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富血小板血浆与软骨修复

Platelet-Rich Plasma and Cartilage Repair.

作者信息

Kennedy Mitchell I, Whitney Kaitlyn, Evans Thos, LaPrade Robert F

机构信息

Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.

The Steadman Clinic, Vail, CO, USA.

出版信息

Curr Rev Musculoskelet Med. 2018 Dec;11(4):573-582. doi: 10.1007/s12178-018-9516-x.

Abstract

PURPOSE OF REVIEW

To assess the utilization and efficacy of platelet-rich plasma (PRP), for the treatment of articular cartilage injury, most commonly characterized by progressive pain and loss of joint function in the setting of osteoarthritis (OA).

RECENT FINDINGS

PRP modulates the inflammatory and catabolic environment through a locally applied concentrate of platelets, leukocytes, and growth factors. Clinically, PRP has been shown to be possibly a viable treatment adjuvant for a variety of inflammatory and degenerative conditions. Recent efforts have focused on optimizing delivery methods that enable platelets to slowly degranulate their biological constituents, which may promote healing and improve OA symptoms for a longer duration. There are various factors that affect the progression of OA within joints, including inhibition of inflammatory cytokines and altering the level of enzymatic expression. PRP therapy aims to mediate inflammatory and catabolic factors in a degenerative environment through the secretion of anti-inflammatory factors and chemotaxic effects. There are a growing number of studies that have demonstrated the clinical benefit of PRP for non-operative management of OA. Additional randomized controlled trials with long-term follow-up are needed in order to validate PRP's therapeutic efficacy in this setting. Additionally, continued basic research along with well-designed pre-clinical studies and reporting standards are necessary in order to clarify the effectiveness of PRP for cartilage repair and regeneration for future clinical applications.

摘要

综述目的

评估富血小板血浆(PRP)在治疗关节软骨损伤中的应用及疗效,关节软骨损伤在骨关节炎(OA)中最常见的特征是进行性疼痛和关节功能丧失。

最新发现

PRP通过局部应用富含血小板、白细胞和生长因子的浓缩物来调节炎症和分解代谢环境。临床上,PRP已被证明可能是治疗多种炎症和退行性疾病的一种可行的辅助治疗方法。最近的研究重点是优化给药方法,使血小板能够缓慢释放其生物成分,这可能促进愈合并在更长时间内改善OA症状。影响关节内OA进展的因素有多种,包括抑制炎性细胞因子和改变酶表达水平。PRP疗法旨在通过分泌抗炎因子和趋化作用来介导退行性环境中的炎症和分解代谢因子。越来越多的研究表明PRP在OA非手术治疗中的临床益处。为了验证PRP在这种情况下的治疗效果,需要进行更多长期随访的随机对照试验。此外,持续的基础研究以及精心设计的临床前研究和报告标准对于阐明PRP在未来临床应用中对软骨修复和再生的有效性是必要的。

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