Efficacy of platelet-rich plasma combined with arthroscopic debridement for treatment of knee osteoarthritis

Abstract

Objective To investigate the clinical effects of platelet-rich plasma (PRP) in combination with arthroscopic debridement for moderate knee osteoarthritis. Methods A total of 25 patients with grade two or grade three knee osteoarthritis according to K-L classification, numerical rating scal (NRS) over five, failed treatment with non-operative methods for more than three months were allocated in the treatment group(n=12) or the control group(n=13). In the treatment group, two times of 5 ml of PRP intra-articular injection were performed with four weeks interval. The first time of PRP intra-articular injection was performed during arthroscopy after arthroscopic debridement. In the control group, the patients were only treated with knee arthroscopic debridement. The outcomes were assessed with NRS, Western Ontario and McMaster Universities osteoarthritis index (WOMAC), the Hospital for Special Surgery (HSS) scores, the short form-36 questionnaire of health survey (SF-36) scores at baseline and six months, one year and two years after treatment. Statistical analysis was performed using the SPSS version 17.0. Data of Gaussian distribution were analyzed by ttest (data between treatment and control groups) or analysis of variance (data within group). Categorized data were analyzed using the Chi-square test. Results The scores of NRS and WOMAC of the treatment group at six months, one year and two years after treatment were lower than the control group; the scores of HSS and SF-36 of the treatment group were higher than the control group. In the treatment group, the scores of NRS and WOMAC at six months after treatment decreased from (7.1±1.0), (74.4±11.1) at baseline to (1.3±0.6)(t=13.415, P 0.05), while the scores of WOMAC and SF-36 at two years after treatment were (21.7±2.7)(t=15.517, P 0.05). Conclusions Both the PRP and arthroscopic debridement could reduce pain, restore knee function and improve the life quality of patients with knee osteoarthritis of K-L grade two and three. The PRP combined with arthroscopic debridement may have better and long-term effects of pain reduction, knee function restoration and life quality improvement within two years compared to arthroscopic debridement alone. The effects of the arthroscopic debridement could maintain for only six months. Key words: Platelet-rich plasma; Arthroscopy; Osteoarthritis; Knee; Treatment outcome