Li Ming, Zhang Changqing, Ai Zisheng, Yuan Ting, Feng Yong, Jia Weitao
Department of Orthopaedics, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1192-6.
Platelet-rich plasma (PRP) can enhance the chondrocyte proliferation and repair of cartilage defects. To explore the safety and efficacy of intra-knee-articular injection of PRP to treat knee articular cartilage degeneration by comparing with injecting sodium hyaluronate (SH).
Thirty consecutive patients (30 knees) with knee articular cartilage degeneration were selected between January 2010 and June 2010. According to different injections, 30 patients were randomly divided into PRP group (test group, n = 15) and SH group (control group, n = 15). There was no significant difference in gender, age, body mass index, and Kellgren-Lawrence grade between 2 groups (P > 0.05). Test group received 3.5 mL of PRP intra-knee-articular injections while control group received 2 mL of SH during the same time period. Both treatments were administered in series of 3 intra-knee-articular injections at 3-week intervals. Then, adverse reactions were recorded. International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were used for evaluation of treatment results.
The patients of 2 groups were followed up 6 months. There were significant differences in IKDC score, WOMAC score, and Lequesne index between pre- and post-injection in 2 groups (P < 0.05); no significant difference was found between different time points (3, 4, and 6 months) in test group (P > 0.05), while significant differences were found between the postoperative 6th month and the postoperative 3rd and 4th months in control group (P < 0.05). There was no significant difference in IKDC score, WOMAC score, and Lequesne index between 2 groups within 4 months (P > 0.05), but the effectiveness of test group was significantly better than that of control group at 6 months after injection (P < 0.05). Adverse reactions occurred in 12 patients (31 injections) of test group and in 12 patients (30 injections) of control group. No significant difference in onset time, termination time, and duration of adverse reactions were found between 2 groups (P > 0.05).
Intra-knee-articular injection of PRP to treat knee articular cartilage degeneration is safe, which can alleviate symptoms of pain and swelling and improve the quality of life of patients; however, further data of large samples and long-term follow-up are needed to confirm the safety and effectiveness.
富血小板血浆（PRP）可促进软骨细胞增殖及修复软骨缺损。通过与注射透明质酸钠（SH）对比，探讨膝关节腔内注射PRP治疗膝关节软骨退变的安全性和有效性。
选取2010年1月至2010年6月连续收治的30例膝关节软骨退变患者（30膝）。根据不同注射药物，30例患者随机分为PRP组（试验组，n = 15）和SH组（对照组，n = 15）。两组患者在性别、年龄、体重指数和凯尔格伦-劳伦斯分级方面差异无统计学意义（P > 0.05）。试验组膝关节腔内注射3.5 mL PRP，对照组同期注射2 mL SH。两种治疗均采用膝关节腔内注射，共3次，间隔3周。然后记录不良反应。采用国际膝关节文献委员会（IKDC）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分及勒奎恩指数评估治疗效果。
两组患者均随访6个月。两组注射前后IKDC评分、WOMAC评分及勒奎恩指数差异有统计学意义（P < 0.05）；试验组不同时间点（3、4、6个月）差异无统计学意义（P > 0.05），而对照组术后6个月与术后3、4个月差异有统计学意义（P < 0.05）。两组在4个月内IKDC评分、WOMAC评分及勒奎恩指数差异无统计学意义（P > 0.05），但注射后6个月试验组疗效明显优于对照组（P < 0.05）。试验组12例患者（31次注射）及对照组12例患者（30次注射）出现不良反应。两组不良反应的发生时间、结束时间及持续时间差异无统计学意义（P > 0.05）。
膝关节腔内注射PRP治疗膝关节软骨退变是安全的，可缓解疼痛和肿胀症状，提高患者生活质量；然而，需要进一步的大样本和长期随访数据来证实其安全性和有效性。
