| Objective: Analysing the efficacy and safety of different concentration platelet rich plasma in the treatment of knee osteoarthritis to evaluate the clinical efficacy of platelet rich plasma in the treatment of knee osteoarthritis,and to search the best platelet concentration of clinical platelet rich plasma in the treatment of knee osteoarthritis.Methods: Selected 101 case with the knee osteoarthritis as the research object were selected in the study were randomly divided into control group and experimental group according to random number table method,and the case in the experimental group were randomly divided into A,B,C,D group again according to random number table method.The control group were treated with intra-articular injection of 2ml Sodium Hyaluronate Injection,the experimental group were treated with intra-articular injection of 2ml of platelet rich plasma.Platelet concentration of platelet rich plasma in A group was(900-1500)×10~9/L,B group was(1200-1500)×10~9/L,C group was(1500-1800)×10~9/L,D group was(1800-2100)×10~9/L.And injection of knee joint in the treatment of 5times as a course of treatment.Followed up patient to evaluate of joint function according to the WOMAC score? osteoarthritis index IKDC score ? VAS pain score and evaluate treatment efficiency according to Diagnostic criteria of TCM symptoms before treatment and after treatment in 3,6 and 9 month.Examed liver function and renal function before and after treatment to evaluat the clinical safety of platelet rich plasma in the treatment of knee osteoarthritis.And to explore the clinical appropriate concentration of platelet rich plasma in the treatment of knee osteoarthritis.Results: The comprehensive efficiency of control group were 73.81%after treatment 3 month,and the comprehensive efficiency were 28.57%on the final follow-up.The comprehensive efficiency of experimental group were 83.05% after treatment 3 month,and the comprehensive efficiency were 55.93% on the final follow-up.VAS score of the control group and the treatment group decreased significantly(3.98 + 1.26 and3.27 + 1.70),and increased in the final follow-up(5.29±1.44 and4.06±1.63);but still lower than before treatment.VAS score of experimental group group was better than the control group at each follow-up time point after treatment.The WOMAC score of each group after treatment 3 months decreased obviously(31.05 + 6.55 and 29.44 +5.63),The WOMAC score of control group after treatment 9 months had no significant difference with the score before treatment(44.02 + 11.60),the experimental group was lower than that before treatment(35.98 +9.16),The WOMAC score of experimental group was better than the control group at each follow-up time point after treatment.The IKDC score of the each group after treatment 3 months decreased obviously(64.05 + 11.14 and 6 8.64 + 9.82),The IKDC score of control group after treatment 9 months had no significant difference with the score before treatment(55.43 + 15.59),the experimental group was lower than that before treatment(60.58 + 8.68),The IKDC score of experimental group was better than the control group at each follow-up time point after treatment.The VAS score of different experimental groups decreased the most obviously in C group case after treatment 3 month(2.35 + 1.06)and after treatment 9month(3.53 + 1.42);The WOMAC score of C group improved the most satisfied after treatment 3 month(27.71±5.46)? 6month(24.94±7.68)and after treatment 9month(3.53 + 1.42);The IKDC score of C group decreased the most satisfied after treatment 3month(73.94±9.42)?6 month(66.06±7.17)and after treatment 9month(65.59±8.99).Conclusion: Intra-articular injection of sodium hyaluronate and platelet rich plasma can effectively improve the clinical symptoms of patients with knee osteoarthritis,the latter is better than the former.The mechanism of platelet rich plasma in the treatment of knee osteoarthritis maybe is platelet rich plasma would repair articular cartilage and relieve aseprtic inflammation of Knee joint.At the same time,the effect of platelet rich plasma on patients with knee osteoarthritis was depends on the given doses of platelet concentration to a certain degree,and the most effeciency platelet concentration should be(1500-1800×10~9/L).The routine blood test?liver function and renal function of each case were normal befor and after treatment,all case was no infection,thrombosis and other serious complications.A small number of adverse reactions can be rapid remission.Therefore,it is safe and effective that the treatment of knee osteoarthritis with autologous platelet rich plasma. |
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