| Background:Chondromalacia patellae（CP）is one of the common causes of anterior knee pain in young adults,which can lead to a decrease in the level of exercise and seriously affect the quality of life of patients.Non-operative treatment is the main treatment of early CP,among which exercise therapy is recommended as the first choice for CP.In recent years,studies have found that Platelet-rich plasma（PRP）can effectively treat CP,but there is few reports on the treatment of CP with PRP combined with exercise therapy.It is also unclear whether there is a difference in the efficacy of exercise therapy alone and PRP combined with exercise therapy in the treatment of CP,which is worthy of further investigation.Objective:Observe and analyze the knee joint score and knee MRI in the treatment of chondromalacia patella with simple exercise therapy and platelet-rich plasma combined with exercise therapy,and comprehensively compare the efficacy of the two treatment schemes in the treatment of chondromalacia patellae.Methods:From January 2020 to August 2021,40 patients（60 knees）who went to The First Affiliated Hospital of Dali University for CP were analyzed retrospectively.According to the different treatment schemes,they are divided into: 1.20 cases（30knees）in the control group were treated with exercise therapy alone;2.20 cases（30knees）in the experimental group were treated with PRP combined with exercise therapy.By comparing the Lysholm knee score,Kujala anterior knee pain score,KOOS score,and patellar cartilage MRI changes before treatment and 1 month,3 months,and 6months of treatment,comprehensively evaluate the efficacy of the two treatments in each stage.Results:All 40 patients participated in the whole process of systemic treatment and completed follow-up at each stage.In the control group,the Lysholm knee score increased from 50.2±5.6 before treatment to 77.6±4.2 at the last follow-up（P<0.05）.and the Kujala anterior knee pain score increased from 52.6±7.0 before treatment to80.3±3.9 at the last follow-up（P<0.05）.The scores of KOOS subscale "pain","symptoms","activities of daily living","sports and entertainment ability" and "quality of life related to knee joint" increased from 55.7±4.3、66.3±6.7、56.6±3.9、31.7±7.9、35.5±7.2 before treatment to 86.4±5.9、85.8±4.9、88.3±3.4、53.8±8.4、56.2±5.8 at the last follow-up（P<0.05）.In the experimental group,the Lysholm knee joint score increased from 49.7±6.3 before treatment to 89.2±2.8 at the last follow-up（P<0.05）,and the Kujala anterior knee joint pain score increased from 51.8±7.9 before treatment to 91.0±2.9 at the last follow-up（P<0.05）.The scores of KOOS subscale "pain","symptoms","activities of daily living","sports and entertainment ability" and "quality of life related to knee joint" increased from 54.8±3.2、65.1±6.8、55.5±3.4、30.8±7.0、35.2±7.4 before treatment to 88.0±3.4、87.2±4.9、89.4±2.7、65.8±9.7、68.0±10.1 at the last follow-up（P<0.05）.Comparison between the two groups,the experimental group scored higher than the control group on the three kinds of scoring scale in each follow-up stage.The differences of Lysholm knee score,Kujala anterior knee pain score,KOOS’s "sports and recreational ability" and "knee related quality of life" were statistically significant at 1,3 and 6 months of treatment（P<0.05）.The differences in scores of the KOOS’s "pain","symptoms" and "ability of daily living activities" were statistically significant at 1 and 3 months of treatment（P<0.05）,but there was no significant difference at 6 months after treatment（P>0.05）.In addition,the MRI manifestations of patella cartilage in the experimental group in 6 months of treatment were also improved significantly compared with those before treatment.Conclusion:1.Exercise therapy alone and PRP combined with exercise therapy had satisfactory short-term and medium-term effects on CP.2.Compared with exercise therapy alone,PRP combined with exercise therapy can quickly and effectively relieve pain and improve the movement level of knee joint. |
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