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.	馬馳蛟. 關節腔內注射富血小板血漿與透明質酸治療膝骨關節炎療效觀察. 山西醫藥雜志, 2018, 47(17): 2083-2085.
2.	王美玲. 小針刀配合等速肌力訓練對老年膝骨性關節炎患者的療效觀察. 國際醫藥衛生導報, 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, 張厚慶, 等. 關節內注射富血小板血漿與玻璃酸鈉治療膝關節骨關節炎的對比研究. 中國微創外科雜志, 2015, 15(8): 676-680.
6.	呂帥潔, 厲駒, 何斌, 等. 富血小板血漿關節內注射治療膝骨關節炎的前瞻性隨機對照研究. 中華創傷雜志, 2016, 32(7): 626-631.
7.	陳艷, 王大壽, 孫文陽明, 等. 自體富血小板血漿(PRP)治療膝關節骨性關節炎的療效觀察. 貴州醫藥, 2019, 43(5): 731-732.
8.	梁穎, 許開英, 李俊, 等. 等速肌力訓練結合常規康復治療腦卒中患者膝過伸的效果. 實用臨床醫學, 2018, 19(4): 23-25.
9.	中華醫學會骨科學分會. 骨關節炎診治指南(2007 年版). 中華骨科雜志, 2007, 27(10): 793-796.
10.	Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
11.	侯來永, 徐瑞澤, 唐學章, 等. 推拿結合等速肌力訓練治療膝關節骨性關節炎臨床療效研究. 中國康復醫學雜志, 2019, 34(5): 551-555, 572.
12.	黃樂春, 胡惠民, 梁宇翔. 膝關節功能評分量表評述. 中國醫藥科學, 2016, 6(13): 50-53.
13.	郭軍寶. 關節腔內注射玻璃酸鈉配合肌力訓練對膝關節骨性關節炎患者關節功能的影響觀察. 湖南師范大學學報(醫學版), 2016, 13(5): 60-62.
14.	謝磊, 劉佳, 王華軍, 等. 關節腔注射透明質酸及富血小板血漿對老年膝骨關節炎的治療作用比較. 中國老年學雜志, 2018, 38(5): 1129-1131.
15.	吳開澤, 陳獻聰, 康禹, 等. 富血小板血漿在膝關節骨關節炎治療中的應用. 國際骨科學雜志, 2015, 36(6): 414-418.
16.	中國醫療保健國際交流促進會骨科分會. 富血小板血漿在骨關節外科臨床應用專家共識(2018 年版). 中華關節外科雜志(電子版), 2018, 12(5): 596-600.
17.	袁俊虎, 陳揚, 魏魯青, 等. 富含血小板血漿與常規藥物關節腔注射治療早期膝骨關節炎的臨床療效比較. 骨科, 2019, 10(1): 25-30.
18.	尹正錄, 孟兆祥, 王繼兵, 等. 關節內注射富血小板血漿或玻璃酸鈉聯合等速肌力訓練對膝骨性關節炎的影響. 中華物理醫學與康復雜志, 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.	王劍雄, 周謀望, 吳同絢, 等. 膝關節骨性關節炎患者髖外展肌等速肌力的研究. 中國康復醫學雜志, 2013, 28(12): 1109-1113.

1. 馬馳蛟. 關節腔內注射富血小板血漿與透明質酸治療膝骨關節炎療效觀察. 山西醫藥雜志, 2018, 47(17): 2083-2085.
2. 王美玲. 小針刀配合等速肌力訓練對老年膝骨性關節炎患者的療效觀察. 國際醫藥衛生導報, 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, 張厚慶, 等. 關節內注射富血小板血漿與玻璃酸鈉治療膝關節骨關節炎的對比研究. 中國微創外科雜志, 2015, 15(8): 676-680.
6. 呂帥潔, 厲駒, 何斌, 等. 富血小板血漿關節內注射治療膝骨關節炎的前瞻性隨機對照研究. 中華創傷雜志, 2016, 32(7): 626-631.
7. 陳艷, 王大壽, 孫文陽明, 等. 自體富血小板血漿(PRP)治療膝關節骨性關節炎的療效觀察. 貴州醫藥, 2019, 43(5): 731-732.
8. 梁穎, 許開英, 李俊, 等. 等速肌力訓練結合常規康復治療腦卒中患者膝過伸的效果. 實用臨床醫學, 2018, 19(4): 23-25.
9. 中華醫學會骨科學分會. 骨關節炎診治指南(2007 年版). 中華骨科雜志, 2007, 27(10): 793-796.
10. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
11. 侯來永, 徐瑞澤, 唐學章, 等. 推拿結合等速肌力訓練治療膝關節骨性關節炎臨床療效研究. 中國康復醫學雜志, 2019, 34(5): 551-555, 572.
12. 黃樂春, 胡惠民, 梁宇翔. 膝關節功能評分量表評述. 中國醫藥科學, 2016, 6(13): 50-53.
13. 郭軍寶. 關節腔內注射玻璃酸鈉配合肌力訓練對膝關節骨性關節炎患者關節功能的影響觀察. 湖南師范大學學報(醫學版), 2016, 13(5): 60-62.
14. 謝磊, 劉佳, 王華軍, 等. 關節腔注射透明質酸及富血小板血漿對老年膝骨關節炎的治療作用比較. 中國老年學雜志, 2018, 38(5): 1129-1131.
15. 吳開澤, 陳獻聰, 康禹, 等. 富血小板血漿在膝關節骨關節炎治療中的應用. 國際骨科學雜志, 2015, 36(6): 414-418.
16. 中國醫療保健國際交流促進會骨科分會. 富血小板血漿在骨關節外科臨床應用專家共識(2018 年版). 中華關節外科雜志(電子版), 2018, 12(5): 596-600.
17. 袁俊虎, 陳揚, 魏魯青, 等. 富含血小板血漿與常規藥物關節腔注射治療早期膝骨關節炎的臨床療效比較. 骨科, 2019, 10(1): 25-30.
18. 尹正錄, 孟兆祥, 王繼兵, 等. 關節內注射富血小板血漿或玻璃酸鈉聯合等速肌力訓練對膝骨性關節炎的影響. 中華物理醫學與康復雜志, 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. 王劍雄, 周謀望, 吳同絢, 等. 膝關節骨性關節炎患者髖外展肌等速肌力的研究. 中國康復醫學雜志, 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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