Abstract：
OBJECTIVE: The aim of this consensus was to develop evidence- and expert-based patient-focused recommendations on the appropriateness of intra-articular platelet-rich plasma (PRP) injections in different clinical scenarios of patients with knee osteoarthritis (OA).
METHODS: The RAND/UCLA Appropriateness Method was used by the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA), as well as the International Cartilage Regeneration and Joint Preservation Society (ICRS) to reach a consensus and produce recommendations for specific patient categories combining best available scientific evidence with the collective judgement of a panel of experts.
RESULTS: Scenarios were defined based on first treatment vs first injective treatment vs second injective treatment, age (<50/50-65/66-80/>80), tibiofemoral vs patellofemoral involvement, OA level (Kellgren-Lawrence/KL 0-I/II-III/IV), and joint effusion (dry knee, minor-mild or major effusion). Out of 216 scenarios, in 84 (38.9%) the indication was considered appropriate, in 9 (4.2%) inappropriate and in 123 (56.9%) uncertain. The parameters associated with the highest consensus were PRP use after failed injective treatments (62.5%), followed by PRP after failed conservative treatments and KL 0-III scenarios (58.3%), while the highest uncertainty was found for PRP use as first treatment and KL IV OA (91.7% and 87.5% of uncertain scenarios, respectively).
CONCLUSIONS: This ESSKA-ICRS consensus established recommendations on the appropriateness or inappropriateness of PRP injections for the treatment of knee OA, providing a useful reference for clinical practice. PRP injections are considered appropriate in patients aged ≤80 years with knee KL 0-III OA grade after failed conservative non-injective or injective treatments, while they are not considered appropriate as first treatment nor in KL IV OA grade.
METHODS: Level I.
METHODS: The RAND/UCLA Appropriateness Method was used by the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA), as well as the International Cartilage Regeneration and Joint Preservation Society (ICRS) to reach a consensus and produce recommendations for specific patient categories combining best available scientific evidence with the collective judgement of a panel of experts.
RESULTS: Scenarios were defined based on first treatment vs first injective treatment vs second injective treatment, age (<50/50-65/66-80/>80), tibiofemoral vs patellofemoral involvement, OA level (Kellgren-Lawrence/KL 0-I/II-III/IV), and joint effusion (dry knee, minor-mild or major effusion). Out of 216 scenarios, in 84 (38.9%) the indication was considered appropriate, in 9 (4.2%) inappropriate and in 123 (56.9%) uncertain. The parameters associated with the highest consensus were PRP use after failed injective treatments (62.5%), followed by PRP after failed conservative treatments and KL 0-III scenarios (58.3%), while the highest uncertainty was found for PRP use as first treatment and KL IV OA (91.7% and 87.5% of uncertain scenarios, respectively).
CONCLUSIONS: This ESSKA-ICRS consensus established recommendations on the appropriateness or inappropriateness of PRP injections for the treatment of knee OA, providing a useful reference for clinical practice. PRP injections are considered appropriate in patients aged ≤80 years with knee KL 0-III OA grade after failed conservative non-injective or injective treatments, while they are not considered appropriate as first treatment nor in KL IV OA grade.
METHODS: Level I.
摘要：
目的：本共识的目的是针对膝关节骨性关节炎（OA）患者不同临床情况下关节内注射富血小板血浆（PRP）的适当性，制定以患者为中心的循证和专家建议。
方法：欧洲运动创伤学会使用了RAND/UCLA适当性方法，膝盖手术,和关节镜（ESSKA），以及国际软骨再生和联合保存协会（ICRS）达成共识，并针对特定患者类别提出建议，结合现有最佳科学证据和专家小组的集体判断。
结果：方案的定义是基于第一次治疗、第一次注射治疗和第二次注射治疗，年龄（<50/50-65/66-80/>80），胫骨股与髌股受累，OA水平（Kellgren-Lawrence/KL0-I/II-III/IV），和关节积液(干燥的膝盖，轻度或重度积液）。在216个场景中，在84例（38.9%）中，适应症被认为是适当的，9例（4.2%）不适当，123例（56.9%）不确定。与最高共识相关的参数是注射治疗失败后使用PRP（62.5％），其次是保守治疗失败后的PRP和KL0-III方案(58.3%)，虽然PRP用作首次治疗和KLIVOA的不确定性最高(91.7%和87.5%的不确定方案，分别)。
结论：本ESSKA-ICRS共识确立了PRP注射治疗膝关节OA的适当性或不适当性的建议，为临床实践提供了有益的参考。PRP注射被认为适合于年龄≤80岁且膝关节KL0-IIIOA等级在保守非注射或注射治疗失败后的患者。虽然它们不被认为适合作为首次治疗，也不适合KLIVOA等级。
方法：一级
方法：欧洲运动创伤学会使用了RAND/UCLA适当性方法，膝盖手术,和关节镜（ESSKA），以及国际软骨再生和联合保存协会（ICRS）达成共识，并针对特定患者类别提出建议，结合现有最佳科学证据和专家小组的集体判断。
结果：方案的定义是基于第一次治疗、第一次注射治疗和第二次注射治疗，年龄（<50/50-65/66-80/>80），胫骨股与髌股受累，OA水平（Kellgren-Lawrence/KL0-I/II-III/IV），和关节积液(干燥的膝盖，轻度或重度积液）。在216个场景中，在84例（38.9%）中，适应症被认为是适当的，9例（4.2%）不适当，123例（56.9%）不确定。与最高共识相关的参数是注射治疗失败后使用PRP（62.5％），其次是保守治疗失败后的PRP和KL0-III方案(58.3%)，虽然PRP用作首次治疗和KLIVOA的不确定性最高(91.7%和87.5%的不确定方案，分别)。
结论：本ESSKA-ICRS共识确立了PRP注射治疗膝关节OA的适当性或不适当性的建议，为临床实践提供了有益的参考。PRP注射被认为适合于年龄≤80岁且膝关节KL0-IIIOA等级在保守非注射或注射治疗失败后的患者。虽然它们不被认为适合作为首次治疗，也不适合KLIVOA等级。
方法：一级
