Clinical Evaluation Of Platelet-rich Plasma(PRP)in The Treatment Of Patellofemoral Arthritis

Background:Knee Osteoarthritis(KOA)is a common degenerative disease,its pathological features are mainly subchondral osteoplasia and sclerosis,cartilage stripping,synovial aseptic inflammation,with the progress of the disease,the joint is gradually destroyed,deformity,and eventually lead to Knee dysfunction.As a subtype of KOA,Patellofemoral joint osteoarthritis(PFA)also has a high prevalence in elderly people.Due to the lack of blood vessels and nerves,the ability of articular cartilage to repair and heal spontaneously is limited,and the current clinical treatment methods can only achieve a certain degree of symptom relief.With the development of biological therapy,plate-rich plasma(PRP)has come into the field of research.PRP is a plasma with high concentration of platelets isolated from human venous blood,which contains a large number of growth factors and inflammatory regulatory factors,and has the ability to promote chondrocyte regeneration.At present,there are many clinical studies on PRP in the treatment of KOA,and have obtained relatively satisfactory results.However,as a subtype of KOA,there has been a lack of clinical studies on the treatment of PFA by PRP.Therefore,this study aims to explore the role of PRP in the treatment of PFA by comparing the therapeutic effects of intraarticular injection of PRP and Hyaluronic acid(HA).Purpose:By comparing with HA,the clinical efficacy of intra-articular injection of PRP in the treatment of PFA was observed,providing a safe and effective method for the clinical treatment of PFA.Materials and Methods:Sixty patients diagnosed with early and mid-stage PFA were included,and they were divided into 2 groups according to the treatment method:PRP group and HA group.All patients were followed up before treatment and 1,3,6,and 12 months after the first treatment.Observation indicators included three knee function scales:Visual Analog Scale(VAS),International Knee Documentation Committee knee evaluation form(IKDS),Hospital for Special Surgery(HSS)score,and three secondary evaluation indicators:time to walk 30m,time to walk up and down stairs.Results:The knee VAS score,IKDC score and HSS score were improved in both groups at 1,3,6 and 12 months after treatment(p<0.05).Improvements were most pronounced at 3 and 6 months after treatment.However,at the final 12-month follow-up,the scores had deteriorated,but were still better than before treatment.Inter-group comparisons showed that the HA group improved more at the first month after treatment,but there was no statistically significant difference compared with the PRP group(p>0.05).With the extension of time after treatment,the improvement degree of PRP group was more obvious than that of HA group,and the difference was the largest at the last follow-up,which was statistically significant.For sub-measures,although the trend of 30m walking time was generally similar to the knee function score,the improvement in walking time up and down stairs was significantly greater in PRP group than in HA group(p<0.05).Conclusion:Intra-articular injection of PRP in the treatment of early and middle stage PFA can relieve pain,improve symptoms,and improve the joint function and quality of life of patients,especially in the improvement of anterior knee pain,climbing and climbing disorders and other symptoms.