自体骨髓浓缩物和富血小板血浆治疗膝关节软骨损伤

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Abstract

Objective To compare the effects of arthroscopic debridement (AD)combined with bone marrow concentrate (BMAC)or plateletrich plasma (PRP)on symptoms，functional improvement and cartilage repair in patients with knee cartilage injury by a clinical prospective randomized controlled trial.Methods A total of 62 patients with unilateral knee cartilage injury admitted to 920th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army from July 2020 to August 2021 were included in this study，which including 29 males and 33 females.And their age ranged from 18 to 65 years old，with an average of (32.57±8.58)years old.The mean BMI was (23.02±1.26)kg/m2.And among them，there were 30 cases of grade Ｉ and 32 cases of grade Ⅱ according to the international cartilage repair society (ICRS)classification.Next，these clinical trial patients were randomly divided into AD+BMAC group (n＝22)，AD+PRP group (n＝18)，and AD group (n＝22).Lysholm score，Tegner score，and numerical rating scale (NRS)were used to evaluate the improvement of symptoms and function of patients.MRI and magnetic resonance observation of cartilage repair tissue (MOCART)scores were used to evaluate the effect of cartilage repair.Results The follow-up time was 12 months.According to Lysholm，Tegner，and NRS scores，the symptoms and function of the three groups improved after operation (P＜0.05)，and the improvement was most obvious at 1 month after operation.And at 3，6，and 12 months after operation，the knee joint condition gradually decreased，but was still better than that before operation.The Lysholm，Tegner，and NRS scores of the AD+BMAC group were significantly better than those of the AD+PRP group and the AD group at 1，3，and 6 months after operation (P＜0.05)，while there was no significant difference in the relevant scores compared with the AD+PRP group at 12 months after operation (P＞0.05)，but they were still better than those of the AD group (P＜0.05).And the Lysholm，Tegner，and NRS scores of the AD+PRP group were significantly better than those of the AD group at 1 and 3 months after operation (P＜0.05)，but no significant difference was found at 6 and 12 months after operation (P＞0.05).In addition，the MOCART scores of the three groups at 12 months after operation were not significantly different from those before operation (P＞0.05)，and there was no significant difference between the three groups after operation (P＞0.05).Conclusion In general，compared with AD alone，AD combined with BMAC or PRP is better in relieving symptoms and improving knee joint function，and both have achieved satisfactory short-term efficacy.Specifically，the efficacy of AD combined with BMAC is better than that of AD combined with PRP，and the effect lasts longer.Both AD combined with BMAC or PRP can prevent the further deterioration of knee joint injury，but there is no significant advantage in cartilage repair.

Key words： autologous bone marrow concentrate platelet-rich plasma knee cartilage injury arthroscopic debridement

Corresponding Authors: Tan Hongbo

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	Feng Yujiao
	Zhou Tianhua
	Li Mingjun
	Chen Zhian
	Lv Xiaoyu
	Wang Gang
	Xu Yongqing
	Tan Hongbo

Cite this article:

Feng Yujiao,Zhou Tianhua,Li Mingjun, et al. Bone Marrow Aspiration Concentrate Versus Platelet Rich Plasma in the Treatment of Knee Articular Cartilage Injury[J]. sygkzz, 2023, 29(10): 922-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I10/922

