Fiz Nicolás, Delgado Diego, Garate Ane, Sánchez Pello, Oraa Jaime, Bilbao Ane Miren, Guadilla Jorge, Sánchez Mikel
Arthroscopic Surgery Unit, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
Advanced Biological Therapy Unit, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
J Clin Orthop Trauma. 2020 Jul;11(Suppl 4):S585-S590. doi: 10.1016/j.jcot.2019.12.012. Epub 2019 Dec 28.
Addressing the subchondral bone through intraosseous infiltrations of Platelet-Rich Plasma (PRP) may improve the effectiveness of this technique for severe hip osteoarthritis (HOA).
Forty patients with HOA degree 2 and 3 according to the Tönnis scale were recruited for this study. They were susceptible to a total hip arthroplasty, without response to previous treatment based on intraarticular infiltrations of PRP. Patients received a combination of intraosseous injections into the acetabulum and the femoral head, as well as intraarticular PRP infiltrations. The clinical outcome was evaluated at 2, 6 and 12 months using the Hip Osteoarthritis Outcome Score (HOOS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index.
At 2, 6 and 12 months, patients had significant pain improvement according to HOOS pain, WOMAC pain, and VAS scores. After the treatment, the percentage of patients with minimal clinically important improvement was 40% (16 over 40 patients) at 2 months, 37.5% (15 over 40) at 6 months, and 40% (16 over 40) at 12 months. : The combination of intra-articular and intra-osseous infiltrations of PRP showed a pain reduction and improvement in hip joint functionality up to 12 months in patients with severe HOA, with no severe adverse effects.
通过富血小板血浆(PRP)骨内注射来处理软骨下骨,可能会提高该技术对重度髋骨关节炎(HOA)的疗效。
根据Tönnis量表,招募了40例2级和3级HOA患者进行本研究。他们适合进行全髋关节置换术,对先前基于PRP关节内注射的治疗无反应。患者接受了髋臼和股骨头的骨内注射以及关节内PRP注射的联合治疗。使用髋骨关节炎结局评分(HOOS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)在2、6和12个月时评估临床结局。
在2、6和12个月时,根据HOOS疼痛、WOMAC疼痛和视觉模拟评分(VAS),患者的疼痛有显著改善。治疗后,在2个月时,具有最小临床重要改善的患者百分比为40%(40例患者中的16例),6个月时为37.5%(40例中的15例),12个月时为40%(40例中的16例)。:PRP关节内和骨内注射的联合治疗在重度HOA患者中显示出疼痛减轻和髋关节功能改善,持续长达12个月,且无严重不良反应。