Clinical Efficacy of Intra-Articular Injection With P-PRP Versus That of L-PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial.

Abstract

\n Background: To evaluate the clinical efficacy and safety of intra-articular injection with pure platelet-rich plasma (P-PRP) versus those of leukocyte platelet-rich plasma (L-PRP) in treating knee cartilage lesions, we conducted a double-blind, randomized controlled clinical trial with a larger sample and longer follow-up period.Methods: From October 2019 to October 2020, 95 patients were invited to participate in our study, and 60 (63.2%) were randomized to P-PRP (n = 30) or L-PRP (n = 30) groups. Patients from the two groups were treated with knee intra-articular injections of P-PRP or L-PRP. Visual analog scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were assessed preoperatively and at 6 weeks, 12 weeks, 6 months, and 12 months after intervention.Results: We followed up 27 cases in the P-PRP group and 26 cases in the L-PRP group. No significant differences in VAS and WOMAC scores were found between the two groups before the intervention (P>0.05). The WOMAC Pain and VAS-Motions scores of the P-PRP group were significantly lower than those of the L-PRP group at 6 weeks after the intervention (P<0.05). While the long-term clinical efficacy of both injections was similar and weakened after 12 months, more adverse events were found in the L-PRP group.Conclusions: The short-term results of our study are encouraging and demonstrate that both L-PRP and P-PRP intra-articular injections reduce pain and improve function in patients with knee cartilage lesions. Compared with the L-PRP injection, the P-PRP injection (which had a lower risk of early inflammation caused by leukocytes) showed better clinical efficacy in the early phase of postoperative rehabilitation and resulted in fewer adverse events. However, long-term clinical efficacy for both injections were similar and weakened after 12 months.Trial registration: ChiCTR1900026365. Registered on 3 October 2019, http://www.chictr.org.cn/showproj.aspx?proj=43911.