Effects of intra-articular injection of platelet-rich plasma on rehabilitation of knee osteoarthritis_West China Medical Journal

Authors：

GUAN Jing ,  LI Song , XIA Shixin , SUN Fengwei , WANG Xiaohui , WAN Li

Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China;

Corresponding author：

LI Song, Email: 63271887@qq.com

Keywords：

Knee joint; Knee osteoarthritis; Isokinetic strength training; Platelet-rich plasma

DOI：

10.7507/1002-0179.202003068

Video：

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Objective To explore the effects of intra-articular injection of platelet-rich plasma (PRP) on improving pain, joint function, and muscle strength of knee osteoarthritis (KOA). Methods From March 2017 to August 2019, 100 cases of KOA diagnosed and treated in the First Affiliated Hospital of Harbin Medical University were selected. They were divided into intervention group and control group with 50 cases in each group by random number table method. The patients in the intervention group were given intra-articular injection of PRP (5 mL/time, 1 time/week, 6 times in total) combined with isokinetic strength training (2 times/d, 3 d/week, for 12 consecutive weeks) treatment, and the patients in the control group were given intra-articular injection of sodium hyaluronate (2 mL/time, 1 time/week, for 12 consecutive weeks) combined with isokinetic strength training (2 times/d, 3 d/week, for 12 consecutive weeks). The incidence of adverse reactions during the treatment process and the clinical efficacy at 12 weeks of treatment and 6 months after treatment were recorded, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scoring system was used to evaluate the knee joint function. When the isokinetic strength training instrument measured an angle of 90°/s, the knee joint flexor and extensor peak torque (PT), total work (TW), and average power (AP) were recorded. Results Forty-nine patients of each group completed the study. The between-group differences in WOMAC pain, stiffness, and joint function scores, and extensor and flexor PT, TW, and AP before treatment were not statistically significant (P>0.05). At 12 weeks of treatment and 6 months after treatment, the WOMAC scores of pain, stiffness, and joint function in the two groups were lower than those before treatment (P<0.05), and the extensor and flexor PT, TW, and AP were higher than those before treatment (P<0.05). Six months after treatment, the WOMAC scores of pain, stiffness, and joint function in the intervention group were lower than those in the control group (P<0.05), and the extensor and flexor PT, TW, and AP in the intervention group were higher than those in the control group (P<0.05). There was no significant difference in the effective rate between the two groups at 12 weeks of treatment (95.9% vs. 89.8%, P>0.05). The effective rate in the intervention group was higher than that in the control group 6 months after treatment (93.9% vs. 79.6%, P<0.05). No serious adverse reaction occurred in the two groups during the treatment. Conclusion Intra-articular injection of PRP can reduce pain, improve muscle strength, and improve joint function in patients with KOA, and the long-term effect is better than that of conventional drugs.

Citation： GUAN Jing, LI Song, XIA Shixin, SUN Fengwei, WANG Xiaohui, WAN Li. Effects of intra-articular injection of platelet-rich plasma on rehabilitation of knee osteoarthritis. West China Medical Journal, 2021, 36(11): 1539-1544. doi: 10.7507/1002-0179.202003068 Copy

