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膝关节骨关节炎患者中皮质类固醇与富血小板血浆注射疗法的疗效比较

Comparison of Efficiency Between Corticosteroid and Platelet Rich Plasma Injection Therapies in Patients With Knee Osteoarthritis.

作者信息

Uslu Güvendi Ece, Aşkin Ayhan, Güvendi Güven, Koçyiğit Hikmet

机构信息

Department of Physical Medicine and Rehabilitation, Dumlupınar University Evliya Çelebi Training and Research Hospital, Kütahya, Turkey.

Department of Physical Medicine and Rehabilitation, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.

出版信息

Arch Rheumatol. 2017 Nov 2;33(3):273-281. doi: 10.5606/ArchRheumatol.2018.6608. eCollection 2018 Sep.

Abstract

OBJECTIVES

This study aims to assess whether platelet rich plasma (PRP) is an effective treatment for knee osteoarthritis, and compare its efficiency with corticosteroid treatment in terms of pain control, physical function, and quality of life.

PATIENTS AND METHODS

The study included 50 patients (4 males, 46 females; mean age 61.6±6.9 years; range 50 to 75 years) who were diagnosed as grade 3 knee osteoarthritis. Patients were randomized into three groups as corticosteroid group (receiving one corticosteroid injection), single PRP group (receiving one PRP injection), and three PRP group (receiving three PRP injections with one week interval). All patients were given a home exercise program. Patients were evaluated with Visual Numeric Scale (VNS), Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC), Lequesne index and the Hospital Anxiety and Depression Scale before treatment, and at second and sixth months following the implementation of injections.

RESULTS

In single and three PRP groups; VNS, WOMAC and Lequesne scores decreased significantly at second month follow-up; also, sixth month scores showed a slight increase but remained significantly lower than baseline. In corticosteroid group, all VNS, WOMAC, and Lequesne scores decreased at second month follow-up; however, at sixth month, rest, night VNS and WOMAC stiffness scores were increased while no significant difference was found with baseline. At sixth month; VNS movement, WOMAC pain, function, and the total and Lequesne scores were worse, but remained significantly lower than baseline. When groups were compared, three PRP group's second month VNS movement scores were significantly lower than the corticosteroid group. Sixth month VNS movement and WOMAC pain scores were significantly lower in single and three PRP groups compared to the corticosteroid group, with no significant difference between the PRP groups.

CONCLUSION

Our findings revealed that PRP is a safe treatment option and efficient in osteoarthritis symptom control up to six months after application. Treatment response obtained with corticosteroid injection has a shorter duration than PRP treatment.

摘要

目的

本研究旨在评估富血小板血浆(PRP)是否为膝关节骨关节炎的有效治疗方法,并在疼痛控制、身体功能和生活质量方面将其疗效与皮质类固醇治疗进行比较。

患者与方法

该研究纳入了50例被诊断为3级膝关节骨关节炎的患者(4例男性,46例女性;平均年龄61.6±6.9岁;年龄范围50至75岁)。患者被随机分为三组:皮质类固醇组(接受一次皮质类固醇注射)、单次PRP组(接受一次PRP注射)和三次PRP组(接受三次PRP注射,间隔一周)。所有患者均接受家庭锻炼计划。在治疗前、注射实施后的第二个月和第六个月,使用视觉数字量表(VNS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、勒凯斯内指数和医院焦虑抑郁量表对患者进行评估。

结果

在单次和三次PRP组中,VNS、WOMAC和勒凯斯内评分在第二个月随访时显著降低;此外,第六个月的评分略有上升,但仍显著低于基线。在皮质类固醇组中,所有VNS、WOMAC和勒凯斯内评分在第二个月随访时均降低;然而,在第六个月时,休息、夜间VNS和WOMAC僵硬评分升高,与基线相比无显著差异。在第六个月时,VNS运动、WOMAC疼痛、功能以及总分和勒凯斯内评分更差,但仍显著低于基线。当比较各组时,三次PRP组第二个月的VNS运动评分显著低于皮质类固醇组。与皮质类固醇组相比,单次和三次PRP组在第六个月时的VNS运动和WOMAC疼痛评分显著更低,PRP组之间无显著差异。

结论

我们的研究结果表明,PRP是一种安全的治疗选择,在应用后长达六个月的时间内对骨关节炎症状控制有效。皮质类固醇注射获得的治疗反应持续时间比PRP治疗短。

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