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富血小板血浆(PRP)治疗膝关节炎:一项初级保健中的可行性研究。

Platelet-rich plasma (PRP) therapy for knee arthritis: a feasibility study in primary care.

作者信息

Glynn Liam G, Mustafa Alaa, Casey Monica, Krawczyk Janusz, Blom Jeanete, Galvin Rose, Hannigan Ailish, Dunne Colum P, Murphy Andrew W, Mallen Christian

机构信息

1Graduate Entry Medical School and Health Research Institute, University of Limerick, Limerick, Ireland.

2Department of Haematology, University College Hospital Galway, Galway, Ireland.

出版信息

Pilot Feasibility Stud. 2018 Jul 4;4:93. doi: 10.1186/s40814-018-0288-2. eCollection 2018.

Abstract

BACKGROUND

Platelet-rich plasma (PRP) is a concentrate of autologous blood growth factors which has been shown to provide some symptomatic relief in early osteoarthritis (OA) of the knee. The objective of this study was to test the feasibility and efficacy potential of platelet rich plasma (PRP) in primary care.

METHODS

Feasibility study to assess safety of the intervention procedures and assess primary and secondary outcome measures. Consecutive patients presenting with symptomatic knee OA were recruited in a primary care setting in Ireland. All participants received three injections of PRP 4 weeks apart. The following self-reported clinical outcomes were evaluated before and after therapy (4 months): Pain and disability (ICOAP questionnaire); health utility (EUROQol); adverse events; patient satisfaction and goal-orientated outcomes.

RESULTS

Seventeen potential patients were identified of whom 14 were eligible to participate. Twelve consented and completed the intervention and all outcome measures. There were no losses to follow-up. One patient reported pain and stiffness for 2 days after the first injection but did complete the study. No growth was detected from nine consecutive samples sent for microbiology analysis. Changes in constant, intermittent and total pain scores were reported; pain fully resolved in two patients. In addition, health utility, patient satisfaction and goal-orientated outcomes also demonstrated improvement.

CONCLUSIONS

Platelet-rich plasma therapy is a simple and minimally invasive intervention which is feasible to deliver in primary care to treat osteoarthritis of the knee joint. Well-designed randomised controlled trials are needed to measure outcomes, durability of effect and cost effectiveness.

摘要

背景

富血小板血浆(PRP)是一种自体血液生长因子浓缩物,已被证明能在膝关节早期骨关节炎(OA)中提供一定的症状缓解。本研究的目的是测试富血小板血浆(PRP)在初级保健中的可行性和潜在疗效。

方法

进行可行性研究,以评估干预程序的安全性,并评估主要和次要结局指标。在爱尔兰的一个初级保健机构招募有症状的膝关节OA连续患者。所有参与者每隔4周接受三次PRP注射。在治疗前后(4个月)评估以下自我报告的临床结局:疼痛和残疾(ICOAP问卷);健康效用(欧洲五维度健康量表);不良事件;患者满意度和目标导向性结局。

结果

确定了17名潜在患者,其中14名符合参与条件。12名患者同意并完成了干预及所有结局指标评估。无失访情况。一名患者在首次注射后报告疼痛和僵硬2天,但完成了研究。连续送去进行微生物分析的9个样本均未检测到生长。报告了持续、间歇和总疼痛评分的变化;两名患者疼痛完全缓解。此外,健康效用、患者满意度和目标导向性结局也显示有所改善。

结论

富血小板血浆疗法是一种简单且微创的干预措施,在初级保健中用于治疗膝关节骨关节炎是可行的。需要设计良好的随机对照试验来衡量结局、疗效持久性和成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cc/6030745/e2cfef1df35a/40814_2018_288_Fig1_HTML.jpg

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