From the Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China (Y-TW, K-CH, T-YL, L-CC); Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China (Y-TW, T-YL); and Department of Radiology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China (C-KC).
Am J Phys Med Rehabil. 2018 Apr;97(4):248-254. doi: 10.1097/PHM.0000000000000874.
No studies comparing the effects of platelet-rich plasma (PRP) injection and placebo injection in bilateral knee osteoarthritis in the same patient, or discussing muscle strength after PRP injection, have been published.
Twenty patients with bilateral knee osteoarthritis were eligible, and 40 knees were randomized into two groups: PRP (knees [right or left by a coin toss] receiving a single intra-articular PRP injection) and saline group (the contralateral knee of the same patient, into which single 4-mL intra-articular injection of normal saline was administered). The primary outcome measure was Western Ontario and McMaster's Universities Osteoarthritis Index and the secondary included isokinetic test results. The evaluation was at baseline and at 2 wks, 1, 3, and 6 mos after injection.
The PRP group showed a significant reduction in the Western Ontario and McMaster's Universities Osteoarthritis Index pain and total scores compared with normal saline group (P < 0.05). Although a significantly greater percentage of knee strength (extensor > flexor) was found in the PRP group during a longer follow-up period, PRP treatment resulted in insignificant differences in muscle strength compared with normal saline.
Platelet-rich plasma treatment significantly improves pain, stiffness, and disability in patients with knee osteoarthritis compared with normal saline treatment. Additional strength training is recommended to enhance muscle strength recovery.
目前尚无研究比较富血小板血浆(PRP)注射和安慰剂注射对同一患者双侧膝骨关节炎的影响,也没有探讨 PRP 注射后肌肉力量的变化。
共有 20 例双侧膝骨关节炎患者符合纳入标准,将 40 个膝关节随机分为两组:PRP 组(通过抛硬币决定膝关节[右侧或左侧]接受单次关节内 PRP 注射)和盐水组(同一患者的对侧膝关节,接受单次 4 mL 关节内生理盐水注射)。主要结局指标为西安大略和麦克马斯特大学骨关节炎指数,次要结局指标包括等速测试结果。评估在基线时以及注射后 2 周、1 个月、3 个月和 6 个月时进行。
与生理盐水组相比,PRP 组的西安大略和麦克马斯特大学骨关节炎指数疼痛和总分明显降低(P < 0.05)。虽然在更长的随访期间,PRP 组的膝关节力量(伸肌>屈肌)有更大的百分比增加,但 PRP 治疗与生理盐水治疗相比,肌肉力量的差异无统计学意义。
与生理盐水治疗相比,PRP 治疗可显著改善膝骨关节炎患者的疼痛、僵硬和残疾。建议进行额外的力量训练以增强肌肉力量的恢复。