Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis

BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.

Enlightenment from Development Experience of World-Class Universities in Foreign Inland Regions

Only a few world-class universities are in inland regions.The development of inland universities is restricted by many factors,which is especially true in the construction of universities of the Double First Class initiative in China’s western inland regions.①To learn more about how this situation evolved,we conducted research focused on world-class inland universities in foreign countries to sort out their experiences during their development.Through literature reviews and online surveys,we found that the development of such universities is restricted by the economic and social environment of the cities and regions in which they are located.Further,these universities are good at seizing historic development opportunities to actively advance internal reform and fully integrate into regional economic and social development.As a result,they have made great contributions to talent training and scientific research.They have also enhanced their strength and international influence in the process of coordinated development with their region.Therefore,we suggest universities in western China draw on such experience to grow into double first-class universities.Specifically,they should closely follow major national and regional strategies and comprehensively integrate into regional economic and social construction to seek opportunities by taking full advantage of local development.They should also continuously deepen institutional and systematic restructuring to unleash their vitality and potential in education management and development and focus on major projects to expand influence in their regions.