To investigate the clinical efficacy of shock wave combined with platelet-rich plasma(PRP)following arthroscopic microfractures treatment on osteoarthritis patients with medial condylar cartilage injury.

In accordance with the 2018 Chinese Medical Orthopedic Osteoarthritis Standards, outpatient patients with medial condyle cartilage injury and age over 45 years were included. Exclusion criteria were: patients with knee valgus deformity or narrowing lateral space of knee, cartilage damage in the lateral compartment of the knee during knee arthroscopy, autoimmune disease arthritis, ligament injury inside knee joint cavity, coagulopathy and hematologic disorders, severe cardio- and cerebrovascular diseases and poor compliance, history of knee surgery. Arthroscopic micro-fractures in the cartilage injury area was performed, and shock waves combined with platelet-rich plasma were given after surgery. The clinical symptoms and functional improvement of patients before and after treatment were evaluated by visual analogue scale(VAS), Lequesne index, the Western Ontario & McMaster Universities osteoarthritis index(WOMAC )and gait analysis. The data were analyzed by analysis of variance and LSD-t test.

VAS pain scores, Lequesne scores, and WOMAC scores at two months after surgery improved remarkably compared with those before surgery(t=20.35, 23.39, 27.49, all P<0.05). The pain, function and stiffness scores in WOMAC scores were also significantly lower than those at preoperative (t=10.44, 8.00, 19.96, all P<0.05). VAS pain scores, Lequesne scores, and WOMAC scores at the three months after surgery were significantly lower than the data before operation(t=16.76, 27.38, 40.98, all P<0.05)and data of two months after operation(t=6.27, 11.52, 24.76, all P<0.05). VAS pain scores, Lequesne scores, and WOMAC scores were significantly lower at postoperative six months than the data before operation(t=-17.97, 18.82, -33.65, all P<0.05)and data of two months(t=-7.1, -7.7, -28.56, all P<0.05)and three months after operation (t=-3.19, -1.68, -6.99, all P<0.05). The stride rate at two, three and six months after surgery significantly improved compared with the rate before surgery (t=5.26, 52.66, 32.52, all P<0.05). The step length at two and three months after surgery were significantly longer than those before surgery (t=34.68, 8.81, P<0.05). The step length at postoperative six month also significantly improved compared with those before operation at two months and three months after operation (t=13.22, 9.17, 2.54, P<0.05). The stride length at three months after surgery was significantly higher than that at two months after surgery (t=33.94、18.82P<0.05). The stride length obviously increased at six months compared with the data before operation and the data of two months after operation (t=18.39, 13.98, P<0.05).

Shock wave combined with PRP can effectively relieve pain and improve function in knee osteoarthritis patients with medial femoral condylar cartilage injury after arthroscopic microfractures, which is worthy of further clinical research.