富含血小板血浆和透明质酸与自体骨软骨移植联合用作生物辅助剂时并无协同作用。

Platelet-Rich Plasma and Hyaluronic Acid Are Not Synergistic When Used as Biological Adjuncts with Autologous Osteochondral Transplantation.

作者信息

Smyth Niall A, Ross Keir A, Haleem Amgad M, Hannon Charles P, Murawski Christopher D, Do Huong T, Kennedy John G

机构信息

1 University of Miami Miller School of Medicine, Miami, FL, USA.

2 University of Maryland School of Medicine, New York, NY, USA.

出版信息

Cartilage. 2018 Jul;9(3):321-328. doi: 10.1177/1947603517690022. Epub 2017 Feb 8.

Abstract

UNLABELLED

Introduction Autologous osteochondral transplantation (AOT) is a treatment for osteochondral lesions with known concerns, including histological degradation of the graft and poor cartilage integration. Platelet-rich plasma (PRP) and hyaluronic acid (HA) have been described has having the potential to improve results. The aim of this study was to evaluate the effect of PRP and HA on AOT in a rabbit model. Methods Thirty-six rabbits underwent bilateral knee AOT treated with either the biological adjunct (PRP, n = 12; HA, n = 12; PRP + HA, n = 12) or saline (control). PRP and HA were administered as an intra-articular injection. The rabbits were euthanized at 3, 6, or 12 weeks postoperatively. The graft sections were assessed using the modified International Cartilage Repair Society (ICRS) scoring system. The results from the PRP alone group is from previously published data. Results The mean modified ICRS histological score for the PRP-treated group was higher than its control ( P = 0.002). The mean modified ICRS histological score for the HA-treated group showed no difference compared with its control ( P = 0.142). The mean modified ICRS histological score for the PRP + HA-treated group was higher than its control ( P = 0.006). There was no difference between the mean modified ICRS scores of the PRP- and the PRP + HA-treated grafts ( P = 0.445). Conclusion PRP may decrease graft degradation and improve chondral integration in an animal model. In this model, the addition of HA was not synergistic for the parameters assessed.

LEVEL OF EVIDENCE

Basic science, Level V.

CLINICAL RELEVANCE

PRP can be used as an adjunct to AOT, which may decrease graft degeneration and improve clinical outcomes. HA may not influence AOT.

摘要

未标注

引言 自体骨软骨移植(AOT)是治疗骨软骨损伤的一种方法,但存在一些已知问题,包括移植物的组织学退变和软骨整合不良。富血小板血浆(PRP)和透明质酸(HA)已被描述具有改善治疗效果的潜力。本研究的目的是在兔模型中评估PRP和HA对AOT的影响。方法 36只兔接受双侧膝关节AOT,分别用生物辅助剂(PRP,n = 12;HA,n = 12;PRP + HA,n = 12)或生理盐水(对照)治疗。PRP和HA通过关节内注射给药。术后3、6或12周对兔实施安乐死。使用改良的国际软骨修复协会(ICRS)评分系统评估移植物切片。单独使用PRP组的结果来自先前发表的数据。结果 PRP治疗组的平均改良ICRS组织学评分高于其对照组(P = 0.002)。HA治疗组的平均改良ICRS组织学评分与其对照组相比无差异(P = 0.142)。PRP + HA治疗组的平均改良ICRS组织学评分高于其对照组(P = 0.006)。PRP治疗组和PRP + HA治疗组移植物的平均改良ICRS评分之间无差异(P = 0.445)。结论 在动物模型中,PRP可能会减少移植物退变并改善软骨整合。在该模型中,添加HA对所评估的参数没有协同作用。

证据水平

基础科学,V级。

临床相关性

PRP可作为AOT的辅助手段,这可能会减少移植物退变并改善临床结果。HA可能不会影响AOT。

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