1.	马驰蛟. 关节腔内注射富血小板血浆与透明质酸治疗膝骨关节炎疗效观察. 山西医药杂志, 2018, 47(17): 2083-2085.
2.	王美玲. 小针刀配合等速肌力训练对老年膝骨性关节炎患者的疗效观察. 国际医药卫生导报, 2017, 23(1): 58-61.
3.	Mascarenhas R, Saltzman BM, Fortier LA, et al. Role of platelet-rich plasma in articular cartilage injury and disease. J Knee Surg, 2015, 28(1): 3-10.
4.	Nguyen C, Lefèvre-Colau MM, Poiraudeau S, et al. Evidence and recommendations for use of intra-articular injections for knee osteoarthritis. Ann Phys Rehabil Med, 2016, 59(3): 184-189.
5.	徐步靖, 霍小燕, 张厚庆, 等. 关节内注射富血小板血浆与玻璃酸钠治疗膝关节骨关节炎的对比研究. 中国微创外科杂志, 2015, 15(8): 676-680.
6.	吕帅洁, 厉驹, 何斌, 等. 富血小板血浆关节内注射治疗膝骨关节炎的前瞻性随机对照研究. 中华创伤杂志, 2016, 32(7): 626-631.
7.	陈艳, 王大寿, 孙文阳明, 等. 自体富血小板血浆(PRP)治疗膝关节骨性关节炎的疗效观察. 贵州医药, 2019, 43(5): 731-732.
8.	梁颖, 许开英, 李俊, 等. 等速肌力训练结合常规康复治疗脑卒中患者膝过伸的效果. 实用临床医学, 2018, 19(4): 23-25.
9.	中华医学会骨科学分会. 骨关节炎诊治指南(2007 年版). 中华骨科杂志, 2007, 27(10): 793-796.
10.	Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
11.	侯来永, 徐瑞泽, 唐学章, 等. 推拿结合等速肌力训练治疗膝关节骨性关节炎临床疗效研究. 中国康复医学杂志, 2019, 34(5): 551-555, 572.
12.	黄乐春, 胡惠民, 梁宇翔. 膝关节功能评分量表评述. 中国医药科学, 2016, 6(13): 50-53.
13.	郭军宝. 关节腔内注射玻璃酸钠配合肌力训练对膝关节骨性关节炎患者关节功能的影响观察. 湖南师范大学学报(医学版), 2016, 13(5): 60-62.
14.	谢磊, 刘佳, 王华军, 等. 关节腔注射透明质酸及富血小板血浆对老年膝骨关节炎的治疗作用比较. 中国老年学杂志, 2018, 38(5): 1129-1131.
15.	吴开泽, 陈献聪, 康禹, 等. 富血小板血浆在膝关节骨关节炎治疗中的应用. 国际骨科学杂志, 2015, 36(6): 414-418.
16.	中国医疗保健国际交流促进会骨科分会. 富血小板血浆在骨关节外科临床应用专家共识(2018 年版). 中华关节外科杂志(电子版), 2018, 12(5): 596-600.
17.	袁俊虎, 陈扬, 魏鲁青, 等. 富含血小板血浆与常规药物关节腔注射治疗早期膝骨关节炎的临床疗效比较. 骨科, 2019, 10(1): 25-30.
18.	尹正录, 孟兆祥, 王继兵, 等. 关节内注射富血小板血浆或玻璃酸钠联合等速肌力训练对膝骨性关节炎的影响. 中华物理医学与康复杂志, 2019, 41(10): 764-768.
19.	Masuki H, Okudera T, Watanebe T, et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). Int J Implant Dent, 2016, 2(1): 19-26.
20.	Zhou Q, Xu C, Cheng X, et al. Platelets promote cartilage repair and chondrocyte proliferation via ADP in a rodent model of osteoarthritis. Platelets, 2016, 27(3): 212-222.
21.	Bennell KL, Wrigley TV, Hunt MA, et al. Update on the role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am, 2013, 39(1): 145-176.
22.	王剑雄, 周谋望, 吴同绚, 等. 膝关节骨性关节炎患者髋外展肌等速肌力的研究. 中国康复医学杂志, 2013, 28(12): 1109-1113.

