Clinical Efficacy of Intra-Articular Injection with P-PRP Versus that of L-PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial.
Clinical Efficacy of Intra-Articular Injection with P-PRP Versus that of L-PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial.
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DOI：
10.1111/os.13643
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发表时间：
2023-03
影响因子：
2.1
通讯作者：
Wang, Song
中科院分区：
文献类型：
--
作者：
Zhou, Yiqin;Li, Haobo;Cao, Shiqi;Han, Yaguang;Shao, Jiahua;Fu, Qiwei;Wang, Bo;Wu, Jun;Xiang, Dong;Liu, Ziye;Wang, Huang;Zhu, Jun;Qian, Qirong;Yang, Xiaolei;Wang, Song
富血小板血浆（PRP）具有不同浓度的白细胞，可能导致软骨病变治疗的不同效果。到目前为止，目前的研究还没有提供足够的证据。为了评估关节内注射纯富血小板血浆（P - PRP）与白细胞富血小板血浆（L - PRP）治疗膝关节软骨病变的临床疗效和安全性，我们进行了一项双盲、随机对照临床试验，样本量大，随访时间长。2019年10月至2020年10月，95例患者被邀请参加我们的研究，其中60例（63.2%）被随机分为P - PRP组（n = 30）或L - PRP组（n = 30）。两组患者均在膝关节关节内注射P - PRP或L - PRP。术前、干预后6周、12周、6个月和12个月对独立样本采用非配对t检验评估视觉模拟量表（VAS）和西安大略大学和麦克马斯特大学关节炎指数（WOMAC）评分。我们随访了P - PRP组27例，L - PRP组26例。干预前两组VAS评分、WOMAC评分比较，差异均无统计学意义（p < 0.05）。干预后6周，P - PRP组的WOMAC疼痛和VAS - motion评分显著低于L - PRP组（P < 0.05）。虽然两种注射的长期临床疗效相似且在12个月后减弱，但在L - PRP组发现了更多的不良事件。短期结果表明，两组患者在减轻膝关节软骨病变患者疼痛和改善功能方面有积极作用。虽然P - PRP注射液在术后康复早期表现出较好的临床疗效，不良事件较少，但12个月后的长期随访显示相似且疗效减弱。ChiCTR1900026365。2019年10月3日报名，网址：http://www.chictr.org.cn/showproj.aspx?proj=43911。为了评估关节内注射纯富血小板血浆（P - PRP）与白细胞富血小板血浆（L - PRP）治疗膝关节软骨病变的临床疗效和安全性，我们进行了一项双盲、随机对照临床试验，样本量大，随访时间长。2019年10月至2020年10月，95例患者被邀请参加我们的研究，其中60例（63.2%）被随机分为P - PRP组（n = 30）或L - PRP组（n = 30）。两组患者均在膝关节关节内注射P - PRP或L - PRP。术前、干预后6周、12周、6个月和12个月分别评估VAS和WOMAC评分。我们研究的短期结果令人鼓舞，并表明L - PRP和P - PRP关节内注射均可减轻膝关节软骨病变患者的疼痛并改善其功能。与L - PRP注射液相比，P - PRP注射液（具有较低的早期白细胞炎症风险）在术后康复早期表现出更好的临床疗效，导致较少的不良事件。然而，两种注射的长期临床疗效相似，在12个月后减弱。
Platelet‐rich plasma（PRP), with different concentration of leukocytes, may lead to varying effects in the treatment of cartilage lesions. So far, current research has not shown enough evidence on this. To evaluate the clinical efficacy and safety of intra‐articular injection with pure platelet‐rich plasma (P‐PRP) versus those of leukocyte platelet‐rich plasma (L‐PRP) in treating knee cartilage lesions, we conducted a double‐blind, randomized controlled clinical trial with a larger sample and longer follow‐up period. From October 2019 to October 2020, 95 patients were invited to participate in our study, and 60 (63.2%) were randomized to P‐PRP (n = 30) or L‐PRP (n = 30) groups. Patients from the two groups were treated with knee intra‐articular injections of P‐PRP or L‐PRP. Visual analog scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were assessed using an unpaired t‐test for independent samples preoperatively and at 6 weeks, 12 weeks, 6 months, and 12 months after intervention. We followed up 27 cases in the P‐PRP group and 26 cases in the L‐PRP group. No significant differences in VAS and WOMAC scores were found between the two groups before the intervention (p > 0.05). The WOMAC Pain and VAS‐Motions scores of the P‐PRP group were significantly lower than those of the L‐PRP group at 6 weeks after the intervention (p < 0.05). While the long‐term clinical efficacy of both injections was similar and weakened after 12 months, more adverse events were found in the L‐PRP group. The short‐term results demonstrate a positive effect in reducing pain and improving function in patients with knee cartilage lesions in the two groups. While the P‐PRP injection showed better clinical efficacy in the early phase of postoperative rehabilitation and resulted in fewer adverse events, long‐term follow‐up showed similar and weakened efficacy after 12 months. ChiCTR1900026365. Registered on October 3, 2019, http://www.chictr.org.cn/showproj.aspx?proj=43911. To evaluate the clinical efficacy and safety of intra‐articular injection with pure platelet‐rich plasma (P‐PRP) versus those of leukocyte platelet‐rich plasma (L‐PRP) in treating knee cartilage lesions, we conducted a double‐blind, randomized controlled clinical trial with a larger sample and longer follow‐up period. From October 2019 to October 2020, 95 patients were invited to participate in our study, and 60 (63.2%) were randomized to P‐PRP (n = 30) or L‐PRP (n = 30) groups. Patients from the two groups were treated with knee intra‐articular injections of P‐PRP or L‐PRP. VAS and WOMAC scores were assessed preoperatively and at 6 weeks, 12 weeks, 6 months, and 12 months after intervention. The short‐term results of our study are encouraging and demonstrate that both L‐PRP and P‐PRP intra‐articular injections reduce pain and improve function in patients with knee cartilage lesions. Compared with the L‐PRP injection, the P‐PRP injection (which had a lower risk of early inflammation caused by leukocytes) showed better clinical efficacy in the early phase of postoperative rehabilitation and resulted in fewer adverse events. However, long‐term clinical efficacy for both injections were similar and weakened after 12 months.
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