膝关节骨性关节炎的发生受复杂网络的调控,目前尚无特定的治疗药物。针对炎性因子的功能锻炼和治疗已显示出在一定程度上缓解膝关节骨性关节炎的潜力。因此,这项研究的目的是评估关节内注射自体富血小板血浆(PRP)联合物理治疗(PT)治疗膝骨关节炎的疗效.共有128例膝骨关节炎患者被纳入研究,包括64名男性和64名女性。共128例患者分为透明质酸钠组(HA组),PRP组,PRP+PT组,和PT组,每组32例。视觉模拟量表(VAS),西安大略省和麦克马斯特大学骨关节炎指数(WOMAC),和日本骨科协会(JOA)被用来评估患者从疼痛和骨关节炎的恢复。彩色多普勒超声成像技术用于评估关节积液,滑膜厚度,膝骨关节炎患者的关节软骨厚度。采用酶联免疫吸附试验(ELISA)检测白细胞介素-1β(IL-1β)水平,转化生长因子-β1(TGF-β1),和滑液中的基质金属肽酶3(MMP-3)。与HA组相比,PT组,PRP组,PRP联合PT(PRP+PT)组均显示VAS和WOMAC评分降低,JOA分数增加,关节积液减少,滑膜厚度,膝关节软骨厚度。此外,关节液中IL-1β和MMP-3水平降低,TGF-β1水平升高(P<0.05)。与PT组相比,PRP组膝关节VAS和WOMAC评分降低,JOA分数增加,关节积液,滑膜厚度,关节软骨厚度减少,差异无统计学意义(P>0.05),PRP+PT组VAS和WOMAC评分降低,JOA分数增加,减少关节积液,滑膜厚度,膝关节软骨厚度。此外,关节液中IL-1β和MMP-3水平降低,TGF-β1水平升高(P<0.05)。四组均未出现严重不良反应,但PRP+TP组疼痛率明显低于PT组,PRP组,PRP+PT组(P<0.05)。关节腔内注射PRP联合运动疗法治疗膝关节骨性关节炎的疗效优于单纯的HA干预,PRP进样,和PT。此外,关节内注射PRP联合运动疗法在改善与膝骨关节炎相关的炎症水平和促进康复过程方面显示出更高的有效性.
The occurrence of osteoarthritis in the knee joint is regulated by a complex network, and there is currently no specific therapeutic drug available. Functional exercises and treatments targeting inflammatory factors have shown the potential to alleviate knee osteoarthritis to some extent. Therefore, the aim of this study was to assess the intra-articular injection (IAI) of autologous platelet-rich plasma (PRP) combined with physical therapy (PT) in treating knee osteoarthritis. A total of 128 patients with knee osteoarthritis were included in the study, including 64 males and 64 females. A total of 128 patients were divided into sodium hyaluronate group (HA group), PRP group, PRP + PT group, and PT group, with 32 cases in each group. Visual analog scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Japanese Orthopaedic Association (JOA) were employed to evaluate the recovery of patients from pain and osteoarthritis. Color Doppler ultrasound imaging technology was utilized to assess joint effusion, synovial membrane thickness, and articular cartilage thickness in patients with knee osteoarthritis. Enzyme-linked immunosorbent assay (ELISA) was employed to detect the levels of interleukin-1β (IL-1β), transforming growth factor-β1 (TGF-β1), and matrix metallopeptidase 3 (MMP-3) in the synovial fluid. Compared to the HA group, the PT group, PRP group, and PRP combined with PT (PRP + PT) group all showed reduced VAS and WOMAC scores, increased JOA scores, decreased joint effusion, synovial membrane thickness, and articular cartilage thickness in the knee joint. Additionally, levels of IL-1β and MMP-3 in the synovial fluid decreased, while TGF-β1 levels increased (P < 0.05). Compared with the PT group, the VAS and WOMAC scores of the knee joint in the PRP group decreased, JOA scores increased, joint effusion, synovial thickness, and articular cartilage thickness decreased, but there was no statistically significant difference (P > 0.05), and the PRP + PT group showed decreased VAS and WOMAC scores, increased JOA scores, reduced joint effusion, synovial membrane thickness, and articular cartilage thickness in the knee joint. Moreover, levels of IL-1β and MMP-3 in the synovial fluid decreased, while TGF-β1 levels increased (P < 0.05). No severe adverse reactions were observed in any of the four groups, but the pain rate in the PRP + TP group was significantly lower than PT group, PRP group, and PRP + PT group (P < 0.05). The efficacy of intra-articular injection of PRP combined with exercise therapy in the treatment of knee osteoarthritis is superior to that of single interventions such as simple interventions of HA, PRP injection, and PT. Furthermore, intra-articular injection of PRP combined with exercise therapy demonstrates enhanced effectiveness in improving the inflammatory levels associated with knee osteoarthritis and facilitating the rehabilitation process.