Relationship between clinical efficacy and biological characteristics of platelet rich plasma in the treatment of knee osteoarthritis
Objective To investigate the clinical efficacy of intra-articular injection of platelet rich plasma(PRP)in the treatment of the patients with knee osteoarthritis,and analyze the relationship between the clinical efficacy and biological characteristics of PRP.Methods A total of 110 patients with knee osteoarthritis were equally randomized into two groups of PRP and HA,who accepted intra-articular injection of single PRP and hyaluronic acid,respectively.The International Knee Documentation Committee(IKDC)subjective score,VAS pain score and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score were evaluated before treatment and in the 6th week,3rd month and 6th month after treatment.The incidence of adverse events before and after treatment was observed.The cell counts,growth factor and cytokines levels in group PRP were detected for analyzing their relationship with the clinical outcomes.Results Compared with before treatment,the IKDC subjective score,VAS pain score,and WOMAC each item and total scores were improved after treatment in both groups(P＜0.05).The IKDC subjective score in the 6th month after treatment in group PRP was higher than that in group HA(P＜0.05).The function,stiffness and total scores of WOMAC in the 6th week after treatment in group PRP were lower than those in group HA(P＜0.05).The levels of platelet-derived growth factor-BB(PDGF-BB)and PDGF-AB in the patients with VAS pain score more than the minimal clinically important difference(MCID)were higher than those in the patients with VAS pain score less than MCID in group PRP(P＜0.05).There was no statistical difference in the incidence of adverse events between the two groups(P＞0.05).Conclusion The intra-articular injection of PRP has an obvious clinical effect on knee osteoarthritis with higher patients'satisfaction and safety.The levels of growth factors should be considered during the treatment of knee osteoarthritis with PRP.
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