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富血小板血浆关节内及关节外注射治疗膝关节骨关节炎

[Platelet rich plasma intra-articular and extra-articular injection for the treatment of knee osteoarthritis].

作者信息

Du Wei, Cui Hong-Peng, Fu Ben-Sheng, Li Wen, Liu Qian, Zhong Yu-Xian, Dong Yan-Han

机构信息

Department of Rehabilitation, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China.

出版信息

Zhongguo Gu Shang. 2020 Mar 25;33(3):209-13. doi: 10.12200/j.issn.1003-0034.2020.03.004.

Abstract

OBJECTIVE

To observe clinical effects of platelet-rich plasma (PRP) intra-articular and extra-articular injection for patients with knee osteoarthritis (KOA), and analyze its safety and clinical efficacy.

METHODS

From January to December 2017, 48 patients with KOA were randomly divided into observation group and control group, 24 cases in each group. The observation group was treated with intra-articular injection of PRP (2 ml) and extra-articular injection of PRP (2 ml), once a week, for three times, including 8 males and 16 females with an average of (58.04±7.87) years old ranging from 43 to 68 years old, the courses of disease ranged from 1 to 8 years with an average of (4.69±1.96) years, the body mass index (BMI) was (24.53±5.26) kg/m 2 . The control group was treated with intra-articular injection of sodium hyaluronate (20 mg), extra-articular injection of analgesic drug (2 ml for one point), once a week, for three times, including 7 males and 17 females with an average of (60.54±8.93) years old ranging from 47 to 72 years old, the courses of disease ranged from 1.5 to 9 years with an average of (5.27±1.68) years, BMI was (23.47±4.62) kg/m 2 . VAS score and Lysholm score before operation and the 1st, 6th month after treatment were compared between two groups.

RESULTS

All patients were followed up at least 6 months without occurrence serious adverse reactions or complications. VAS score in observation group and control group before treatment and 1st, 6th month after treatment were 7.35±1.47, 4.15±1.52, 2.26±1.02 and 7.51±1.39, 3.84±1.76, 3.66±1.18, respectively; VAS score in obsevation group was lower than that of control group at 6 months after treatment. Lysholm score in observation group and control group before treatment and 1st, 6th month after treatment were 55.21±5.78, 79.16±7.25, 85.45±6.87 and 54.65± 6.40, 77.58±6.94, 82.34±7.12. There were significant differences in Lysholm score before and after injection between two groups (<0.05) . There was no significant difference in Lysholm score between two groups at 1 month after treatment (>0.05), while Lysholm score in observation group was better than that of control group at 6 months after treatment (<0.05) .

CONCLUSION

Intra-articular and extra-articular injection of PRP could relieve pain symptoms and improve function of knee joint with higher safety, although the short-term effect is not significantly different from traditional treatment, its medium-long-term effect is stable. It is a safe and effective method for the treatment of knee osteoarthritis.

摘要

目的

观察富血小板血浆(PRP)关节内及关节外注射治疗膝关节骨关节炎(KOA)患者的临床效果,并分析其安全性和临床疗效。

方法

2017年1月至12月,将48例KOA患者随机分为观察组和对照组,每组24例。观察组采用关节内注射PRP(2 ml)及关节外注射PRP(2 ml)治疗,每周1次,共3次,其中男性8例,女性16例,年龄43~68岁,平均(58.04±7.87)岁,病程1~8年,平均(4.69±1.96)年,体重指数(BMI)为(24.53±5.26)kg/m²。对照组采用关节内注射透明质酸钠(20 mg),关节外注射止痛药物(每点2 ml)治疗,每周1次,共3次,其中男性7例,女性17例,年龄47~72岁,平均(60.54±8.93)岁,病程1.5~9年,平均(5.27±1.68)年,BMI为(23.47±4.62)kg/m²。比较两组术前及治疗后第1、6个月的视觉模拟评分(VAS)和Lysholm评分。

结果

所有患者均随访至少6个月,未发生严重不良反应或并发症。观察组和对照组治疗前及治疗后第1、6个月的VAS评分分别为7.35±1.47、4.15±1.52、2.26±1.02和7.51±1.39、3.84±1.76、3.66±1.18;治疗后6个月观察组VAS评分低于对照组。观察组和对照组治疗前及治疗后第1、6个月的Lysholm评分分别为55.21±5.78、79.16±7.25、85.45±6.87和54.65±6.40、77.58±6.94、82.34±7.12。两组注射前后Lysholm评分差异有统计学意义(<0.05)。治疗后1个月两组Lysholm评分差异无统计学意义(>0.05),而治疗后6个月观察组Lysholm评分优于对照组(<0.05)。

结论

关节内及关节外注射PRP可缓解膝关节疼痛症状,改善膝关节功能,安全性较高,虽然短期效果与传统治疗差异不明显,但其中长期效果稳定。是一种治疗膝关节骨关节炎安全有效的方法。

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