Saraf Amit, Hussain Altaf, Singhal Ayush, Arora Vaneet, Bishnoi Sandeep
Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre, Delhi road. NH 24, Bagadpur, Moradabad, Uttar Pradesh, 244001, India.
J Clin Orthop Trauma. 2023 Jul 16;43:102226. doi: 10.1016/j.jcot.2023.102226. eCollection 2023 Aug.
To study whether age, gender, body mass index(BMI) and disease duration influence the clinical outcomes in kellgren-Lawrence(K-L) grade II,III knee osteoarthritis(KOA) patients treated with serial injections of platelet rich plasma(PRP).
65 patients were given three monthly intra-articular injections of PRP in this prospective interventional study. The patients were divided into subgroups depending on the factor studied: by age(in years) into young <45(n = 7), middle age 45-60(n = 35), and elderly >60(n = 23): by BMI(in kg/m) into; normal <25(n = 25), overweight 25-30(n = 27) and obese >30(n = 13) and disease duration; less(n = 32) or more than 1 year(n = 33) symptom duration. Visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used as outcome measures and assessed before each injection and then at 6 and 9 months post injection. Groups were homogenous with respect to baseline characteristics.
Mean VAS and WOMAC scores showed a statistically significant improvement (P < 0.0001) across all groups and subgroups (age,gender,BMI,disease duration) at follow up. On intra-subgroup comparison, we found no significant differences(P > 0.05) among age, BMI or gender subgroups, however the scores were significantly better in patients with disease duration of less than 1 year than those with more than 1 year duration at both 6 and 9 months[P < 0.001(RC = 9.630,95% CI = 4.037-15.222,P = 0.001)].
PRP injections if given serially can improve the short term subjective scores of VAS and WOMAC scores in patients with K-L grade II and III KOA irrespective of age, gender, BMI or disease duration, however, clinical benefits can be maximized if given early in the disease course.
研究年龄、性别、体重指数（BMI）和病程是否会影响接受富血小板血浆（PRP）系列注射治疗的凯尔格伦-劳伦斯（K-L）分级为II级、III级的膝关节骨关节炎（KOA）患者的临床结局。
在这项前瞻性干预研究中，65例患者接受了每三个月一次的关节腔内PRP注射。根据所研究的因素将患者分为亚组：按年龄（岁）分为年轻组（<45岁，n = 7）、中年组（45 - 60岁，n = 35）和老年组（>60岁，n = 23）；按BMI（kg/m²）分为正常组（<25，n = 25）、超重组（25 - 30，n = 27）和肥胖组（>30，n = 13）以及病程；症状持续时间少于1年（n = 32）或超过1年（n = 33）。采用视觉模拟量表（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）作为结局指标，在每次注射前以及注射后6个月和9个月进行评估。各亚组在基线特征方面具有同质性。
在随访时，所有组和亚组（年龄、性别、BMI、病程）的平均VAS和WOMAC评分均显示出具有统计学意义的改善（P < 0.0001）。在亚组内比较中，我们发现年龄、BMI或性别亚组之间无显著差异（P > 0.05），然而，病程少于1年的患者在6个月和9个月时的评分均显著优于病程超过1年的患者[P < 0.001（RC = 9.630，95%CI = 4.037 - 15.222，P = 0.001）]。
对于K-L分级为II级和III级的KOA患者，连续注射PRP可改善VAS和WOMAC评分的短期主观评分，无论年龄、性别、BMI或病程如何，然而，如果在疾病病程早期给予治疗，临床获益可最大化。
