Comparison Of PRP Intraosseous Injection And Intra-articular Injection To Treat Patients With Knee Osteoarthritis

Objective:Platelet-rich plasma(PRP)has been a hot spot of research in recent years.This kind of autologous blood product contains high concentration of growth factors,and the application of it has also gradually emerged in knee osteoarthritis.various growth factors in PRP can stimulate the natural healing of cartilage injury sites and accelerate the formation of cartilage tissue.It has been reported that intra-articular injection of PRP can effectively improve joint function,stimulate cartilage growth,promote cartilage matrix synthesis and reduce inflammation in the joint cavity,but this treatment method is not enough to reach subchondral bone.The aim of this study was to compare the effects of intraosseous and intra-articular injection of PRP to treat mild and moderate stages of knee osteoarthritis,and to explore the safety and efficacy of platelet-rich plasma in the treatment of knee osteoarthritis.Methods: According to the random number table method,73 patients who met the inclusion and exclusion criteria were randomly divided into A,B,C group.Patients in group A received midpoint of the femoral trochlear and medial intercondylar eminence of tibial plateau injection of PRP 2 ml respectively.Patients in group B received intral-articular injection of PRP 2ml,Patients in group C received intral-articular combined with midpoint of the femoral trochlear and medial intercondylar eminence of tibial plateau injection of PRP 2 ml respectively.All groups were injected once a week for 5 consecutive times.All patients were evaluated using the Visual Analogue Scale(VAS)and Western Ontario and Mc Master Universities(WOMAC)score before the treatment,after the first injection and at 1,3,6 and 12 months after treatment.Results: The one-way analysis of variance study group had no statistical significance for the VAS score and WOMAC score before treatment,after the first injection treatment,and 1 month after treatment(p> 0.05);at 3 months,6 months,and 12 months after treatment,the VAS score showed a significant level of 0.01,and the difference was statistically significant(F values were 12.908 / 11.969 / 15.550,p values were less than 0.01)The total score of WOMAC score showed a significant level of 0.01,and the difference was statistically significant(F values were 18.008 / 13.939 / 28.815,p values were less than 0.01);According to the LSD analysis,there was no significant difference between group A and group C,but both better than group B.The difference of experimental data in the Student’s t test showed that there was no significant difference in indicators among groups A,B and C after the first injection(p>0.05).The indexes at 1,3,6 and 12 month after treatment were all better than those before treatment,with statistically significant difference(p<0.05).Conclusion:1.Intraosseous injection,intra-articular injection and intra-articular injection combined with intra-articular injection of platelet-rich plasma can effectively relieve the clinical symptoms of mild and moderate KOA and improve the quality of life.2.The effect of intraosseous injection and intraosseous combined articular injection after 3 months is better than simple articular injection.3.There was no significant difference in the efficacy between intraosseous injection and intraosseous combined articular injection.Therefore,platelet-rich plasma intraosseous injection in the treatment of knee osteoarthritis is economical,safe and effective.