Purpose

The purpose of this study was to evaluate whether serial intra-articular (IA) Platelet-Rich Plasma (PRP) injections improve pain and function in patients of Kellgren–Lawrence (K–L) Grade IV primary knee osteoarthritis (KOA), not willing for arthroplasty or having relative contraindications to surgery.

Methods

90 patients (84 available at final follow-up) of Grade IV KOA were given 3 PRP or Normal Saline injections at 1-month interval. Pain and functional assessment was done with Visual analog scale (VAS) and Western Ontario and McMaster universities osteoarthritis index (WOMAC) respectively, at baseline and then at three and six months of follow-up. Both groups were homogenous with similar baseline characteristics.

Results

Both groups showed statistically significant improvements in the outcome scores but only PRP showed minimal clinically important difference (25% in WOMAC and > 2 cm difference of mean in VAS at follow-up). For inter-group comparison, PRP showed better results as there was statistically significant difference in WOMAC at 3 months (Difference = − 9.220, 95% CI = − 13.1945 to − 5.2455, P < 0.0001) and at 6 months (Difference = − 10.360, 95% CI = − 14.5358 to − 6.1842, P < 0.0001). Similar results were seen for VAS also (Difference = − 0.580, 95% CI = − 1.1412 to − 0.0188, P = 0.04 at 3 months, Difference = − 0.870, 95% CI − 1.3993 to − 0.3407, P = 0.001 at 6 months). Outcome scores significantly correlated with age and sex but not with body mass index (BMI).

Conclusion

Serial Intra-articular Injections of autologous PRP mildly improve short-term subjective pain and knee function scores in patients of Grade IV KOA without any major complications.

中文翻译：

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连续富含血小板血浆关节内注射治疗 Kellgren 和 Lawrence IV 级膝关节骨关节炎：一项前瞻性盲法安慰剂对照干预研究

目的

本研究的目的是评估连续关节内 (IA) 富血小板血浆 (PRP) 注射是否可以改善 Kellgren–Lawrence (K–L) IV 级原发性膝骨关节炎 (KOA) 患者的疼痛和功能，但不愿意进行关节置换术或有相对手术禁忌症。

方法

90 例（最终随访时有 84 例）IV 级 KOA 患者接受 3 次 PRP 或生理盐水注射，间隔 1 个月。在基线以及三个月和六个月的随访中分别使用视觉模拟量表（VAS）和西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）进行疼痛和功能评估。两组均具有相似的基线特征。

结果

两组的结果评分均显示出统计学上显着的改善，但只有 PRP 显示出最小的临床重要差异（WOMAC 为 25%，随访时 VAS 平均值差异 > 2 cm）。对于组间比较，PRP 显示出更好的结果，因为 WOMAC 在 3 个月时（差异 = − 9.220，95% CI = − 13.1945 至 − 5.2455， P  < 0.0001）和 6 个月时（差异 = − 10.360）存在统计学显着差异。，95% CI = − 14.5358 至 − 6.1842，P  < 0.0001）。VAS 也出现了类似的结果（差异 = − 0.580，95% CI = − 1.1412 至 − 0.0188，3个月时P  = 0.04，差异 = − 0.870，95% CI − 1.3993 至 − 0.3407，6个月时P  = 0.001 ）。结果得分与年龄和性别显着相关，但与体重指数（BMI）无关。

结论

自体 PRP 关节内连续注射可轻度改善 IV 级 KOA 患者的短期主观疼痛和膝关节功能评分，且无任何重大并发症。