［1］Bhosale AM，Richardson JB.Articular cartilage：Structure，injuries and review of management［J］.Br Med Bull，2008(87)：77-95.
［2］Honvo G，Reginster JY，Rannou F，et al.Safety of intraarticular hyaluronic acid injections in osteoarthritis：Outcomes of a systematic review and metaanalysis［J］.Drugs Aging，2019，36(Suppl 1)：101-127.
［3］Gowd AK，Weimer AE，Rider DE，et al.Cartilage restoration of bipolar lesions within the patellofemoral joint delays need for arthroplasty：A systematic review of rates of failure［J］.Arthrosc Sports Med Rehabil，2021，3(4)：e1189-e1197.
［4］Salem HS，Chaudhry ZS，Lucenti L，et al.The importance of staging arthroscopy for chondral defects of the knee［J］.J Knee Surg，2022，35(2)：145-149.
［5］Gudas R，Gudaite A，Mickevicius T，et al.Comparison of osteochondral autologous transplantation，microfracture，or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury：A prospective study with a 3year followup［J］.Arthroscopy，2013，29(1)：89-97.
［6］Urlic I，Ivkovic A.Cell sources for cartilage repairbiological and clinical perspective［J］.Cells，2021，10(9)：2496.
［7］Chahla J，Dean CS，Moatshe G，et al.Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee：A systematic review of outcomes［J］.Orthop J Sports Med，2016，4(1)：2325967115625481.
［8］Anz AW，Plummer HA，Cohen A，et al.Bone marrow aspirate concentrate is equivalent to plateletrich plasma for the treatment of knee osteoarthritis at 2 years：A prospective randomized trial［J］.Am J Sports Med，2022，50(3)：618-629.
［9］Cassano JM，Kennedy JG，Ross KA，et al.Bone marrow concentrate and plateletrich plasma differ in cell distribution and interleukin 1 receptor antagonist protein concentration［J］.Knee Surg Sports Traumatol Arthrosc，2018，26(1)：333-342.
［10］Danieli MV，Guerreiro JPF，Queiroz AO，et al.Leucocyte-poor-platelet-rich plasma intra-operative injection in chondral knee injuries improve patients outcomes.A prospective randomized trial［J］.Int Orthop，2021，45(2)：463-471.
［11］Filardo G，Kon E，Roffi A，et al.Plateletrich plasma：Why intra-articular?A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration［J］.Knee Surg Sports Traumatol Arthrosc，2015，23(9)：2459-2474.
［12］Cavallo C，Boffa A，de Girolamo L，et al.Bone marrow aspirate concentrate quality is affected by age and harvest site［J］.Knee Surg Sports Traumatol Arthrosc，2023，31(6)：2140-2151.
［13］Sch-fer R，Debaun MR，Fleck E，et al.Quantitation of progenitor cell populations and growth factors after bone marrow aspirate concentration［J］.J Transl Med，2019，17(1)：115.
［14］Anz AW，Hubbard R，Rendos NK，et al.Bone marrow aspirate concentrate is equivalent to platelet-rich plasma for the treatment of knee osteoarthritis at 1 year：A prospective，randomized trial［J］.Orthop J Sports Med，2020，8(2)：2325967119900958.
［15］Kijowski R，Blankenbaker DG，Munoz Del Rio A，et al.Evaluation of the articular cartilage of the knee joint：Value of adding a T2 mapping sequence to a routine MR imaging protocol［J］.Radiology，2013，267(2)：503-513.
［16］Belk JW，Kraeutler MJ，Houck DA，et al.Platelet rich plasma versus hyaluronic acid for knee osteoarthritis：A systematic review and metaanalysis of randomized controlled trials［J］.Am J Sports Med，2021，49(1)：249-260.
［17］Kim GB，Seo MS，Park WT，et al.Bone marrow aspirate concentrate：Its uses in osteoarthritis［J］.Int J Mol Sci，2020，21(9)：3224.
［18］Holton J，Imam M，Ward J，et al.The basic science of bone marrow aspirate concentrate in chondral injuries［J］.Orthop Rev (Pavia)，2016，8(3)：6659.
［19］Kon E，Mandelbaum B，Buda R，et al.Plateletrich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology：From early degeneration to osteoarthritis［J］.Arthroscopy，2011，27(11)：1490-1501.
［20］Laver L，Marom N，Dnyanesh L，et al.PRP for degenerative cartilage disease：A systematic review of clinical studies［J］.Cartilage，2017，8(4)：341-364.
［21］Bansal H，Leon J，Pont JL，et al.Platelet-rich plasma (PRP)in osteoarthritis (OA)knee：Correct dose critical for long term clinical efficacy［J］.Sci Rep，2021，11(1)：3971.
［22］Kreuz PC，Kruger JP，Metzlaff S，et al.Plateletrich plasma preparation types show impact on chondrogenic differentiation，migration and proliferation of human subchondral mesenchymal progenitor cells［J］.Arthroscopy，2015，31(10)：1951-1961.
［23］Del Torto M，Enea D，Panfoli N，et al.Hamstrings anterior cruciate ligament reconstruction with and without platelet rich fibrin matrix［J］.Knee Surg Sports Traumatol Arthrosc，2015，23(12)：3614-3622.
［24］Sundman EA，Cole BJ，Karas V，et al.The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis［J］.Am J Sports Med，2014，42(1)：35-41.
［25］Andia I，Maffulli N.A contemporary view of platelet-rich plasma therapies：Moving toward refined clinical protocols and precise indications［J］.Regen Med，2018，13(6)：717-728.
［26］Andia I，Martin JI，Maffulli N.Plateletrich plasma and mesenchymal stem cells：Exciting，but are we there yet?［J］.Sports Med Arthrosc Rev，2018，26(2)：59-63.
［27］Imam MA，Mahmoud SSS，Holton J，et al.A systematic review of the concept and clinical applications of bone marrow aspirate concentrate in orthopaedics［J］.SICOT J，2017(3)：17.
［28］Shapiro SA，Arthurs JR，Heckman MG，et al.Quantitative T-2 MRI mapping and 12-month follow-up in a randomized，blinded，placebo controlled trial of bone marrow aspiration and concentration for osteoarthritis of the knees［J］.Cartilage，2019，10(4)：432-443.
［29］Centeno C，Sheinkop M，Dodson E，et al.A specific protocol of autologous bone marrow concentrate and platelet products versus exercise therapy for symptomatic knee osteoarthritis：A randomized controlled trial with 2 year follow-up［J］.J Transl Med，2018，16(1)：355.
［30］Sugaya H，Yoshioka T，Kato T，et al.Comparative analysis of cellular and growth factor composition in bone marrow aspirate concentrate and platelet-rich plasma［J］.Bone Marrow Res，2018(2018)：1549826.
［31］ZIegler CG，Van Sloun R，Gonzalez S，et al.Characterization of growth factors，cytokines，and chemokines in bone marrow concentrate and platelet-rich plasma：A prospective analysis［J］.Am J Sports Med，2019，47(9)：2174-2187.
［32］Everts P，Onishi K，Jayaram P，et al.Plateletrich plasma：New performance understandings and therapeutic considerations in 2020［J］.Int J Mol Sci，2020，21(20)：7794.
［33］Everts PA，Van Erp A，Desimone A，et al.Platelet rich plasma in orthopedic surgical medicine［J］.Platelets，2021，32(2)：163-174.
［34］Cobianchi Bellisari F，De Marino L，Arrigoni F，et al.T-2mapping MRI evaluation of patellofemoral cartilage in patients submitted to intra-articular platelet-rich plasma (PRP)injections［J］.Radiol Med，2021，126(8)：1085-1094.
［35］Hede K，Christensen BB，Jensen J，et al.Combined bone marrow aspirate and platelet-rich plasma for cartilage repair：Two-year clinical results［J］.Cartilage，2021，13(1 Suppl)：937s-947s.

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