Regenerative technologies in the treatment of knee osteoarthritis

摘要

Knee osteoarthritis (OA) causes substantial pain, physical dysfunction and impaired quality of life. There is no cure for knee OA, and for some people, the disease may involve progressive symptomatic and structural deterioration over time. Platelet-rich plasma (PRP) is a therapeutic agent that aims to address underlying biological processes responsible for OA pathogenesis. Thirty four women with 2nd or 3rd Kellgren-radiologic stage OA had been divided into 3 groups. All ones were treated by hyaluronic acid intra-articular injection. Fifteen patients (1st group) hadn't got any additional treatment. AS was carried out for 6 peoples (2nd group). For 13 patients (3rd group) PRP intra-articular injections were used in common with medical AS. The growth of cartilage in the region of the upper pole of the patella was found in the 1st group after 3 months of treatment: mean values 1.84 vs. 2.39, p = 0.015. Positive dynamic was also detected at 3 and 6 months in the second (the mean values were 2.08 vs. 2.45 and 2.42, p=0.049) and third groups of patients (2.3 vs. 2.8 and 2.35, p=0.02). The cartilage thickness in the medial condyle of the tibia had increased at 3 and 6 months in the 2nd (the mean values were 1.61 vs. 2.11 and 1.98, p = 0.001) and 3rd group (1.66 vs. 2.01 and 1.89, p = 0.019). A change of the cartilage thickness in the lateral condyle of the tibia was not statistically significant in the all groups of patients. The pain level, stiffness, restriction decreased according to the questionnaire (WOMAC, Leken index) in all groups of patients. The clinical effectiveness of intra-articularly hyaluronic acid therapy and surgical methods of OA-treatment (medical AS) have been confirmed by ultrasound visualization and questionnaires.