1. 马驰蛟. 关节腔内注射富血小板血浆与透明质酸治疗膝骨关节炎疗效观察. 山西医药杂志, 2018, 47(17): 2083-2085.
2. 王美玲. 小针刀配合等速肌力训练对老年膝骨性关节炎患者的疗效观察. 国际医药卫生导报, 2017, 23(1): 58-61.
3. Mascarenhas R, Saltzman BM, Fortier LA, et al. Role of platelet-rich plasma in articular cartilage injury and disease. J Knee Surg, 2015, 28(1): 3-10.
4. Nguyen C, Lefèvre-Colau MM, Poiraudeau S, et al. Evidence and recommendations for use of intra-articular injections for knee osteoarthritis. Ann Phys Rehabil Med, 2016, 59(3): 184-189.
5. 徐步靖, 霍小燕, 张厚庆, 等. 关节内注射富血小板血浆与玻璃酸钠治疗膝关节骨关节炎的对比研究. 中国微创外科杂志, 2015, 15(8): 676-680.
6. 吕帅洁, 厉驹, 何斌, 等. 富血小板血浆关节内注射治疗膝骨关节炎的前瞻性随机对照研究. 中华创伤杂志, 2016, 32(7): 626-631.
7. 陈艳, 王大寿, 孙文阳明, 等. 自体富血小板血浆(PRP)治疗膝关节骨性关节炎的疗效观察. 贵州医药, 2019, 43(5): 731-732.
8. 梁颖, 许开英, 李俊, 等. 等速肌力训练结合常规康复治疗脑卒中患者膝过伸的效果. 实用临床医学, 2018, 19(4): 23-25.
9. 中华医学会骨科学分会. 骨关节炎诊治指南(2007 年版). 中华骨科杂志, 2007, 27(10): 793-796.
10. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
11. 侯来永, 徐瑞泽, 唐学章, 等. 推拿结合等速肌力训练治疗膝关节骨性关节炎临床疗效研究. 中国康复医学杂志, 2019, 34(5): 551-555, 572.
12. 黄乐春, 胡惠民, 梁宇翔. 膝关节功能评分量表评述. 中国医药科学, 2016, 6(13): 50-53.
13. 郭军宝. 关节腔内注射玻璃酸钠配合肌力训练对膝关节骨性关节炎患者关节功能的影响观察. 湖南师范大学学报(医学版), 2016, 13(5): 60-62.
14. 谢磊, 刘佳, 王华军, 等. 关节腔注射透明质酸及富血小板血浆对老年膝骨关节炎的治疗作用比较. 中国老年学杂志, 2018, 38(5): 1129-1131.
15. 吴开泽, 陈献聪, 康禹, 等. 富血小板血浆在膝关节骨关节炎治疗中的应用. 国际骨科学杂志, 2015, 36(6): 414-418.
16. 中国医疗保健国际交流促进会骨科分会. 富血小板血浆在骨关节外科临床应用专家共识(2018 年版). 中华关节外科杂志(电子版), 2018, 12(5): 596-600.
17. 袁俊虎, 陈扬, 魏鲁青, 等. 富含血小板血浆与常规药物关节腔注射治疗早期膝骨关节炎的临床疗效比较. 骨科, 2019, 10(1): 25-30.
18. 尹正录, 孟兆祥, 王继兵, 等. 关节内注射富血小板血浆或玻璃酸钠联合等速肌力训练对膝骨性关节炎的影响. 中华物理医学与康复杂志, 2019, 41(10): 764-768.
19. Masuki H, Okudera T, Watanebe T, et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). Int J Implant Dent, 2016, 2(1): 19-26.
20. Zhou Q, Xu C, Cheng X, et al. Platelets promote cartilage repair and chondrocyte proliferation via ADP in a rodent model of osteoarthritis. Platelets, 2016, 27(3): 212-222.
21. Bennell KL, Wrigley TV, Hunt MA, et al. Update on the role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am, 2013, 39(1): 145-176.
22. 王剑雄, 周谋望, 吴同绚, 等. 膝关节骨性关节炎患者髋外展肌等速肌力的研究. 中国康复医学杂志, 2013, 28(12): 1109-1113.

West China Medical Journal

Effects of intra-articular injection of platelet-rich plasma on rehabilitation of knee osteoarthritis

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