Objective To investigate the effect of body mass index(BMI) on the efficacy of single-collected platelet-rich plasma (PRP) in the treatment of patients with knee osteoarthritis (KOA) and the recovery of joint function. Methods A retrospective analysis was conducted on 120 KOA patients who received single-collected PRP treatment at the First Medical Center of PLA General Hospital from January 2023 to October 2024. The patients were divided into a normal weight group(BMI 18.5-23.9 kg/m2, n=40), an overweight group(BMI 24.0-27.9 kg/m2, n=40), and an obese group (BMI≥28.0 kg/m2, n=40) according to BMI. All patients received 3 ultrasound-guided PRP joint cavity injections, with an interval of 2 weeks. Visual Analogue Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM), and MRI T2-mapping values were evaluated before treatment, 3 months, 6 months, and 12 months after treatment. Results At 12 months after treatment, VAS scores in all the three groups decreased significantly from baseline (P<0.001), but the reduction in the obese group (3.25±0.94) was significantly less than that in the overweight group (2.37±0.82) and normal weight group (1.68±0.71) (F=17.362, P<0.001). The improvement in the total KOOS score was significantly higher in the normal weight group (33.48±7.21) than in the overweight group (24.57±6.35) and obese group (15.69±5.82) (F=20.475, P<0.001). The reduction in the total WOMAC score showed a similar trend,, with the normal weight group (25.36±5.47) better than the overweight group (18.93±4.86) and obese group (12.57±4.32) (F=18.734, P<0.001). The improvement in joint ROM was significantly greater in the normal weight group (19.73±5.42)° than in the overweight group (13.42±4.68) °and obese group (7.95±3.76)°(F=16.537, P<0. 001). The reduction in the MRI T2-mapping value of the medial tibial plateau was significantly greater in the normal weight group (6.37±1.84) ms than in the overweight group (4.25±1.63) ms and the obese group (2.16±1.28) ms (F=19.654, P<0.001). Multivariate regression analysis showed that BMI (β=0.612, P<0.001) and age (β=0.386, P=0.008) were independent predictors of the efficacy of PRP treatment. Conclusions BMI is an important factor affecting the efficacy of single-collected PRP in treating KOA. Normal-weight patients can achieve more significant pain relief and functional improvement, while obese patients have relatively limited efficacy, suggesting that individualized treatment plans should be developed based on BMI in clinical practice.
Key words
body mass index /
platelet-rich plasma /
knee osteoarthritis /
joint function /
magnetic resonance imaging
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