Background

The role of subchondral bone as a key mediator in pathogenesis of osteoarthritis (OA) is emerging and various injectable modalities are being tried to address the subchondral pathology. Intraosseous (IO) infiltrations of PRP is biological way of addressing the pathology. This review aimed to explore the role of IO PRP in OA knees.

Methods

A systematic literature search was conducted on the electronic databases of PubMed, Embase, Scopus, Web of Science and Ovid for relevant articles on IO PRP with a predefined search strategy. Data from eligible studies were extracted and was analyzed.

Results

There were only five studies on the study topic which included 112 patients (112 knees) who received IO PRP injection. IO PRP was associated with significant improvements in VAS, KOOS and WOMAC scores. The most commonly reported complication was pain at injection site. Meta-analysis revealed that combined intraarticular (IA) and IO PRP were associated with significantly better WOMAC scores, compared to only IA PRP. However, VAS and KOOS scores were equivocal.

Conclusion

IO PRP infiltration for OA knees is safe and effective and results in improved patient-reported outcome scores based on the current limited literature. However, its added advantage over only IA PRP is not well established and clear due to limited available published data.

中文翻译：

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富含血小板血浆治疗膝骨关节炎的骨内浸润：文献系统回顾和有限荟萃分析

背景

软骨下骨作为骨关节炎（OA）发病机制中关键介质的作用正在显现，并且正在尝试各种注射方式来解决软骨下病理学问题。PRP 骨内 (IO) 浸润是解决病理学问题的生物学方法。本综述旨在探讨 IO PRP 在 OA 膝关节中的作用。

方法

使用预定义的检索策略，在 PubMed、Embase、Scopus、Web of Science 和 Ovid 的电子数据库上对 IO PRP 的相关文章进行了系统的文献检索。提取并分析了合格研究的数据。

结果

关于该研究主题的研究只有 5 项，其中包括接受 IO PRP 注射的 112 名患者（112 个膝盖）。IO PRP 与 VAS、KOOS 和 WOMAC 评分的显着改善相关。最常见的并发症是注射部位疼痛。荟萃分析显示，与仅使用 IA PRP 相比，联合关节内 (IA) 和 IO PRP 与显着更好的 WOMAC 评分相关。然而，VAS 和 KOOS 评分是模棱两可的。

结论

根据目前有限的文献，IO PRP 浸润治疗 OA 膝关节是安全有效的，并且可以改善患者报告的结果评分。然而，由于可用的已发表数据有限，其相对于 IA PRP 的额外优势尚未得到充分证实和明确。