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      Application Effect of Different Concentrations of Platelet-Rich Plasma Combined with Quadriceps Training on Cartilage Repair of Knee Osteoarthritis

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      1 , 1 , 2 , 1 ,
      Journal of Healthcare Engineering
      Hindawi

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          Abstract

          We investigated the application effect of different concentrations of platelet-rich plasma (PRP) combined with quadriceps training on cartilage repair of knee osteoarthritis. Data of 37 patients with knee osteoarthritis (KOA) treated in our hospital (November 2019–February 2021) were retrospectively analyzed and the patients were divided into low concentration group (LCG) ( n = 12), medium concentration group (MCG) ( n = 12), and high concentration group (HCG) ( n = 13) according to the order of admission. All patients received quadriceps training. Three groups above received knee injection of PRP, and the platelet concentrations were 1000–1400 × 10 9/L, 1400–1800 × 10 9/L, and 1800–2100 × 10 9/L, respectively. Articular cartilage thickness of the medial and lateral femur, knee joint function scores, inflammatory factor levels, and matrix metalloproteinases (MMPs) levels were compared. After treatment, compared with the MCG and HCG, articular cartilage thickness of the medial and lateral femur of the diseased side in the LCG was obviously lower ( P < 0.05). At 2 months after treatment ( T 3), compared with the HCG, articular cartilage thickness of the medial and lateral femur of the diseased side in the MCG was obviously higher ( P < 0.05), without remarkable difference in articular cartilage thickness of the medial and lateral femur of the healthy side among three groups ( P > 0.05). After treatment, compared with the LCG, knee joint function scores of the MCG and HCG were obviously better ( P < 0.001). Compared with the HCG, the knee function score at T 3 in the MCG was obviously better ( P < 0.001). After treatment, compared with the LCG, inflammatory factor levels and levels of MMPs in the MCG and HCG were obviously lower ( P < 0.05). Compared with the HCG, inflammatory factor levels and levels of MMPs at T 3 in the MCG were obviously lower ( P < 0.05). PRP combined with quadriceps training can accelerate cartilage repair of patients with KOA and reduce inflammatory factor levels and levels of MMPs, but the treatment effect of PRP depends on platelet concentration, with the best range of 1400–1800 × 10 9/L. Too high or too low platelet concentrations will affect recovery of knee function.

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          Most cited references28

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          Intra-articular Mesenchymal Stem Cells in Osteoarthritis of the Knee: A Systematic Review of Clinical Outcomes and Evidence of Cartilage Repair

          To provide a systematic review of the clinical literature reporting the efficacy of mesenchymal stem cells (MSCs) in terms of clinical outcomes including pain and function and cartilage repair in patients with osteoarthritis.
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            MSC Therapy for Osteoarthritis: An Unfinished Story

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              Combined surgery and chondrocyte cell-sheet transplantation improves clinical and structural outcomes in knee osteoarthritis

              Current cartilage regenerative therapies are not fully effective in treating osteoarthritis of the knee (OAK). We have developed chondrocyte sheets for autologous transplantation and tested these in in vitro and in vivo preclinical studies, and have reported that the transplantation of chondrocyte sheets promoted hyaline cartilage repair in rat, rabbit, and minipig models. However, autologous transplantation of chondrocyte sheets has yet to be reported in humans. Here, we report our combination therapy in which conventional surgical treatment for OAK, is followed by autologous chondrocyte sheet transplantation for cartilage repair. Eight patients with OAK and cartilage defects categorized arthroscopically as Outerbridge grade III or IV receive the therapy. Patients are thoroughly assessed by preoperative and postoperative X-rays, magnetic resonance imaging (MRI), arthroscopy, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm Knee Score (LKS), and a laser-induced photoacoustic method to assess cartilage viscoelasticity. Arthroscopic biopsies of all patients are performed 12 months after transplantation for histological evaluation. The properties of the chondrocyte sheets are evaluated using gene expression analysis to investigate the ability to predict the clinical and structural outcomes of the therapy. For this small initial longitudinal series, combination therapy is effective, as assessed by MRI, arthroscopy, viscoelasticity, histology, and the clinical outcomes of KOOS and LKS. Gene marker sets identified in autologous chondrocyte sheets may be predictive of the overall KOOS, LKS, and histological scores after therapy. These predictive gene sets may be potential alternative markers for evaluating OAK treatment.
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                Author and article information

                Contributors
                Journal
                J Healthc Eng
                J Healthc Eng
                JHE
                Journal of Healthcare Engineering
                Hindawi
                2040-2295
                2040-2309
                2022
                10 January 2022
                : 2022
                : 7878064
                Affiliations
                1Department of Orthopedics, The First Affiliated Hospital of Shaoyang University, Shaoyang, 422000, Hunan, China
                2Department of Radiology, The First Affiliated Hospital of Shaoyang University, Shaoyang, 422000, Hunan, China
                Author notes

                Academic Editor: Bhagyaveni M.A

                Author information
                https://orcid.org/0000-0002-3734-5446
                https://orcid.org/0000-0002-6157-1021
                https://orcid.org/0000-0002-4583-2500
                https://orcid.org/0000-0001-5617-7305
                Article
                10.1155/2022/7878064
                8801772
                35111289
                93277c2a-64da-4c28-ace2-e8e6659fd7af
                Copyright © 2022 Zutong Wu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 November 2021
                : 29 November 2021
                : 9 December 2021
                Funding
                Funded by: Hunan Province Clinical Medical Technology Innovation Guidance Project
                Award ID: 2020SK52104
                Categories
                Research Article

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