Clinical Study of Combined Arthroscopic Drilling and Platelet Rich Plasma Injection in Knee Osteochondral Lesions in Middle-aged Patients

Abstrakts

Background: Osteochondral lesions commonly occur in the knee joints and causes detrimental effects on the quality of life. Arthroscopic drilling is the treatment option for mild to moderate lesions. However, it is debatable whether regenerated cartilage from arthroscopic drilling surgery is durable. It is speculated that induction of chondrocyte differentiation from subchondral mesenchymal stem cells is facilitated by platelet-rich plasma (PRP), which is a rich source of diverse growth factors. Aim of work: To evaluate the procedures of combined arthroscopic drilling and PRP injection intra-articularly for mild to moderate knee osteochondral lesions management. Patients and Methods: This randomized prospective study involved 100 cases (40-60y) treated in Banha Teaching Hospital from April 2021 to December 2023. They were randomly categorized equally into 2 groups: group A who were managed by arthroscopic drilling alone and group B who were managed by combined arthroscopic drilling and PRP injection intra-articularly. All the studied cases were assessed prior to intervention and at 3 and 12 months after intervention using visual analogue scale (VAS) score and Lysholm score. Results: Significant gradual improvement in both scores over the period of treatment (at 3 and 12 months after intervention), was observed in all the cases (P Conclusion: Arthroscopic drilling combined with autologous PRP injection serve a vital role in pain reduction, life quality enhancement, gradual improvement of knee function of patients suffering from mild to moderate severe knee osteochondral lesions especially in patients with low BMI.