Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis

IF 1.5 Q3 ORTHOPEDICS

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-10-01 DOI:10.1016/j.asmart.2024.09.006

Kohei Kamada , Takehiko Matsushita , Takahiro Yamashita , Tomoyuki Matsumoto , Hideki Iwaguro , Ryosuke Kuroda , Satoshi Sobajima

{"title":"Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis","authors":"Kohei Kamada , Takehiko Matsushita , Takahiro Yamashita , Tomoyuki Matsumoto , Hideki Iwaguro , Ryosuke Kuroda , Satoshi Sobajima","doi":"10.1016/j.asmart.2024.09.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).</div></div><div><h3>Methods</h3><div>This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). A linear mixed-effects model was employed with ΔVAS as a random effect and age, sex, BMI, KL classification, pre-treatment VAS, treatment duration, and the number of PRP injections as fixed effects. Evaluations using the Kellgren-Lawrence (KL) classification were added.</div></div><div><h3>Results</h3><div>Age, KL grade, and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.</div></div><div><h3>Conclusions</h3><div>Age, pain before treatment, KL grade and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage KOA.</div></div><div><h3>Trial registration</h3><div>Retrospectively registration.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"38 ","pages":"Pages 43-48"},"PeriodicalIF":1.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214687324000244","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).

Methods

This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). A linear mixed-effects model was employed with ΔVAS as a random effect and age, sex, BMI, KL classification, pre-treatment VAS, treatment duration, and the number of PRP injections as fixed effects. Evaluations using the Kellgren-Lawrence (KL) classification were added.

Results

Age, KL grade, and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.

Conclusions

Age, pain before treatment, KL grade and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage KOA.

Trial registration

Retrospectively registration.

查看原文本刊更多论文

影响多次关节内注射富血小板血浆治疗膝关节骨关节炎疗效的因素

背景血小板-血浆（PRP）作为膝关节骨性关节炎（KOA）的一种保守治疗方法正在迅速推广，然而其疗效却存在争议。本研究旨在探讨影响接受多次PRP注射（PRP-I）患者关节内PRP治疗KOA疗效的因素。方法这是一项历史队列研究，纳入了2018年至2020年期间接受PRP-I治疗KOA的701例患者的1057个膝关节。PRP-I前后视觉模拟量表（VAS）评分的差异被定义为VAS的变化量（ΔVAS）。采用线性混合效应模型，ΔVAS 为随机效应，年龄、性别、体重指数、KL 分级、治疗前 VAS、治疗持续时间和 PRP 注射次数为固定效应。结果年龄、KL分级、治疗前以及三、四、五次PRP-I后的VAS评分与ΔVAS评分显著相关。根据 KL 分级，KL 4 级组的年龄与ΔVAS 评分明显相关。治疗前的 VAS 评分与ΔVAS 评分明显相关，与 KL 分级无关。在 KL 1 级和 2 级组中，三次 PRP-I 与ΔVAS 显著相关。结论年龄、治疗前疼痛、KL分级和注射次数与关节内PRP-I治疗KOA后疼痛减轻有关。如果患者年龄较小或治疗前疼痛剧烈，则注射 PRP-I 后疼痛有望减轻。建议对早期 KOA 患者进行三次 PRP-I 治疗以减轻疼痛，对晚期 KOA 患者进行三次以上的 PRP-I 治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Multiple-

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

98 days

期刊介绍： The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.