Effectiveness of Autologous Platelet-rich Plasma on Knee Cartilage Injury
Condition: Cartilage Injury
MeSH terms: Wounds and Injuries
Study type: Interventional

Summary: 
      To analyze the effectiveness of intra-articular injection of autologous PRP on knee cartilage
      repair and evaluating functional recovery of the knee joint in knee cartilage injury
      patients.
    

Detailed description: 
      Recent studies have shown that platelets, which contain a large number of cytokines and
      growth factors, can be beneficial in inflammatory response and postoperative bleeding,
      infection, bone formation, injury, muscle strain, and soft tissue healing. Platelets release
      a plethora of biologically active proteins to aggregate macrophages, mesenchymal stem cells
      (MSCs) and osteoblasts, thereby promoting degradation and clearing necrotic tissue, thus
      further activating wound healing. In fact, platelet-rich plasma (PRP) is now used clinically
      to promote cartilage repair.

      By retrieving the Web of Science, a study by Havva et al. reported the clinical use of
      autologous PRP in 82 patients with advanced knee osteoarthritis with good outcomes. However,
      the clinical applications of this treatment have not been adequately investigated in
      randomized controlled trials. Given this, additional studies on the exact efficacy of this
      treatment are indispensible.

      Three similar trial protocols to the current trial include 'Treatment of Osteoarthritis by
      Intra-articular Injection of Bone Marrow Mesenchymal Stem Cells With Platelet Rich Plasma
      (NCT02365142)', 'PRP vs HA Intra-articular Knee Injections for Cartilage Defects
      (NCT02012530)', and 'Mesenchymal Stem Cells Enhanced With PRP Versus PRP In OA Knee
      (MSCPRPOAK) (NCT01985633)'. In these trial protocols, knee injury extent and treatment
      success were assessed by Osteoarthritis Score, Western Ontario and McMaster Universities
      Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) score as outcome measures.
      However, there are several differences in the inclusion criteria and randomization of these
      trials in comparison with the current trial protocol.

      Since autologous PRP predominantly functions to relieve pain and inhibit inflammatory
      responses, clinical injection of autologous PRP for cartilage injury can stimulate
      chondrocyte growth and matrix metabolism. Existing evidence has shown that autologous PRP can
      increase type II collagen production and reduce apoptosis in chondrocytes when combined with
      autologous bone marrow-MSCs. Furthermore, PRP can improve cartilage degeneration and inhibit
      the development of osteoarthritis (OA) when combined with hydrogel microspheres. Accordingly,
      the clinical use of autologous PRP can alleviate the symptoms of OA, promote recovery of
      motor function, and ultimately improve patient quality of life.

      To date, the clinical use of low-dose autologous PRP has been reported to alleviate pain at
      the injury site in the treatment of articular cartilage injury, and achieve cartilage repair
      and proliferation by releasing growth factors that promote extracellular matrix synthesis and
      vascular reconstruction. However, the clinical applications of autologous PRP have not been
      systemically reported in randomized controlled clinical trials, leading to a lack of
      objective evidence on its effectiveness.
    

Intervention name(s): autologous platelet-rich plasma; normal saline
Intervention type(s): Drug; Drug
Intervention description(s): The patients with knee cartilage injury were randomized to the intra-articular injection of autologous platelet-rich plasma group.; The patients with knee cartilage injury were randomized to the normal saline group.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment