| Background and objective:Knee osteoarthritis(KOA)is a degenerative disease characterized by pain and dysfunction.There is a growing literature on the need to minimize local pain in early KOA patients and delay total knee replacement.Currently KOA treatment can only temporary improvement function,alleviate limb pain,short-term effect is satisfactory,but the effect and safety of still being questioned,internal and external factors such as fatigue,treatment will affect the treatment effect of exercise therapy,other studies confirm the acetaminophen for pain and function improvement,and corticosteroids may cause damage to the articular cartilage.China has a large population,and with the increasing incidence of KOA and the trend of getting younger,this problem deserves more attention from us.Therefore,the exploration of safe,effective and standardized non-surgical treatment of KOA is still a key issue in clinical practice and scientific research.Platelet-rich plasma(PRP)is produced from autologous venous blood and is centrifuged into a concentrate where the number of platelets is higher than the baseline blood level.PRP is widely used in various fields because it contains high concentrations of platelets and growth factors(GFs).There is evidence that PRP can well relieve the discomfort of early KOA symptoms,but there are still many views on the clinical application and efficacy of PRP,and there is a lack of clarity on the optimal number of treatments for PRP and the ideal treatment for all stages from cartilage injury to late KOA.At present,PRP is widely used in clinical practice.In order to better benefit patients,it has become a concern for us to explore the optimal injection frequency.Therefore,we discussed the effect of injection frequency of ultrasonic-guided PRP precise injection on the efficacy of the treatment of grade II and III knee osteoarthritis on the optimal treatment mode of KOA.Methods:In this study,90 patients who met the inclusion criteria in the outpatient and inpatient wards of the rehabilitation department of henan people's hospital from October 2018 to October 2019 were included.Group A,group B and group C were divided by random number table method.A group were given 1 time of platelet-rich plasma injection,B group were treated with three injections of platelet-rich plasma and five C group were treated with five injections of platelet rich plasma.30 cases in each group,once a week.Seven patients fell out and 83 completed the study throughout treatment and follow-up.VAS score,WOMAC score and AKS score were used to evaluate knee pain and function before treatment,6 weeks after treatment,12 weeks after treatment,24 weeks after treatment.And the treatment effect of different groups was evaluated according to the ultrasound images before treatment and 6 months after treatment.Results:Scores of the 3 groups after treatment[After 6 weeks,the VAS scores in A,B and C group were(3.52±0.80)points,(2.32±0.82)points and(2.14±1.11)points,respectively.WOMAC scores were(106.30±16.61)points,(82.57±19.72)points and(73.93±19.25)points,respectively.AKS scores were:(122.00±9.13)points,(163.00±12.26)points and(169.07±5.99)points,respectively.After 12 weeks,the VAS scores in A,B and C group were(4.30±0.95)points,(2.21±0.74)points and(1.82±0.77)points,respectively.WOMAC score were(113.07±17.33)points,(81.11±19.53)points and(71.36±17.87)points,respectively.AKS scores were(112.78±15.55)points,(165.82±12.03)points and(171.25±6.73)points,respectively.After 24 weeks,VAS scores in A,B and C group were(5.30±0.91)points,(2.14±0.80)points and(1.79±0.63)points,respectively.WOMAC scores were(141.59±28.96)points,(79.61±17.83)points and(69.50±17.14)points,respectively.AKS scores were(89.78±12.69)points,(168.50±13.18)points and(174.04±7.22)points,respectively].All were better than the scores before treatment in the group[VAS scores in the A group,B group and C group were(6.70±0.91)points,(6.71±0.90)points and(6.71±0.81)points,respectively.WOMAC scores were :(159.89±27.44)points,(170.86±19.49)points and(170.00±14.67)points,respectively.AKS scores were(84.37±10.04)points,(83.86±10.54)points and(84.11±11.20)points,respectively].Statistical analysis showed significant difference(P<0.05).The scores of the B and C group were significantly improved compared with the A group(P<0.05).There was no significant difference between the B group and the C group(P>0.05).According to the ultrasonic imaging of the reexamination of knee joint effusion after 24 weeks,the effusion in group A was slightly less than that before treatment,and the articular surface was still rough;the effusion in group B was less than that before treatment,and the articular surface roughness was also improved;the effusion in group C was significantly less than that before treatment,and the articular surface roughness was also improved.Conclusion:Multiple ultrasound-guided PRP treatment of knee osteoarthritis had better efficacy than single PRP treatment,but there was no significant difference in short-term efficacy between 3 and 5 injections. |
PDF Full Text Request