关节内血小板丰富血浆治疗膝关节骨性关节炎患者

Bashir Mohammed Chowdhary, Mudasir Ahmad Bhat
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摘要

简介膝关节骨性关节炎是世界上最常见的退行性关节疾病,也是一种伴有疼痛和发病率的常见病,严重影响患者的活动能力和生活质量。治疗方法包括锻炼、减轻体重、行走支撑、支具、局部和口服非甾体抗炎药、关节内注射皮质类固醇和血液制品(包括血小板-血浆)。自体血液制品含有高比例的各种生长因子(GFs)、细胞因子和调节因子,如 PRP,在实现这一目标方面已显示出良好的效果。这项前瞻性研究旨在评估富血小板血浆(PRP)注射对 1 至 3 级 Kellgren Lawrence(KL)分级的膝关节骨性关节炎(KOA)患者的疗效和安全性。材料和方法:在这项研究中,共有 30 名患者经放射学证实患有膝关节骨性关节炎。所有患者均接受了关节内注射富血小板血浆治疗。在治疗后的基线、1 周、6 周、12 周、18 周、24 周和 48 周,采用 VAS、KSS 和 IKDC 量表对目标膝关节的疼痛和功能进行评估。结果显示本研究发现,治疗 24 周和 48 周后,VAS 平均值比基线值分别降低了 5 ± 0.4 和 4。治疗24周和48周后,KSS平均值较基线分别有32.10±1.5和21.4±4.9的明显改善。同样,在治疗24周和48周后,平均IKDC与基线相比分别有47.1±3.9和32.1±4.6的明显改善。结论关节腔内血小板丰富血浆在治疗I、II和III级膝骨关节炎患者的对症治疗方面效果显著,包括改善疼痛控制、减轻关节僵硬和更好地参与日常活动。
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INTRA-ARTICULAR PLATELET RICH PLASMA IN THE TREATMENT OF PATIENTS WITH KNEE OSTEOARTHRITIS
Introduction: Osteoarthritis of knee is the most common worldwide degenerative joint disease and is a common condition associated with pain and morbidity which significantly impacts the patients mobility and quality of life. It is treated by use of exercises, weight reduction, walking supports, bracing, topical and oral NSAID, intra-articular (IA) injections of corticosteroids and blood-derived products, including platelet-rich-plasma. An autologous blood product containing a high percentage of various growth factors (GFs), cytokines and modulating factors as PRP has shown promising results in achieving this goal. The aim of this prospective study was to evaluate the efficacy and safety of Platelet Rich Plasma (PRP) injections in patients affected by knee osteoarthritis (KOA) of grades from 1 to 3 Kellgren‑Lawrence (KL) grading. Materials and Methods: In this study a total of 30 patients, radiologically confirmed with knee osteoarthritis. All patients were managed with intra-articular platelet rich plasma injection. The pain and function of the target knee were evaluated by the VAS, KSS and IKDC scales at the baseline, 1 week, 6 weeks, 12 weeks, 18 weeks, 24 weeks and 48 weeks after treatment. Results: In this study, there was reduction of 5 ± 0.4 and 4 in mean VAS from baseline was found after 24 and 48 weeks after treatment. A significant function improvements of 32.10±1.5 and 21.4±4.9 in mean KSS from baseline was seen after 24 and 48 weeks respectively after treatment. Similarly a significant function improvements of 47.1±3.9 and 32.1±4.6 in mean IKDC from baseline was seen after 24 and 48 weeks respectively after treatment. Conclusion: Intra articular platelet rich plasma produce superior outcomes for symptomatic management in the treatment of patients with knee osteoarthritis grade I, II and III, including improved pain management, less joint stiffness and better participation in daily activity.
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