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超声引导下注射富血小板血浆或自体全血治疗腘绳肌近端肌腱病:一项双盲随机对照试验

Ultrasound-Guided Intratendinous Injections With Platelet-Rich Plasma or Autologous Whole Blood for Treatment of Proximal Hamstring Tendinopathy: A Double-Blind Randomized Controlled Trial.

作者信息

Davenport Kathleen L, Campos Jose Santiago, Nguyen Joseph, Saboeiro Gregory, Adler Ronald S, Moley Peter J

机构信息

Preferred Orthopedics of the Palm Beaches, Boynton Beach, Florida USA (K.L.D.); Carteret Comprehensive Medical Care, PC, Carteret, New Jersey USA (J.S.C.); Departments of Epidemiology and Biostatistics (J.N.), Radiology and Imaging (G.S.), and Physiatry (P.J.M.), Hospital for Special Surgery, New York, New York USA; and Department of Radiology and Imaging, New York University Langone Medical Center, New York, New York USA (R.S.A.).

出版信息

J Ultrasound Med. 2015 Aug;34(8):1455-63. doi: 10.7863/ultra.34.8.1455.

Abstract

OBJECTIVES

To compare the effects of ultrasound-guided platelet-rich plasma (PRP) and whole blood (WB) injections in patients with chronic hamstring tendinopathy.

METHODS

In a prospective double-blind randomized controlled trial, PRP or WB was injected under ultrasound guidance into the proximal hamstring tendon in a cohort of patients with clinically suspected hamstring tendinosis. Questionnaires were administered before injection and 2, 6, and 12 weeks and 6 months after injection. Pain and function outcomes were measured via the Modified Harris Hip Score (MHHS), Hip Outcome Scores for activities of daily living (ADL) and sport-specific function, and International Hip Outcome Tool 33 (IHOT-33). Diagnostic ultrasound was used to compare preinjection and 6-month postinjection tendon appearances.

RESULTS

The WB group showed greater improvements in pain and function over the PRP group before 12 weeks, whereas the PRP group showed improved outcomes over WB at 6 months. None of these between-group outcome measures, except 6-week IHOT-33, showed statistical significance. Comparing preinjection and 6-month scores, the PRP group showed significant improvements in ADL (P = .018) and IHOT-33 (P = .28) scores, whereas the WB group showed no significant improvements from baseline. The WB group showed significantly decreased pain with 15-minute sitting (P= .008) at 6 months. Ultrasound imaging showed no significant differences between PRP and WB group tendon appearances.

CONCLUSIONS

Both PRP and WB groups showed improvements in all outcome measures at 6 months. The PRP group showed significant improvements in 6-month ADL and IHOT-33 scores. The WB group reached significance in 15-minute sitting pain. No significant between-group differences were observed at any time point.

摘要

目的

比较超声引导下富血小板血浆(PRP)注射与全血(WB)注射对慢性腘绳肌腱病患者的疗效。

方法

在一项前瞻性双盲随机对照试验中,在超声引导下将PRP或WB注射到一组临床疑似腘绳肌腱病患者的腘绳肌近端肌腱中。在注射前以及注射后2周、6周、12周和6个月时进行问卷调查。通过改良Harris髋关节评分(MHHS)、日常生活活动(ADL)髋关节结果评分和特定运动功能评分以及国际髋关节结果工具33(IHOT-33)来测量疼痛和功能结果。使用诊断超声比较注射前和注射后6个月时的肌腱外观。

结果

在12周之前,WB组在疼痛和功能方面的改善优于PRP组,而PRP组在6个月时的结果优于WB组。除了6周时的IHOT-33外,这些组间结果指标均无统计学意义。比较注射前和6个月时的评分,PRP组在ADL(P = .018)和IHOT-33(P = .28)评分方面有显著改善,而WB组与基线相比无显著改善。WB组在6个月时15分钟坐位时疼痛明显减轻(P = .008)。超声成像显示PRP组和WB组的肌腱外观无显著差异。

结论

PRP组和WB组在6个月时所有结果指标均有改善。PRP组在6个月时的ADL和IHOT-33评分有显著改善。WB组在15分钟坐位疼痛方面达到显著水平。在任何时间点均未观察到显著的组间差异。

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