Objective This study aims to clarify the dose-response relationship between the concentrations of growth factors (TGF-β, PDGF, IGF) in platelet-rich plasma (PRP) and the repair of meniscus injury. Methods 80 patients with acute meniscal injury were enrolled from 2021 to 2024. Among them, 60 patients were divided into low-, medium-, and high-bioactivity groups based on the composite Z-score of three growth factors (TGF-β, PDGF, IGF) (n=20 per group), while the remaining 20 patients served as the saline control group. Standard PRP prepared from a single donor was used (baseline concentration: TGF-β 18.5 ng/mL). The target concentration windows were achieved by gradient-adjusting with lyophilized human recombinant growth factor (TGF-β: HumanZyme HZ-1023) (low group: 12-15 ng/mL; medium group: 18-22 ng/mL; high group: 25-30 ng/mL). Measured concentration deviation after reconstitution was<5% for all batches. Efficacy was evaluated using the modified MRI Stoller score and Lysholm/IKDC functional scales pre- and post-intervention. Results The repair score of the high biological activity group was significantly better than that of the control group (24.5±2.3 vs 17.9±2.5, P<0.001); The comprehensive score was strongly positively correlated with functional improvement (r=0.79, P<0.001), and TGF-β had the highest contribution (regression β=0.62, 95% CI: 0.48-0.76); The ROC curve determines that a comprehensive score>1.2 (AUC=0.88) is the optimal treatment threshold, corresponding to an effective concentration window of growth factors TGF-β 23.5-28.7 ng/mL、PDGF 17.2-20.4 ng/mL、IGF 11.3-14.1 ng/mL. Conclusion The repair efficacy of PRP is concentration dependent, and precise regulation of freeze-dried PRP based on comprehensive scoring can optimize the therapeutic effect. When the concentration of TGF-β is greater than 23.5 ng/mL, the repair efficacy is significantly improved.
Key words
platelet-rich plasma /
growth factor concentration /
meniscal repair /
personalized treatment
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