OBJECTIVE: To study effect of joint distraction osteogenesis combined with platelet-rich plasma injections on traumatic ankle arthritis (TAA).
METHODS: 106 patients with TAA admitted to our hospital (from January 2018 to January 2020) were recruited as the study cohort and randomly divided into a surgical group and a combined group. The surgical group was treated with simple joint retraction surgery, and the combined group was treated with platelet-rich plasma injections in addition to the surgery administered to the operation group. After 6 months of treatment, the clinical efficacy of the two groups was evaluated, and the changes in the ankle joint function, the serum related factors, and the quality of life before and at six months after the treatment were observed. The incidences of adverse reactions (ARS) in the two groups were counted to evaluate the treatment safety.
RESULTS: The total effective rate was 98.11% in the combined group and 77.36% in the operation group. The overall curative effect of the combined group was better than it was in the operation group (P<0.05). After the treatment, the ankle joint movement angles, the joint function, the serum factor levels, and the quality of life of the patients in combined group were better than they were in the operation group (P<0.05). No significant difference was found in the incidence of ARs (P>0.05).
CONCLUSIONS: Arthroplasty with platelet-rich plasma injections can improve joint function recovery, inhibit the inflammatory factor expression levels, and enhance TAA patients\' quality of life.

To report the 5-year clinical efficacy of PRP intra articular injections in knee osteoarthritis (OA) and to investigate the risk factors predictive for treatment failure and poor clinical outcome.
We retrospectively evaluated 118 patients treated for low to moderate knee OA demonstrated by X-Ray and magnetic resonance imaging (MRI) with autologous PRP injection from 2014 to 2018 with a mean 51.1 ± 14.8 (range 29 to 89) months follow-up. All the patients were evaluated with Lysholm and WOMAC score. The role of Kellgren Lawrence (KL) grade, patello-femoral (PF) degeneration, age, body mass index (BMI), relevant comorbilities, smoking status, gender, previous surgery or conservative measures were analyzed with univariate and multivariate analysis.
There was a significant improvement of all outcome measures at final follow-up and high satisfaction rate (79.7%). The overall failure rate was of 15.3% after a mean of 57.7 ± 15.1 (range 33 to 85) months. The BMI and the KL grade were identified as significant independent risk factor related to failure of autologous PRP injection. Patients under 60 reported significantly higher Tegner activity scale (p = 0.032) at final follow-up. Patients with KL grade 3 and patients with PF MRI-KL grade 3 had significantly lower Lysholm scores (p = 0.026 and p = 0.042 respectively) at final assessment. Younger patients with lower BMI and lower grade of radiographic OA had significantly longer therapeutic benefit (p < 0.05).
Intra articular PRP injections led to a significant clinical improvement in middle-aged adults with a low to moderate knee OA. BMI and high KL grade have been identified as significant risk factors predictive for failure at mid-term follow-up.

METHODS: Systematic review of randomized controlled trials.
OBJECTIVE: To determine the most effective non-surgical treatment interventions for reducing pain and improving function for patients with patellar tendinopathy.
METHODS: Studies considered for this systematic review were from peer-reviewed journals published between January 2012 and September 2017. All included studies used a visual analogue scale (VAS) to evaluate the participant\'s pain. The majority of the included studies also used the Victorian Institute of Sport Assessment Patellar Tendinopathy (VISA-P questionnaire) to assess participant\'s symptoms and function.
RESULTS: Nine randomized controlled trials fit the inclusion criteria and were analyzed. The results of three studies supported the use of isometric exercise to reduce pain immediately. One study found patellar strapping and sports taping to be effective for reduction in pain during sport and immediately after. Eccentric exercise, Dry Needling (DN) (2 studies), injections with Platelet Rich Plasma (PRP), Autologous Blood Injection (ABI), and saline were found to have a more sustained effect on reducing pain and improving knee function.
CONCLUSIONS: Isometric exercise, patellar strapping, sports taping, eccentric exercise, injections with PRP, ABI, and saline and DN demonstrated a short-term pain relieving and functional improvement effect in subjects with patellar tendinopathy. Longer term follow up on interventions involving eccentric exercise, DN, and injections with PRP, ABI and saline showed sustained pain reduction and improvement in knee function.
METHODS: Level 1.

Osteochondritis dissecans is a common disorder of knee and can be treated by various methods, depending on age of patient and stability of chondral fragment. In Osteochondritis dissecans ICRS type III lesion i.e. articular cartilage discontinuity but no dislocation, variable rate of union as well as high rate of non-union was observed in previous studies when treated with arthroscopic or open reduction and fixation. In previous study it has been also shown that platelet rich plasma help in fracture healing. In this study we are trying to extend the benefit of platelet rich plasma to Osteochondritis dissecans lesion. We took six patients with OCD, ICRS scale of OCD type III lesion. All Patients were operated Arthroscopiclly. Chondral flap of OCD lesion were fixed with stainless steel cannulated cancellous screw. To enhance union we used platelet rich plasma injections. .We access the union of chondral fragment to parent bone and knee function. Chondral fragment united to parent bone in all patients. To access knee function we used Tagner- Lysholm knee scoring system, in this study preoperatively score was 52.8 where as postoperatively it was 91.8. This study showed PRP is helpful in healing of chondral flap as all the chondral flap of osteochondral lesion united in this study.