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同源富血小板血浆治疗特定老年患者膝关节骨关节炎:一项开放标签、非对照的试点研究。

Homologous platelet-rich plasma for the treatment of knee osteoarthritis in selected elderly patients: an open-label, uncontrolled, pilot study.

作者信息

Bottegoni Carlo, Dei Giudici Luca, Salvemini Sergio, Chiurazzi Enrico, Bencivenga Rosella, Gigante Antonio

机构信息

Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy.

Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.

出版信息

Ther Adv Musculoskelet Dis. 2016 Apr;8(2):35-41. doi: 10.1177/1759720X16631188. Epub 2016 Feb 12.

Abstract

OBJECTIVE

The objective of this study was to evaluate the safety and the effect of platelet-rich plasma (PRP) intra-articular injections obtained from blood donors (homologous PRP) on elderly patients with early or moderate knee osteoarthritis (OA) who are not candidates for autologous PRP treatment.

METHODS

A total of 60 symptomatic patients, aged 65-86 years, affected by hematologic disorders and early or moderate knee OA, were treated with 5 ml of homologous PRP intra-articular injections every 14 days for a total of three injections. Clinical evaluations before the treatment, and after 2 and 6 months were performed by International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) and Equal Visual Analogue Scale (EQ VAS) scores. Adverse events and patient satisfaction were recorded.

RESULTS

No severe complications were noted during the treatment and the follow-up period. A statistically significant improvement from basal evaluation to the 2-month follow-up visit was observed, whereas a statistically significant worsening from the 2-month to the 6-month follow-up visit was showed. The overall worst results were observed in patients aged 80 years or over and in those affected by minor bone attrition. It was found that 90% of patients were satisfied at the 6-month evaluation.

CONCLUSIONS

Homologous PRP has an excellent safety profile but offers only a short-term clinical improvement in selected elderly patients with knee OA who are not candidates for autologous PRP treatment. Increasing age and developing degeneration result in a decreased potential for homologous PRP injection therapy. Further studies are needed to confirm these findings.

摘要

目的

本研究的目的是评估从献血者获得的富血小板血浆(PRP)关节内注射(同源PRP)对不适合自体PRP治疗的早期或中度膝骨关节炎(OA)老年患者的安全性和疗效。

方法

共有60例年龄在65 - 86岁、患有血液系统疾病且伴有早期或中度膝OA的有症状患者,每14天接受5毫升同源PRP关节内注射,共注射三次。在治疗前、治疗后2个月和6个月进行国际膝关节文献委员会(IKDC)、膝关节损伤和骨关节炎结局评分(KOOS)以及视觉模拟评分量表(EQ VAS)评分等临床评估。记录不良事件和患者满意度。

结果

在治疗和随访期间未观察到严重并发症。从基础评估到2个月随访观察到有统计学意义的改善,而从2个月到6个月随访则显示有统计学意义的恶化。在80岁及以上患者和轻度骨质磨损患者中观察到总体最差结果。发现在6个月评估时有90%的患者感到满意。

结论

同源PRP具有良好的安全性,但对于不适合自体PRP治疗的特定膝OA老年患者仅提供短期临床改善。年龄增长和退变会导致同源PRP注射治疗的潜力降低。需要进一步研究来证实这些发现。

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