Platelet-Rich Plasma Treatment in Symptomatic Patients With Knee Osteoarthritis: Preliminary Results in a Group of Active Patients
Platelet-Rich Plasma Treatment in Symptomatic Patients With Knee Osteoarthritis: Preliminary Results in a Group of Active Patients
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DOI：
10.1177/1941738111431801
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发表时间：
2012-03-01
影响因子：
3.3
通讯作者：
Malchira, Somanna
中科院分区：
文献类型：
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作者：
Gobbi, Alberto;Karnatzikos, Georgios;Malchira, Somanna
背景：随着越来越多的人使用富血小板血浆 (PRP) 制剂来治疗软骨损伤，以恢复组织稳态并延缓膝骨关节炎 (OA) 的进展。目的：确定关节内 PRP 注射对活动性膝关节 OA 患者的有效性，并评估既往接受过或未接受过软骨损伤手术治疗的患者的临床结果。研究设计：病例系列。材料和方法：对 50 名膝关节 OA 患者进行了随访。至少 12 个月。所有患者均接受 2 次自体 PRP 关节内注射治疗。 25 名患者之前曾接受过软骨损伤手术干预，而 25 名患者则没有接受过手术干预。手术患者接受了软骨剃除或微骨折。在治疗前以及治疗后6个月和12个月时收集多项评价评分。通过统计功效分析预先确定所需的患者样本；国际膝关节文献委员会（主观）评分被定义为主要参数。 P 值小于 0.05 被认为具有统计显着性。一般线性模型重复测量测试评估了所有患者每个变量的时间内改善情况。进行多重比较的 Bonferroni 调整事后测试，以研究总样本中每个变量的时间评估改进的显着性。还调查了手术患者和非手术患者以及性别之间的改善差异。结果：所有患者在 6 个月和 12 个月时的所有评分均显示出显着改善（P < 0.01），并恢复了之前的活动。评估的亚组之间没有发现显着的改善差异（P < 0.01）。结论：PRP 治疗对膝关节 OA 患者显示出积极的效果。手术和非手术患者通过减轻疼痛、改善症状和生活质量而表现出显着改善。临床相关性：关于 PRP 治疗骨关节炎膝关节软骨的研究很少。不同的 PRP 产品可能或多或少适合治疗不同类型的组织和病理。 PRP 的临床疗效仍存在争议，并且尚未建立标准化方案。
Background: With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treat cartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA).Purpose: To determine the effectiveness of intra-articular PRP injections in active patients with knee OA and to evaluate clinical outcomes in patients with and without previous surgical treatment for cartilage lesions.Study Design: Case series.Materials and Methods: Fifty patients with knee OA were followed for a minimum of 12 months. All were treated with 2 intra-articular injections of autologous PRP. Twenty-five patients had undergone a previous operative intervention for cartilage lesions, whereas 25 had not. Operated patients had undergone either cartilage shaving or microfracture. Multiple evaluative scores were collected at pretreatment and at 6 and 12 months posttreatment. The required sample of patients was determined beforehand by using statistical power analysis; International Knee Documentation Committee (subjective) score was defined as the primary parameter. A P value of less than 0.05 was considered statistically significant. General linear model-repeated measure test evaluated within-time improvement for each variable for all patients. Post hoc test with Bonferroni adjustment for multiple comparisons was performed to investigate the significance in improvement within time evaluations for each variable for the total sample. The differences in improvement between operated and nonoperated patients were also investigated, as were those between sexes.Results: All patients showed significant improvement in all scores at 6 and 12 months (P < 0.01) and returned to previous activities. No significant difference in improvement was found between the evaluated subgroups (P < 0.01).Conclusions: The PRP treatment showed positive effects in patients with knee OA. Operated and nonoperated patients showed significant improvement by means of diminishing pain and improved symptoms and quality of life.Clinical Relevance: There are only a few studies of PRP treatment for cartilage on osteoarthritic knees. Different PRP products might be more or less appropriate to treat different types of tissues and pathologies. The clinical efficacy of PRP remains under debate, and a standardized protocol has not yet been established.