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关节内注射透明质酸与富血小板血浆治疗髋骨关节炎的比较

Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis.

作者信息

Di Sante Luca, Villani Ciro, Santilli Valter, Valeo Massimo, Bologna Emmalisa, Imparato Luca, Paoloni Marco, Iagnocco Annamaria

机构信息

Physical Medicine and Rehabilitation Unit, AziendaPoliclinico Umberto I, Rome, Italy.

Orthopaedic Clinic Azienda Policlinico Umberto I, Department of Orthopedic Science, Sapienza Università di Roma, Rome, Italy.

出版信息

Med Ultrason. 2016 Dec 5;18(4):463-468. doi: 10.11152/mu-874.

Abstract

AIM

To compare the efficacy of ultrasound-guided intra-articular (IA) treatment with platelet-rich plasma (PRP) versus viscosupplementation (hyaluronic acid HA) in hip osteoarthritis. METHODS: A total of 43 patients affected by monolateral severe hip osteoarthritis (OA) were included in the study. Patients were randomized to receive either intra-articular PRP (3 ml) or HA (30 mg/2 ml; 1,000-2,900 kDa), 3 injections in total - 1/week. Clinical assessments for each patient were made at baseline (T0), 4 (T1), and 16 weeks (T2) of follow-up. The primary efficacy outcome was pain reduction as measured by VAS and by WOMAC pain subscale.

RESULTS

Data analysis revealed that, compared to T0, in the PRP-treated group VAS scores significantly decreased at T1 but not at T2, thereby indicating an early effect on pain which was not maintained at a longer term follow-up. In the HA group a significant decrease of both VAS and WOMAC values was registered only between T0 and T2.

CONCLUSIONS

Intra-articular PRP had an immediate effect on pain that was not maintained at longer term follow-up when, on the contrary, the effects of intra-articular HA were evident.

摘要

目的

比较超声引导下关节内注射富血小板血浆(PRP)与玻璃酸钠补充疗法(透明质酸HA)治疗髋骨关节炎的疗效。方法:本研究共纳入43例单侧重度髋骨关节炎(OA)患者。患者被随机分为两组,分别接受关节内注射PRP(3毫升)或HA(30毫克/2毫升;1000 - 2900千道尔顿),共注射3次,每周1次。在随访的基线期(T0)、4周(T1)和16周(T2)对每位患者进行临床评估。主要疗效指标是通过视觉模拟评分法(VAS)和Western Ontario和McMaster大学骨关节炎指数(WOMAC)疼痛子量表测量的疼痛减轻情况。结果:数据分析显示,与T0相比,PRP治疗组的VAS评分在T1时显著降低,但在T2时未降低,这表明对疼痛有早期影响,但在长期随访中未持续。在HA组中,仅在T0和T2之间VAS和WOMAC值均显著降低。结论:关节内注射PRP对疼痛有即时作用,但在长期随访中未持续,相反,关节内注射HA的效果明显。

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