Abstract：
OBJECTIVE: Platelet-rich plasma (PRP) is an emerging biological intervention for osteoarthritis (OA), yet the outcomes remain uncertain. The purpose of this study was to review current literature regarding the use of PRP for knee and hip OA.
RESULTS: Recent systematic reviews have found significant clinical improvements in outcomes after the administration of PRP compared to hyaluronic acid (HA) in patients with knee OA. One of these reviews included bone marrow aspirate concentrate (BMAC) as a comparison group and found no significant differences in outcomes between PRP and BMAC. Currently, the literature is lacking on whether leukocyte-rich or leukocyte-poor PRP is superior in patients with knee OA. The literature on PRP for hip OA has not provided consistent results as it has for the knee. Two recent systematic reviews evaluated RCTs for patients undergoing treatment with either PRP or HA for hip OA and found no significant differences in clinical outcomes between groups at final follow-up. Current literature regarding the association between OA grade and PRP efficacy has found varying results. The use of PRP injections in the treatment of knee OA appears to be favorable, resulting in clinically comparable or superior outcomes compared to other injection treatments. However, the clinical efficacy of PRP injections in hip OA is far less consistent. Evidence is lacking to suggest that the presence of leukocytes significantly influences clinical outcomes. Further randomized controlled trials on larger cohorts, with longer follow-up, and with comparable formulations are required before recommendations can be made regarding use of PRP for hip OA, the effect of leukocyte concentration, and clinical efficacy based on OA grade.
RESULTS: Recent systematic reviews have found significant clinical improvements in outcomes after the administration of PRP compared to hyaluronic acid (HA) in patients with knee OA. One of these reviews included bone marrow aspirate concentrate (BMAC) as a comparison group and found no significant differences in outcomes between PRP and BMAC. Currently, the literature is lacking on whether leukocyte-rich or leukocyte-poor PRP is superior in patients with knee OA. The literature on PRP for hip OA has not provided consistent results as it has for the knee. Two recent systematic reviews evaluated RCTs for patients undergoing treatment with either PRP or HA for hip OA and found no significant differences in clinical outcomes between groups at final follow-up. Current literature regarding the association between OA grade and PRP efficacy has found varying results. The use of PRP injections in the treatment of knee OA appears to be favorable, resulting in clinically comparable or superior outcomes compared to other injection treatments. However, the clinical efficacy of PRP injections in hip OA is far less consistent. Evidence is lacking to suggest that the presence of leukocytes significantly influences clinical outcomes. Further randomized controlled trials on larger cohorts, with longer follow-up, and with comparable formulations are required before recommendations can be made regarding use of PRP for hip OA, the effect of leukocyte concentration, and clinical efficacy based on OA grade.
摘要：
目的：富血小板血浆（PRP）是骨关节炎（OA）的新兴生物干预措施，然而结果仍然不确定。这项研究的目的是回顾有关PRP用于膝关节和髋关节OA的最新文献。
结果：最近的系统评价发现，与透明质酸（HA）相比，在膝关节OA患者中，PRP给药后的临床结局显着改善。其中一篇综述将骨髓穿刺液浓缩物（BMAC）作为对照组，发现PRP和BMAC之间的结果没有显着差异。目前,缺乏关于富含白细胞或缺乏白细胞的PRP在膝OA患者中的优势的文献.关于PRP治疗髋关节OA的文献并没有提供与膝关节一致的结果。最近的两项系统评价评估了接受PRP或HA治疗的髋部OA患者的RCT，发现在最终随访时，两组之间的临床结果没有显着差异。关于OA等级和PRP疗效之间的关联的现有文献已经发现了不同的结果。使用PRP注射治疗膝关节OA似乎是有利的，与其他注射治疗相比，临床结果相当或更好。然而,PRP注射治疗髋部OA的临床疗效远不一致.缺乏证据表明白细胞的存在显着影响临床结果。更多关于更大队列的随机对照试验，随着随访时间的延长，并且在提出关于使用PRP治疗髋关节OA的建议之前，需要类似的配方，白细胞浓度的影响，以OA分级为基础的临床疗效。
结果：最近的系统评价发现，与透明质酸（HA）相比，在膝关节OA患者中，PRP给药后的临床结局显着改善。其中一篇综述将骨髓穿刺液浓缩物（BMAC）作为对照组，发现PRP和BMAC之间的结果没有显着差异。目前,缺乏关于富含白细胞或缺乏白细胞的PRP在膝OA患者中的优势的文献.关于PRP治疗髋关节OA的文献并没有提供与膝关节一致的结果。最近的两项系统评价评估了接受PRP或HA治疗的髋部OA患者的RCT，发现在最终随访时，两组之间的临床结果没有显着差异。关于OA等级和PRP疗效之间的关联的现有文献已经发现了不同的结果。使用PRP注射治疗膝关节OA似乎是有利的，与其他注射治疗相比，临床结果相当或更好。然而,PRP注射治疗髋部OA的临床疗效远不一致.缺乏证据表明白细胞的存在显着影响临床结果。更多关于更大队列的随机对照试验，随着随访时间的延长，并且在提出关于使用PRP治疗髋关节OA的建议之前，需要类似的配方，白细胞浓度的影响，以OA分级为基础的临床疗效。
