Expert consensus on intraarticular injection of autologous apheresis platelet-rich plasma in the treatment of knee osteoarthritis / 中国输血杂志

ABSTRACT

Knee osteoarthritis (KOA) is one of the most common musculoskeletal diseases. Platelet-rich plasma (PRP) has been widely used in the treatment of KOA. However, the effectiveness of KOA treatment has been affected due to the large differences in PRP preparation technology, storage method, and intra-articular injection treatment plan. Based on a comprehensive and systematic literature review and clinical practice experience, experts in blood transfusion medicine, orthopedics and rehabilitation medicine and other disciplines (departments) from a number of domestic large-scale tertiary hospitals with experience in the treatment of KOA with apheresis PRP formed this expert consensus by in-depth study. The consensus includes four aspects the background of the formation of the consensus, the advantages of preparing PRP from autologous platelets apheresis for KOA treatment, the theoretical basis and the frozen storage method of apheresis PRP, and the clinical application scheme of apheresis PRP intraarticular injection for the treatment of KOA. Recommendations are as follows autologous PRP prepared by platelets apheresis is used to treat KOA by intra-articular injection; the platelet concentration(Plt) in PRP prefers (1 000~1 800)×109/L, the red blood cells(RBC) contamination should be ≤3.2×1010/L, and the leukocytes(WBC) contamination should be ≤2.0×109/ L; PRP is suitable to be stored at -80℃, within 6-months storage; a course of treatment prefers 3 to 4 occasions of injection, with an interval of 1 to 2 weeks; the injection volume of one knee joint could be (4~8)mL/person; the joint effusion should be removed before injection without mixing with anesthetics or corticosteroids; restriction of strenuous exercise for 48 hours after injection is necessary. This consensus is intended to promote the standardized application of autologous apheresis PRP in the treatment of KOA, improve the effectiveness of clinical treatment of KOA and the scientificity of its evaluation, so as to lay a preliminary foundation for formulating standardized guidelines or (and) standards for the treatment of KOA with autologous apheresis PRP in the future.