Objective: Platelet-rich plasma (PRP) can enhance the chondrocyte proliferation and repair of cartilage defects. To explore the safety and efficacy of intra-knee-articular injection of PRP to treat knee articular cartilage degeneration by comparing with injecting sodium hyaluronate (SH).
Methods: Thirty consecutive patients (30 knees) with knee articular cartilage degeneration were selected between January 2010 and June 2010. According to different injections, 30 patients were randomly divided into PRP group (test group, n = 15) and SH group (control group, n = 15). There was no significant difference in gender, age, body mass index, and Kellgren-Lawrence grade between 2 groups (P > 0.05). Test group received 3.5 mL of PRP intra-knee-articular injections while control group received 2 mL of SH during the same time period. Both treatments were administered in series of 3 intra-knee-articular injections at 3-week intervals. Then, adverse reactions were recorded. International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were used for evaluation of treatment results.
Results: The patients of 2 groups were followed up 6 months. There were significant differences in IKDC score, WOMAC score, and Lequesne index between pre- and post-injection in 2 groups (P < 0.05); no significant difference was found between different time points (3, 4, and 6 months) in test group (P > 0.05), while significant differences were found between the postoperative 6th month and the postoperative 3rd and 4th months in control group (P < 0.05). There was no significant difference in IKDC score, WOMAC score, and Lequesne index between 2 groups within 4 months (P > 0.05), but the effectiveness of test group was significantly better than that of control group at 6 months after injection (P < 0.05). Adverse reactions occurred in 12 patients (31 injections) of test group and in 12 patients (30 injections) of control group. No significant difference in onset time, termination time, and duration of adverse reactions were found between 2 groups (P > 0.05).
Conclusion: Intra-knee-articular injection of PRP to treat knee articular cartilage degeneration is safe, which can alleviate symptoms of pain and swelling and improve the quality of life of patients; however, further data of large samples and long-term follow-up are needed to confirm the safety and effectiveness.