Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, India.
Injury. 2023 Feb;54(2):728-737. doi: 10.1016/j.injury.2022.11.036. Epub 2022 Nov 15.
The objective of the study was to determine the changes in clinical outcome (pain and knee activity) and assess bone/ cartilage biomarkers and inflammatory activity in persons with osteoarthritis (OA) knee following a single injection of intra-articular platelet-rich plasma (IA-PRP) and combination of intra-articular, intraosseous PRP (IA+IO-PRP).
This prospective, randomized, single-blind clinical trial was conducted at a tertiary care teaching hospital in India. Ninety-six persons with OA knee with a Kellgren-Lawrence score of 3 were randomized into three groups- Group-I (IA-PRP), Group-II (IA+IO-PRP)], Group-III, [intra-articular normal saline (IA-NS)]. The primary outcome was a visual analog scale (VAS) for pain. The secondary outcomes were the Knee Injury and Osteoarthritis Outcome Score (KOOS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), bone/ cartilage turnover biomarkers [C-telopeptide (CTX-II), N-telopeptide (NTX-I), cartilage oligomeric matrix protein (COMP), N-terminal propeptide of collagen type-IIA (PIIANP), and hyaluronic acid (HA)], ultrasonography (USG) findings of the knee joint. The outcome measures were assessed at baseline, 6, and 12 weeks of follow-up.
Compared to IA-NS injection, IA-PRP and IA+IO-PRP injections significantly improved VAS-pain and KOOS scores at 6 and 12 weeks. Furthermore, both PRP groups showed a significant reduction in ESR, CRP, and CTX-II at 12 weeks following PRP injections. In addition, at 12 weeks, the IA+IO-PRP group showed a significant reduction (p=0.009) in NTX-I level. Persons in the IA+IO-PRP group reported significant reductions in the synovial-effusion and infra-patellar bursitis.
Significant clinical improvements were noticed following IA-PRP and IA-IO-PRP injections compared to IA-NS injections. Both PRP groups reported a significant reduction in ESR, CRP, and CTX-II levels at 12 weeks. Persons in the IA+IO-PRP group reported significant changes in u-NTX-I level and knee-USG findings.
本研究旨在确定单次关节内富血小板血浆（IA-PRP）注射和关节内、骨内 PRP 联合注射（IA+IO-PRP）后，骨关节炎（OA）膝关节的临床结果（疼痛和膝关节活动度）变化，并评估骨/软骨生物标志物和炎症活性。
这是一项在印度一家三级教学医院进行的前瞻性、随机、单盲临床试验。96 例膝关节 OA 患者，Kellgren-Lawrence 评分 3 分，随机分为三组：I 组（IA-PRP）、II 组（IA+IO-PRP）、III 组（关节内生理盐水 IA-NS）。主要结局是视觉模拟评分（VAS）用于评估疼痛。次要结局是膝关节损伤和骨关节炎结果评分（KOOS）、红细胞沉降率（ESR）、C 反应蛋白（CRP）、骨/软骨转化生物标志物[C 端肽（CTX-II）、N 端肽（NTX-I）、软骨寡聚基质蛋白（COMP）、II 型胶原 N 端前肽（PIIANP）和透明质酸（HA）]、膝关节超声（USG）检查。在基线、6 周和 12 周随访时评估结局指标。
与 IA-NS 注射相比，IA-PRP 和 IA+IO-PRP 注射在 6 周和 12 周时显著改善了 VAS 疼痛和 KOOS 评分。此外，两种 PRP 组在 PRP 注射后 12 周时 ESR、CRP 和 CTX-II 均显著降低。此外，在 12 周时，IA+IO-PRP 组 NTX-I 水平显著降低（p=0.009）。IA+IO-PRP 组患者的关节滑液和髌下囊炎症显著减轻。
与 IA-NS 注射相比，IA-PRP 和 IA-IO-PRP 注射后临床改善显著。两种 PRP 组在 12 周时 ESR、CRP 和 CTX-II 水平均显著降低。IA+IO-PRP 组患者 u-NTX-I 水平和膝关节 USG 检查结果有显著变化。
