (arthrosis) of all the joints above varied from 6 months up to 3 years. As it was previously noted, before reference, all patients repeatedly received various types of conservative treatment: NSAIDs, glucocorticoids (GCs), or various types of physiotherapy that have not resulted in any positive effect, or gained just a short-term improvement. In the case of the treatment of osteoarthritis of the knee joint, the median value under WOMAC scale was 74 points before the course. Based on the results of treatment, the patients were divided into 2 groups. In a week most of patients (83%) (first group) have shown decrease down 17 - 27 points, and 17% (second group) – down to 37 - 43 points. After 3 months the value went down to 20 points. After 6 months, pain arose only after long-time household works and going downstairs after extended walk (2 hours ad more). Presentation of restoration dynamics for functional capabilities of the joint includes both groups, since it does not interfere with general positive trend of the remission (see Figure 1).
Before the initiation of therapy for lateral epicondylitis of the elbow joint, VAS median value reached 6-7 points when pain interferes with basic needs. The results of treatment within 6 months period were tracked for 20 patients, within 12 months - for 9 patients. During the first month after the course, pain activity ranged from 1 to 3, after 2 and 6 months - from 0 to 2 points and disappeared after 12 months (Figure 2).
Only 1 patient demonstrated an increase in pain up to 4 points within the last period. He has undergone PL retreatment which resulted in 1 point value under VAS scale within 2nd month.
Before the treatment of ankle osteoarthritis, the VAS median value was 4-5 points. By the end of the first month after treatment initiation, VAS indicator slightly decreased down to 2-3 points. However, the pain syndrome quickly restored with the course of time (in 2 months or later) (see Figure 3).
The therapy of shoulder joint osteoarthritis by PL method has also demonstrated positive results based on clinical case. Right after the treatment movements of the right joint were significantly limited by severe pain (abduction up to 70, flexion up to 90 degrees), then after 2 years the joint range reached up to 170 for abduction and up to 160 degrees for flexion.
Thus, the PL method is an effective and applicable for treatment injuries of various natures of the joints of the upper and lower extremities at the base of Republican Clinical Hospital of Ministry of Health Care of the Republic of Tatarstan. It is preferable compared against GCs and NSAIDs treatments, since it does not require extended intervals (up to 1 month) between injections, which forces the patient to endure pain, and, moreover, in some cases does not lead to a positive result. However, the PL method on various joints shows diversity in effectiveness. Whereas the treatment of the knee, elbow and shoulder joints shows a sound positive dynamics, then the therapy of the ankle joint under similar conditions does not demonstrate any significant success. Summing up the positive effect of the PL method on the functional state of the joints of the upper and lower extremities, the following can be noted. In our study, knee joint therapy reduces symptoms by more than 70% of the initial pain intensity within first three months and by almost 60% by the sixth month after the injection course. Even at the absence of significant improvements immediately after the course of treatment, the maximum effect had been also achieved by the 3rd month after treatment.
For patients with lateral epicondylitis, who had daily moderate physical activity, treatment with the PL method reduces pain symptoms by 80% within the first two months. The maximum effect was gained by the 2nd month, which prolonged for periods of 6 and 12 months. Thus, PL therapy is an effective and safe method of treatment that provides a long-term positive effect for the joints under discussion. In contrast, the treatment of the ankle joint with the introduction of autologous platelet mass shows only a short-term positive effect.