Clinical analysis of treatment of knee osteoarthritis with external artificial knee joint assisted platelet lysate

doi:10.3877/cma.j.issn.2096-0263.2018.04.007

Abstract

Abstract:

Objective

To evaluate the clinical effect of intra-articular platelet lysat injection in the treatment of knee osteoarthritis (OA) assist with external artificial knee joint (EAKJ).

Methods

This prospective randomized controlled clinical trial involved 100 patients admitted in Shandong Wendeng orthopaedic hospital from January 2012 to September 2016. The patients were randomly divided into two groups: PL group and EAKJ+PL group (n=50). There were 43 males (43%) and 57 females (57%) with an average age of (57±8) years. All patients received PL 2 times a week, 5 ml per time and continue for 5 times. The EAKJ+PL group wore a brace at least 4 hours a day for no less than 6 months. The visual analogue scale/score (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and the Hospital for Special Surgery (HSS) score were recorded and compared 1 day before the treatment, 1 day, 1 month, 3 months and 6 months after the treatment. Femur-tibia angle (FTA) and width of medial knee joint space were documented through a load bearing X-ray 1 day before the treatment and 6 months after the treatment.

Results

47 cases in PL group and 46 cases in EAKJ+PL group successfully completed the treatment and followed for more than 6 months. The VAS and WOMAC scores in EAKJ+PL group (3.0±0.4, 2.6±0.4, 2.2±0.4; 32±6, 29±5, 28±5) were lower than those in PL group (3.5±0.4, 3.1±0.4, 2.7±0.4; 35.0±5.8, 28.7±4.7, 28.4±4.6) (F=6.924, F=6.015, F=6.163; F=2.214, F=3.428, F=5.314, P<0.05) at 1 month, 3 months and 6 months after treatment (P<0.05). HSS scores between two groups has no statistically significant. After 6 months treatment, the FTAs of EAKJ+PL group (177.0±2.5)° were less than that of PL group (179.2±2.4)°(t=4.231, P<0.05), and the width of medial tibiofemoral joint space (3.24±0.27) mm were greater than those of PL group (2.56±0.32) mm (t=-11.175, P<0.05). Compared with pre-treatment, width of medial tibiofemoral joint space and FTA were significantly improved in EAKJ+PL group (t=-14.201, t=8.571, P<0.05), but there was no significant improvement in PL group.

Conclusion

EAKJ assisted platelet lysate injection in the treatment of knee osteoarthritis can achieve a good clinical effect in relieving symptoms and improving the force line of lower limb, which is worth promoting.

Key words: Osteoarthritis, Orthotic devices, Injections, intra-articular, Platelet lysate

Changjun Ju, Hongjiang Jiang, Guangling Gao, Xin Yu, Debao Zou, Wei Yan, Lei Li. Clinical analysis of treatment of knee osteoarthritis with external artificial knee joint assisted platelet lysate[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(04): 224-230.

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References 23

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组别	例数	性别		平均年龄（岁，±s）	BMI（kg/m²，±s）	K-L分级（例）		病程（年，±s）
组别	例数	男性	女性	平均年龄（岁，±s）	BMI（kg/m²，±s）	Ⅱ	Ⅲ	病程（年，±s）
PL组	47	21	26	57±8	26.3±2.1	35	12	29±10
EAKJ+PL组	46	22	24	56±8	26.1±1.9	36	10	26±11
统计值	?	χ²=0.093		t=0.185	t=0.639	χ²=0.185		t=1.594
P值	?	0.761		0.854	0.524	0.667		0.114

组别	例数	性别		平均年龄（岁，±s）	BMI（kg/m²，±s）	K-L分级（例）		病程（年，±s）
组别	例数	男性	女性	平均年龄（岁，±s）	BMI（kg/m²，±s）	Ⅱ	Ⅲ	病程（年，±s）
PL组	47	21	26	57±8	26.3±2.1	35	12	29±10
EAKJ+PL组	46	22	24	56±8	26.1±1.9	36	10	26±11
统计值	?	χ²=0.093		t=0.185	t=0.639	χ²=0.185		t=1.594
P值	?	0.761		0.854	0.524	0.667		0.114

组别	例数	治疗开始前1 d	第一次注射治疗开始后				F值	P值
组别	例数	治疗开始前1 d	1d	1个月	3个月	6个月	F值	P值
PL组	47	5.2±0.6	4.6±0.5*	3.5±0.4*	3.1±0.4*	2.7±0.4*	428.638	<0.05
EAKJ+PL组	46	4.9±0.9	3.7±0.5*	3.0±0.4*	2.6±0.4*	2.2±0.4*	428.638	<0.05
F值	?	1.625	8.522	6.924	6.015	6.163	?	?
P值	?	0.108	<0.05	<0.05	<0.05	<0.05	?	?

组别	例数	治疗开始前1 d	第一次注射治疗开始后				F值	P值
组别	例数	治疗开始前1 d	1d	1个月	3个月	6个月	F值	P值
PL组	47	5.2±0.6	4.6±0.5*	3.5±0.4*	3.1±0.4*	2.7±0.4*	428.638	<0.05
EAKJ+PL组	46	4.9±0.9	3.7±0.5*	3.0±0.4*	2.6±0.4*	2.2±0.4*	428.638	<0.05
F值	?	1.625	8.522	6.924	6.015	6.163	?	?
P值	?	0.108	<0.05	<0.05	<0.05	<0.05	?	?

组别	例数	治疗开始前1 d	第一次注射治疗开始后				F值	P值
组别	例数	治疗开始前1 d	1d	1个月	3个月	6个月	F值	P值
PL组	47	68±7	69±7	73±7*	73±6*	76±7*	33.478	<0.05
EAKJ+PL组	46	67±7	72±7*	70±8	73±8*	76±8*	33.478	<0.05
F值	?	0.204	-1.596	1.132	-0.006	-0.403	?	?
P值	?	0.839	0.114	0.261	0.995	0.688	?	?

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