Curative effect of platelet-rich plasma in treatment of knee osteoarthritis and influences on serum cytokines levels

doi:10.3877/cma.j.issn.1674-134X.2020.02.002

Abstract

Abstract:

Objective

To observe the curative effect of platelet rich plasma (PRP)intra-articular injection in the treatment of knee osteoart-hritis and the effect of serum interleukin (IL)- 1β、IL-6, matrix metalloprotein(MMP) -9 , MMP-13, tumor necrosis factor - α(TNF-α )level.

Methods

A total of 80 patients with knee osteoarthritis of grade Ⅱ and Ⅲ (Kellgren-Lawrence classification)were assigned to the platelet-rich plasma(PRP)and sodium hyaluronate(SH) group according to the date of consultation, 38 cases in SH group and 39 cases in PRP group had got the complete follow-up. Both the two groups adopted intra-articular injection.All the patients were prospectively evaluated before the treatment and at the third, sixth and 12th month after the treatment by the visual analogue scale(VAS) scores , the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and the X-ray score of the knee.The changes of serum IL-1β、IL-6、MMP- 9、MMP-13、TNF-α were observed by enzyme-linked immunosorbent assay (ELISA). Between the two groups serum cytokines levels were compared using t test at each time point, within the groups the levels were compared by repeated measures analysis of variance.

Results

Among the 80 patients, 77 were followed up, 39 in PRP group, 38 in SH group. At the three, six and 12 months after the treatment, the levels of the cytokines, VAS, WOMAC and the X-ray scores of the PRP group were lower than before. There were significant differences between the two groups (t=1.14, 4.673, 0.410, 9.852, 7.845, 12.03, 6.108, 11.66, 11.34, 13.89, 9.779, 15.83, 13.71, 28.84, 7.182, 27.76, all P<0.05) .At the three, six and 12 months after the treatment, there was no significant change ofcytokinesand the X-ray score of the SH groups (t=-5.316, -10.943, -9.804, -9.554, -11.829, -14.256, -11.664, -10.259, -13.732, -12.837, -15.708, -12.919, -28.607, -20.693, -27.623, -23.344, all P>0.05) .No serious adverse event was detected in the two groups. According to the follow-up evaluations, both the groups presented clinical improvements at three months after the treatment.(P<0.05). The improvement of all above indexes in PRP group were more significant than those in SH group at the six and 12 months after the treatment (P<0.05).

Conclusion

PRP intra-articular injection has similar short-term effect compared with SH, while after six or 12 months of treatment, the clinical effect of PRP with superior pain relief is better than SH.

Key words: Knee osteoarthritis, Platelet-rich plasma, Tumor necrosis factor, Interleukin, Matrix metalloproteinase

Jiasen Zeng, Yaqin Zhang, Liang Zhou, Wanchang Lin, Hongbin Chen, Jianping Zhang, Zhibiao Chen, Weizhen Xu, Yumin Huang, Weichang Lin, Chaoxian Chen. Curative effect of platelet-rich plasma in treatment of knee osteoarthritis and influences on serum cytokines levels[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(02): 137-143.

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References 27

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组别	例数	男/女	年龄[岁，(±s)]	患肢比例(左/右)	病程(月)
PRP组	39	16/23	53±4	17/22	21±8
SH组	38	16/22	52±4	17/21	21±9
统计值		χ²＝0.01	t ＝1.19	χ²＝0.01	t＝－0.51
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	男/女	年龄[岁，(±s)]	患肢比例(左/右)	病程(月)
PRP组	39	16/23	53±4	17/22	21±8
SH组	38	16/22	52±4	17/21	21±9
统计值		χ²＝0.01	t ＝1.19	χ²＝0.01	t＝－0.51
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	治疗前	治疗后3个月	治疗后6个月	治疗后12个月	F值	P值
PRP组	39	5.3±1.9	3.8±1.1^a	2.8±0.7^ab	3.1±0.6^ab	82	<0.01
SH组	38	5.4±1.7	4.1±1.2^a	3.6±0.8^a	5.1±0.9^a	64	<0.01
t值		－0.102	－0.992	－5.316	－10.943
P值		>0.05	>0.05	<0.01	<0.01

组别	例数	治疗前	治疗后3个月	治疗后6个月	治疗后12个月	F值	P值
PRP组	39	5.3±1.9	3.8±1.1^a	2.8±0.7^ab	3.1±0.6^ab	82	<0.01
SH组	38	5.4±1.7	4.1±1.2^a	3.6±0.8^a	5.1±0.9^a	64	<0.01
t值		－0.102	－0.992	－5.316	－10.943
P值		>0.05	>0.05	<0.01	<0.01

组别	例数	治疗前	治疗后3个月	治疗后6个月	治疗后12个月	F值	P值
PRP组	39	48±5	25±5^a	19±5^ab	23±6^ab	1 666	<0.01
SH组	38	48±6	25±5^a	31±6^a	36±7^a	913	<0.01
t值		0.502	－0.380	－9.804	－9.554
P值		>0.05	>0.05	<0.01	<0.01

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