Yan Jie, Liu Qi, Dai Gang, Wu Chunxi, Song Nali, Zhang Bin, Yang Liu, Yao Chunyan
Department of Blood Transfusion, First Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
Center for Joint Surgery, First Affiliated Hospital, Army Medical University (Army Medical University), Chongqing, 400038, China.
J Orthop Surg Res. 2025 Apr 4;20(1):339. doi: 10.1186/s13018-025-05756-6.
The lack of standardized Platelet-Rich Plasma (PRP) protocols for Knee Osteoarthritis (KOA), combined with significant patient variability, leads to inconsistent PRP effectiveness across studies. This study aims to assess the influence of PRP injection frequencies on KOA treatment and explore the role of patient characteristics and PRP properties in the treatment's effectiveness.
A retrospective cohort study was conducted with KOA patients who received three PRP injections (4-week intervals) at a hospital in Chongqing. The Wilcoxon signed-rank test was used to analyze differences in self-reported recovery rates across different treatment time points, with Bonferroni correction applied for significance level adjustment (α). The Mann-Whitney U test, Kruskal-Wallis H test, Spearman correlation analysis, and restricted cubic spline models were used to assess the associations between sex, baseline Kellgren-Lawrence grade, age, PRP red blood cell (RBC) concentration, PRP white blood cell (WBC) concentration, PRP platelet concentration, the multiple of PRP platelet concentration relative to the baseline autologous level (Enrichment-PLT), and self-reported recovery rates.
The study included 28 KOA patients. Significant improvement in self-reported recovery rate was observed 4 weeks after the first treatment (median: 30.0%, P < 0.008) and after the second treatment (median: 45.0%, P < 0.008). However, no significant change was noted 4 weeks after the third treatment (median: 55.0%, P = 0.058), and recovery rates at 8, 12, and 24 weeks post-third treatment showed no significant differences compared to 4 weeks (all P > 0.008). Additionally, no correlations were found between sex, baseline Kellgren-Lawrence grade, age, PRP RBC concentration, PRP WBC concentration, PRP platelet concentration, or Enrichment-PLT and self-reported recovery rates.
At least two PRP injections are recommended, with effects lasting for at least 24 weeks. Factors such as sex, age, baseline Kellgren-Lawrence grade, and PRP properties (prepared by apheresis) do not significantly affect treatment outcomes.
膝关节骨关节炎（KOA）缺乏标准化的富血小板血浆（PRP）方案，再加上患者个体差异较大，导致各研究中PRP的疗效不一致。本研究旨在评估PRP注射频率对KOA治疗的影响，并探讨患者特征和PRP特性在治疗效果中的作用。
对在重庆某医院接受三次PRP注射（间隔4周）的KOA患者进行回顾性队列研究。采用Wilcoxon符号秩检验分析不同治疗时间点自我报告的恢复率差异，并应用Bonferroni校正进行显著性水平调整（α）。采用Mann-Whitney U检验、Kruskal-Wallis H检验、Spearman相关分析和受限立方样条模型评估性别、基线Kellgren-Lawrence分级、年龄、PRP红细胞（RBC）浓度、PRP白细胞（WBC）浓度、PRP血小板浓度、PRP血小板浓度相对于基线自体水平的倍数（富集血小板）与自我报告的恢复率之间的关联。
该研究纳入了28例KOA患者。首次治疗后4周（中位数：30.0%，P < 0.008）和第二次治疗后（中位数：45.0%，P < 0.008），自我报告的恢复率有显著改善。然而，第三次治疗后4周未观察到显著变化（中位数：55.0%，P = 0.058），第三次治疗后8周、12周和24周的恢复率与4周时相比无显著差异（所有P > 0.008）。此外，性别、基线Kellgren-Lawrence分级、年龄、PRP RBC浓度、PRP WBC浓度、PRP血小板浓度或富集血小板与自我报告的恢复率之间均未发现相关性。
建议至少进行两次PRP注射，效果可持续至少24周。性别、年龄、基线Kellgren-Lawrence分级和PRP特性（通过单采制备）等因素对治疗结果无显著影响。
