Coviello Michele, Abate Antonella, Maccagnano Giuseppe, Geronimo Alessandro, Caiaffa Elio, Nappi Vittorio, Caiaffa Vincenzo, Solarino Giuseppe
Department of Clinical and Experimental Medicine, Orthopaedics Unit, Faculty of Medicine and Surgery, University of Foggia, Policlinico Riuniti di Foggia, 71122 Foggia, Italy.
Orthopaedic and Traumatology Unit, "Di Venere" Hospital, 70131 Bari, Italy.
J Funct Morphol Kinesiol. 2025 Apr 21;10(2):138. doi: 10.3390/jfmk10020138.
Knee osteoarthritis (OA) is a progressive joint disorder characterized by pain, stiffness, and functional impairment. Platelet-rich plasma (PRP) has been widely studied as a biological treatment for OA, with autologous PRP (A-PRP) being the most commonly used formulation. Recently, umbilical cord-derived PRP (C-PRP) has emerged as a potential alternative due to its hypothesized higher regenerative potential. However, evidence supporting its superiority over A-PRP remains limited. This study aims to compare the efficacy and safety of C-PRP and A-PRP in terms of pain relief and functional improvement over a 12-month follow-up period. This prospective cohort study included 84 patients with mild-to-moderate knee OA (Kellgren-Lawrence grades I-III), into two groups: 44 patients received a single intra-articular injection of C-PRP, and 40 received A-PRP. Pain and functional outcomes were assessed at baseline, 3, 6, 9, and 12 months using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Statistical analysis was performed using the Mann-Whitney U, Exact Fisher test, repeated measures general linear model (GLM) and multivariate logistic regression. Both C-PRP and A-PRP led to significant pain reduction and functional improvement over 12 months ( < 0.01 for both groups). Short-term analysis (3-6 months) showed slightly greater pain relief in the C-PRP group (VAS, = 0.03 at 3 months), but this difference diminished at later time points. By 9 and 12 months, no significant differences were observed between the two groups in any clinical outcome measures (VAS, WOMAC, KOOS; > 0.05). No serious adverse events were reported, and both treatments were well tolerated. This study found no long-term superiority of C-PRP over A-PRP in terms of pain relief or functional improvement in knee OA. While C-PRP showed a transient advantage in early pain relief, both treatments demonstrated similar clinical outcomes at 12 months. Given the limited scientific evidence supporting C-PRP and its higher logistical costs, A-PRP should remain the preferred PRP therapy for knee OA. Further randomized controlled trials with longer follow-up periods are needed to confirm these findings.
膝关节骨关节炎（OA）是一种以疼痛、僵硬和功能障碍为特征的进行性关节疾病。富血小板血浆（PRP）作为OA的一种生物治疗方法已得到广泛研究，自体PRP（A-PRP）是最常用的制剂。最近，脐带血来源的PRP（C-PRP）因其假定的更高再生潜力而成为一种潜在的替代方法。然而，支持其优于A-PRP的证据仍然有限。本研究旨在比较C-PRP和A-PRP在12个月随访期内缓解疼痛和改善功能方面的疗效和安全性。这项前瞻性队列研究纳入了84例轻度至中度膝关节OA患者（Kellgren-Lawrence分级I-III级），分为两组：44例患者接受单次关节内注射C-PRP，40例接受A-PRP注射。在基线、3个月、6个月、9个月和12个月时，使用视觉模拟量表（VAS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及膝关节损伤和骨关节炎结局评分（KOOS）评估疼痛和功能结局。使用曼-惠特尼U检验、精确费舍尔检验、重复测量一般线性模型（GLM）和多变量逻辑回归进行统计分析。C-PRP和A-PRP在12个月内均导致疼痛显著减轻和功能改善（两组均P<0.01）。短期分析（3-6个月）显示C-PRP组疼痛缓解略多（VAS，3个月时P=0.03），但在后期时间点这种差异减小。到9个月和12个月时，两组在任何临床结局指标（VAS、WOMAC、KOOS；P>0.05）上均未观察到显著差异。未报告严重不良事件，两种治疗耐受性均良好。本研究发现，在膝关节OA的疼痛缓解或功能改善方面，C-PRP并不优于A-PRP。虽然C-PRP在早期疼痛缓解方面显示出短暂优势，但两种治疗在12个月时的临床结局相似。鉴于支持C-PRP的科学证据有限且其后勤成本较高，A-PRP应仍然是膝关节OA的首选PRP治疗方法。需要进一步进行随访期更长的随机对照试验来证实这些发现。
