Subramanyam Koushik, Alguvelly Rajkumar, Mundargi Abhishek, Khanchandani Prakash
Department of Orthopaedics, Sri Sathya Sai Institute of Higher Medical Sciences - Prashanthigram, Puttaparthi, Andhra Pradesh, India.
Arch Rheumatol. 2021 Jan 14;36(3):326-334. doi: 10.46497/ArchRheumatol.2021.8408. eCollection 2021 Sep.
This study aims to compare the effectiveness of single, double, and triple doses of intra-articular (IA) platelet rich plasma (PRP) in early stages of osteoarthritis (OA) of the knee.
This single-blind, randomized, superiority trial included a total of 180 knees of 90 patients (22 males, 68 females; mean age: 47.9 years; range, 36 to 60 years) with bilateral OA knee of Kellgren-Lawrence Grade 1-2 between May 2017 and December 2018. The patients were randomized (30 in each group) to receive single, double, or triple doses of IA PRP (two weeks apart in repeat injections). The outcome measures were Visual Analog Scale, International Knee Documentation Committee Score, Knee Injury and Osteoarthritis Outcome Score, and Tegner Lysholm Knee Score. The assessor of outcome was blinded. The scores were collected before intervention and at six weeks, three months, six months, and one year after the intervention.
All patients completed the study. All three groups were comparable with respect to demographic and disease characteristics. All four scores were comparable among the three groups before intervention and at six weeks, three months, and six months. However, at one-year follow-up, the three-dose group showed superiority to others in terms of all four scores. All three groups showed improvement until six months and deterioration thereafter, which was only marginal in the three-dose group. All groups showed a statistically significant improvement of scores compared to baseline scores at one year. There were no major complications.
The IA administration of three doses of PRP yields superior outcome to single and double doses at the end of one year. Repeat doses are probably needed to sustain the benefit achieved at one year.
本研究旨在比较单剂量、双剂量和三剂量关节内注射富血小板血浆（PRP）治疗膝关节早期骨关节炎（OA）的有效性。
本单盲、随机、优效性试验纳入了2017年5月至2018年12月期间90例双侧Kellgren-Lawrence 1-2级OA膝关节患者（男22例，女68例；平均年龄47.9岁；范围36至60岁）的180个膝关节。患者被随机分组（每组30例），接受单剂量、双剂量或三剂量关节内注射PRP（重复注射间隔两周）。观察指标为视觉模拟评分、国际膝关节文献委员会评分、膝关节损伤和骨关节炎疗效评分以及Tegner Lysholm膝关节评分。结果评估者为盲法。在干预前以及干预后6周、3个月、6个月和1年收集评分。
所有患者均完成研究。三组在人口统计学和疾病特征方面具有可比性。干预前以及6周、3个月和6个月时，三组的所有四项评分均具有可比性。然而，在1年随访时，三剂量组在所有四项评分方面均优于其他组。所有三组在6个月前均显示改善，此后恶化，三剂量组的恶化程度较小。与基线评分相比，所有组在1年时评分均有统计学意义的改善。未出现重大并发症。
关节内注射三剂量PRP在1年末的疗效优于单剂量和双剂量。可能需要重复给药以维持1年时获得的益处。
