Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Osteoarthritis Cartilage. 2021 May;29(5):718-727. doi: 10.1016/j.joca.2021.02.001. Epub 2021 Feb 10.
The vascularization of subchondral bone plays a significant role in the progression of knee osteoarthritis (OA). Treatment with platelet-rich plasma (PRP) has positive effects on cartilage lesions. However, PRP's efficacy for subchondral bone marrow lesions and the relationship of these lesions to cartilage are still undiscovered. Therefore, our aims were first to longitudinally investigate the change in subchondral flow by dynamic contrast enhanced MRI and degeneration of cartilage by MRI T2 in an anterior cruciate transection rodent (ACLT) model, and second to examine changes in parameters after intra-articular PRP injection.
A 32-week investigation in 18 rats allocated to sham-control, ACLT with normal saline injection (ACLT + NS), and ACLT with PRP injection groups ended with histological evaluation. Another rat was used as a donor of allogenic PRP.
Compared to the sham-control group, the ACLT + NS group had higher subchondral blood volume A (0.051, 95% confidence interval: 0.009, 0.092) and lower venous washout k (-0.030: -0.055, -0.005) from week 4; lower permeability k from week 18 (-0.954: -1.339, -0.569); higher cartilage T2 values (1.803: 1.504, 2.102) reflecting collagen loss beginning at week 10. For the PRP treatment group, subchondral bone marrow A and cartilage T2 decreased from week 10. Histological results confirmed and were correlated with the MRI findings.
Subchondral hyper-perfusion plays a vital role in the pathogenesis of OA and was associated with cartilage degeneration. The efficacy of PRP can be observed from reduced perfusion and MRI T2 values.
软骨下骨的血管化在膝关节骨关节炎（OA）的进展中起着重要作用。富血小板血浆（PRP）的治疗对软骨病变有积极影响。然而，PRP 对软骨下骨髓病变的疗效及其与软骨的关系尚不清楚。因此，我们的目的首先是通过动态对比增强 MRI 纵向研究前交叉韧带切断（ACLT）模型中软骨下的血流变化和 MRI T2 评估软骨退变，其次是检查关节内注射 PRP 后参数的变化。
18 只大鼠分为假手术对照、ACL 生理盐水注射（ACLT+NS）和 ACL 富血小板血浆注射（ACLT+PRP）组，进行 32 周的研究，最后进行组织学评估。另一只大鼠作为同种异体 PRP 的供体。
与假手术对照组相比，ACLT+NS 组从第 4 周开始出现软骨下血容量 A（0.051，95%置信区间：0.009，0.092）增加和静脉洗脱 k 值降低（-0.030：-0.055，-0.005）；第 18 周时，渗透性 k 值降低（-0.954：-1.339，-0.569）；第 10 周开始出现胶原丢失，软骨 T2 值升高（1.803：1.504，2.102）。对于 PRP 治疗组，从第 10 周开始，软骨下骨髓 A 和软骨 T2 降低。组织学结果证实并与 MRI 结果相关。
软骨下高灌注在 OA 的发病机制中起着重要作用，与软骨退变有关。PRP 的疗效可以从灌注和 MRI T2 值的降低中观察到。
