The Efficacy of PRP Combined With Exercise to Treat Knee Osteoarthritisq

Study Overview
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Brief Summary
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Objective. In this study, the investigators aimed to investigate the efficacy of combined a single platelet-rich plasma (PRP) and physical exercise (leg swing and quadriceps strengthening exercise) versus PRP and hyaluronic acid (HA) combination therapy. Methods. One hundred and six patients with grade Ⅱ-Ⅲ Knee osteoarthritis (KOA) according to the Kellgren-Lawrence classification were randomly divided into intra-articular injection of PRP combined with leg swing and quadriceps strengthening exercise (group A) and intra-articular combination injections of PRP and HA (group B). Patients in group A received twice intra-articular injection of PRP (2 ml, 2 weeks apart) and regular leg swing and quadriceps strengthening exercise for 3 months. Patients in group B received twice intra-articular combination injections of PRP (2 ml) and HA (2 ml) every 2 weeks. The primary outcome measures were Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score. The second outcomes included single leg stance test (SLS) and functional activity by 2 minutes walking test (2MWT) and time up and go test (TUGT). All outcomes were evaluated at baseline and after 1,3,6, and 12 months.

Official Title
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The Efficacy of PRP Combined With Leg Swing and Quadriceps Strengthening Exercise to Treat Knee Osteoarthritis

Conditions
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Platelet-rich Plasma, Physical Exercise, Knee Osteoarthritis

Intervention / Treatment
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* Drug: platelet-rich plasma


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged ≥ 45 years old; KOA was diagnosed according to the American College of Rheumatology Classification Criteria; patients with the Kellgren-Lawrence grade (K-L grade) for KOA of Ⅰ-Ⅲ; a history of symptoms more than three month, and patients with independent mobility. Exclusion Criteria: lower limb axial deviation large than 5° (valgus and varus knee); patients with diabetes mellitus, sever cardiovascular disease, immunosuppressive status, mental illness or other diseases than might affect the results; injections or other invasive treatments into the lower extremities were used in the past three months; patients willing to follow the doctor's recommendation for exercise training; patients with previous knee fracture or malignancy; patients with a previous history of hip or knee joint surgery; patients participating in hip or knee muscle strengthening in the past 3 months; patients did not complete the intervention strategies or regular follow-up.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PRP combined with leg swing and quadriceps strengthening exercise<br>Group A received twice intra-articular injection of platelet-rich plasma (2 ml, 2 weeks apart) and regular leg swing and quadriceps strengthening exercise for three months. | Drug: platelet-rich plasma<br>* intra-articular combination injections of platelet-rich plasma and hyaluronic acid or intra-articular combination injections of PRP combined with leg swing and quadriceps strengthening exercise<br>|
| Active Comparator: intra-articular combination injections of PRP and HA<br>Group B received twice intra-articular combination injections of PRP (2 ml) and HA (2 ml) every 2 weeks. | Drug: platelet-rich plasma<br>* intra-articular combination injections of platelet-rich plasma and hyaluronic acid or intra-articular combination injections of PRP combined with leg swing and quadriceps strengthening exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale (VAS) | Degree of knee pain during treatment | 12 months | 
| Western Ontario and McMaster Universities (WOMAC) score | Severity of knee osteoarthritis | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| single leg stance test (SLS) | Assess the patient's balance | 12 months | 
| 2 minutes walking test (2MWT) | Assess the patient's functional activity | 12 months | 
| time up and go test (TUGT) | time up and go test (TUGT) | 12 months |