Repetto Ilaria, Biti Besmir, Cerruti Paola, Trentini Roberto, Felli Lamberto
Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
Orthopedist, Department of Surgical Sciences, Orthopaedic and Traumatologic Clinic, University of Genoa, IRCCS University Hospital San Martino IST, National Institute for Cancer Research, Genoa, Italy.
J Foot Ankle Surg. 2017 Mar-Apr;56(2):362-365. doi: 10.1053/j.jfas.2016.11.015.
Osteoarthritis is the most common and disabling of the orthopedic diseases. Currently, the conservative treatment of osteoarthritis is limited to symptomatic treatment, whose goal is to improve function and pain control. Ankle osteoarthritis is relatively uncommon, in contrast to osteoarthritis of the hip and knee, and the therapeutic options (both pharmacologic and surgical) are limited, with surgery providing poorer and less predictable results. The effectiveness of platelet-rich plasma injections for osteoarthritis is still controversial, especially so for ankle arthritis, owing to the lack of evidence in the present data. We retrospectively evaluated the mid- to long-term clinical results (mean follow-up of 17.7 months) for platelet-rich plasma injections in 20 patients (20 ankles) with ankle osteoarthritis. We evaluated the presence of pain using the visual analog scale, function using the Foot and Ankle Disability Index, and subjective satisfaction. The pre- and post-treatment scores, obtained from the clinical records and from telephone interviews during the follow-up period, were compared using the Student t test. We found a strong positive effect for 4 platelet-rich plasma injections (injected once a week) on pain (p = .0001) and function (p = .001), with 80% of patients very satisfied and satisfied, and only 2 patients (10%) required surgery because of early treatment failure. These results suggest that the use of platelet-rich plasma injection is a valid and safe alternative to postpone the need for surgery.
骨关节炎是最常见且致残的骨科疾病。目前，骨关节炎的保守治疗仅限于对症治疗，其目标是改善功能和控制疼痛。与髋部和膝部骨关节炎相比，踝关节骨关节炎相对少见，并且治疗选择（包括药物和手术治疗）有限，手术效果较差且可预测性较低。由于现有数据缺乏证据，富血小板血浆注射治疗骨关节炎的有效性仍存在争议，对于踝关节关节炎尤其如此。我们回顾性评估了20例踝关节骨关节炎患者（20个踝关节）接受富血小板血浆注射的中长期临床结果（平均随访17.7个月）。我们使用视觉模拟量表评估疼痛程度，使用足踝功能障碍指数评估功能，并评估主观满意度。通过临床记录和随访期间的电话访谈获得治疗前后的评分，使用学生t检验进行比较。我们发现每周注射一次，共注射4次富血小板血浆对疼痛（p = .0001）和功能（p = .001）有显著的积极效果，80%的患者非常满意或满意，只有2例患者（10%）因早期治疗失败而需要手术。这些结果表明，使用富血小板血浆注射是一种有效且安全的替代方法，可以推迟手术需求。
