富血小板血浆注射治疗在膝骨关节炎中的应用进展

Progress on the Application of Platelet-rich Plasma Injection in Knee Osteoarthritis

富血小板血浆(platelet-rich plasma,PRP)由于富含多种活性生长因子,能够刺激软骨细胞增殖,促进软骨前体细胞增殖、迁移、向软骨细胞分化,促进胶原蛋白合成以及抑制软骨的炎性反应和退变,提供有利于组织修复的内环境,延缓病情进展。近年来PRP注射治疗已成为治疗与骨关节炎(osteoarthritis,OA)相关疾病的新型选择,并且疗效显著。为了进一步提高其效用,PRP注射治疗不仅在关节腔内进行,还可在软骨下骨内进行注射。软骨下骨的病变会加速软骨损耗,故有必要将软骨下骨也当作OA众多发病机制和病理过程的关键因素之一。根据PRP的生物特效以及PRP注射治疗在膝骨关节炎(knee osteoarthritis,KOA)中应用的研究进展进行了综述,同时对软骨下骨内PRP注射治疗KOA的研究进行了展望,以期为KOA的治疗提供更加有效的方法。

Platelet-rich plasma(PRP)has a lot of active growth factors,which can stimulate the proliferation of chondrocytes,promote the proliferation and migration of cartilage precursor cells,induce cartilage precursor cells differentiate into chondrocytes,promote collagen synthesis as well as inhibit the inflammatory response and degeneration of cartilage,provide an internal environment conductive to cartilage repair and delay disease development.In recent years,PRP injection has become a new choice for the treatment of osteoarthritis(OA),and has significant therapeutic effect.To further increase its effectiveness,PRP injection therapy has been performed not only in the articular cavity but also under the subchondral bone.Subchondral bone lesions will accelerate cartilage loss,so it is necessary to consider subchondral bone as one of the key points of the pathogenesis and pathological process of OA.In this paper,the bioeffects of PRP and the application of PRP injection in the treatment of knee osteoarthritis(KOA)were reviewed.Meanwhile,this paper prospected the research of PRP treatment which was injected under the subchondral bone for KOA,to seek more effective methods for the treatments of KOA.