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与单次关节内注射富含生长因子的富血小板血浆(PRGF-Endoret)相比,对于有症状的膝关节骨关节炎患者,两次关节内注射可改善膝关节僵硬和日常生活活动能力,但不能改善疼痛。

Two cycles of plasma rich in growth factors (PRGF-Endoret) intra-articular injections improve stiffness and activities of daily living but not pain compared to one cycle on patients with symptomatic knee osteoarthritis.

机构信息

Department of Orthopaedic Surgery, Príncipe de Asturias University Hospital, Ctra. Alcalá-Meco s/n, 28805, Alcalá de Henares, Spain.

BTI Biotechnology Institute ImasD, S.L. C/Jacinto Quincoces, 39, 01007, Vitoria, Spain.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2615-2621. doi: 10.1007/s00167-017-4565-z. Epub 2017 May 19.

Abstract

PURPOSE

To assess the clinical efficacy and safety of a treatment based on one cycle versus two cycles of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) on patients with knee osteoarthritis (OA).

METHODS

Ninety patients with knee OA were included and evaluated. A total of 48 patients received one cycle (OC group) (3 injections on a weekly basis), while 42 patients received two cycles of PRGF-Endoret (TC group) spaced 6 months between them. Patients were evaluated with LEQUESNE and WOMAC scores before treatment and after 48 weeks. Safety assessment was also performed.

RESULTS

A significant reduction of all assessed outcome measures was shown for both groups at 48 weeks compared with baseline values (P < 0.001). Patients of TCs group showed a significantly higher reduction (P < 0.05) in WOMAC stiffness subscales. Regarding LEQUESNE INDEX, a significantly higher reduction was observed in the TC group in all subscales except in pain score. In the maximum walking distance subscale (MCD), the improvement rate was 31.8% higher for the TCs group compared with the OC group (P < 0.01). In addition, the TC group showed a significant improvement in LEQUESNE activities of daily living (ADV) and global subscales of 14.7 and 11.8% (P < 0.05) higher, respectively, than the OC group.

CONCLUSIONS

Treatment with two cycles of PRGF did not show a significantly higher pain reduction compared with one cycle treatment. However, two cycles of PRGF showed a significant improvement in WOMAC stiffness, LEQUESNE MCD, LEQUESNE ADV and LEQUESNE global subscales. Therefore, patients treated with two cycles present an improvement in quality of life.

LEVEL OF EVIDENCE

II.

摘要

目的

评估基于一个周期与两个周期关节内注射富含生长因子的血浆(PRGF-Endoret)治疗膝关节骨关节炎(OA)患者的临床疗效和安全性。

方法

纳入 90 例膝关节 OA 患者并进行评估。共 48 例患者接受一个周期(OC 组)(每周 3 次注射),而 42 例患者接受两个周期的 PRGF-Endoret(TC 组),间隔 6 个月。患者在治疗前和 48 周后接受 LEQUESNE 和 WOMAC 评分评估。还进行了安全性评估。

结果

与基线值相比,两组在 48 周时所有评估的结果测量值均显著降低(P<0.001)。TC 组在 WOMAC 僵硬亚量表中的降低幅度显著更高(P<0.05)。关于 LEQUESNE 指数,TC 组在除疼痛评分外的所有亚量表中均观察到显著降低。在最大步行距离亚量表(MCD)中,TC 组的改善率比 OC 组高 31.8%(P<0.01)。此外,TC 组在 LEQUESNE 日常生活活动(ADV)和全球亚量表中分别显示出 14.7%和 11.8%(P<0.05)更高的改善率。

结论

与一个周期的治疗相比,两个周期的 PRGF 治疗并未显示出显著更高的疼痛缓解率。然而,两个周期的 PRGF 治疗在 WOMAC 僵硬、LEQUESNE MCD、LEQUESNE ADV 和 LEQUESNE 全球亚量表方面显示出显著改善。因此,接受两个周期治疗的患者生活质量得到改善。

证据水平

II。

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