Department of Orthopedic Surgery, La Paz University Hospital, 28046 Madrid, Spain.
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital-Autonomous University of Madrid), 28046 Madrid, Spain.
Int J Mol Sci. 2022 Jan 24;23(3):1301. doi: 10.3390/ijms23031301.
Knee osteoarthritis (OA) is estimated to affect more than 10% of the population, with a lifetime risk of 45%. Contemporary guidelines advise control of body weight, therapeutic physical exercise, drug treatment (oral non-steroidal anti-inflammatory drugs, paracetamol, opioids), and mechanical aids (walking aids, braces, orthoses). Nevertheless, these treatments typically have only short-term benefits. Intra-articular corticosteroids are typically advised, but only for short-term pain alleviation, given that their benefits last only a few weeks. The efficacy of hyaluronic acid is controversial. When the aforesaid options fail, total knee arthroplasty is generally recommended as an efficacious treatment. However, it is costly and can involve medical and postoperative complications. Therefore, determining alternate safe and effective treatments for knee OA is paramount. Platelet-rich plasma (PRP) has lately been investigated for the treatment of knee OA. This article reviews recent knowledge concerning PRP's molecular mechanisms of action. The effectiveness of intra-articular PRP injections in the knee joint remains controversial, although most recent publications show pain alleviation in the short term. Orthopedic surgeons treating people with knee OA are becoming increasingly interested in PRP, despite indecisive clinical data and basic science information. Further studies comparing PRP with placebo are required.
膝关节骨关节炎(OA)估计影响超过 10%的人口,终生风险为 45%。当代指南建议控制体重、治疗性体育锻炼、药物治疗(口服非甾体抗炎药、扑热息痛、阿片类药物)和机械辅助(助行器、支具、矫形器)。然而,这些治疗通常只有短期益处。通常建议关节内皮质类固醇治疗,但仅用于短期缓解疼痛,因为其益处仅持续数周。透明质酸的疗效存在争议。当上述选择失败时,全膝关节置换术通常被推荐为有效的治疗方法。然而,它成本高昂且可能涉及医疗和术后并发症。因此,确定膝关节骨关节炎的替代安全有效的治疗方法至关重要。富含血小板的血浆(PRP)最近已被用于治疗膝关节骨关节炎。本文综述了 PRP 作用的分子机制的最新知识。关节内 PRP 注射治疗膝关节的有效性仍存在争议,尽管最近的大多数出版物显示短期疼痛缓解。尽管临床数据和基础科学信息不明确,但治疗膝关节骨关节炎患者的骨科医生对 PRP 的兴趣日益浓厚。需要进一步比较 PRP 与安慰剂的研究。