Mizue Orthopedic Clinic, 4 Chome-45-1 Mizue, Edogawa-ku, Tokyo, 132-0011, Japan.
Faculty of Health and Medical Sciences, Department of Physical Therapy, Teikyo Heisei University, 2 Chome-51-4 Higashi-Ikebukuro, Toshima-ku, Tokyo, 170-8445, Japan.
J Orthop Surg Res. 2024 Oct 28;19(1):696. doi: 10.1186/s13018-024-05186-w.
Platelet-rich plasma (PRP) is a promising treatment for knee osteoarthritis (OA). However, exercise therapy and activities of daily living (ADL) guidance are recommended as core treatments in the Osteoarthritis Research Society International (OARSI) guidelines. However, the effects of PRP combined with exercise therapy are not fully understood. This study aimed to clarify the effectiveness of this treatment.
We assigned patients diagnosed with knee OA and treated between January 2021 and December 2022 to groups who underwent PRP + exercise (PE), PRP (P), or exercise (E) therapy. Outcomes were evaluated using Knee Injury and Osteoarthritis Outcome Scores (KOOS) before, and 1, 3, and 12 months after treatment. Within-group comparisons according to the time of each score were statistically assessed using a one-way analysis of variance, then differences were analyzed using Bonferroni multiple comparisons p < 0.05). Treatment responses were determined using Outcome Measures in Rheumatology (OMERACT)-OARSI Responder criteria.
Pre-treatment KOOS did not significantly differ among the groups. Pain in the PE group improved within 1 month, symptoms, ADL, and quality of life (QOL) improved after 3, months and continued for 12 months. Pain and symptoms improved in the P group within 1 month, but ADLs and the QOL did not significantly change. Pain improved after 3 months in the E group and ADL, and QOL improved by 12 months. The response among the groups was the highest for the PE, with 50.0% at 1 and 3 months, and 65.0% at 12 months.
Therapy with PRP immediately relieved pain, whereas exercise conferred late, but enduring effects. Combining PRP with exercise conferred synergistic advantages that persisted for up to 12 months.
富含血小板的血浆 (PRP) 是治疗膝骨关节炎 (OA) 的有前途的方法。然而，运动疗法和日常生活活动 (ADL) 指导被国际骨关节炎研究协会 (OARSI) 指南推荐为核心治疗方法。然而，PRP 联合运动疗法的效果尚未完全清楚。本研究旨在阐明这种治疗方法的效果。
我们将 2021 年 1 月至 2022 年 12 月期间诊断为膝 OA 并接受治疗的患者分为 PRP+运动 (PE)、PRP (P) 或运动 (E) 治疗组。使用膝关节损伤和骨关节炎结果评分 (KOOS) 评估治疗前、治疗后 1、3 和 12 个月的疗效。使用单向方差分析对每个评分的时间进行组内比较，然后使用 Bonferroni 多重比较分析差异 (p<0.05)。使用 OMERACT-OARSI 反应标准确定治疗反应。
治疗前，PE 组的 KOOS 疼痛在 1 个月内得到改善，症状、ADL 和生活质量 (QOL) 在 3 个月后得到改善，并持续 12 个月。P 组的疼痛和症状在 1 个月内得到改善，但 ADL 和 QOL 没有显著变化。E 组的疼痛在 3 个月后得到改善，ADL 和 QOL 在 12 个月后得到改善。各组的反应以 PE 组最高，1 个月和 3 个月时为 50.0%，12 个月时为 65.0%。
PRP 治疗即刻缓解疼痛，而运动疗法则在后期产生持久的效果。PRP 联合运动疗法具有协同优势，可持续长达 12 个月。
