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新型多孔套管骨抽吸浓缩物治疗骨关节炎的早期临床疗效观察。

Positive early clinical outcomes of bone marrow aspirate concentrate for osteoarthritis using a novel fenestrated trocar.

机构信息

Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA; Advanced Orthopaedic Specialists, Fayetteville, AR, USA.

Advanced Orthopaedic Specialists, Fayetteville, AR, USA.

出版信息

Knee. 2020 Oct;27(5):1627-1634. doi: 10.1016/j.knee.2020.08.018. Epub 2020 Sep 23.

Abstract

BACKGROUND

This study sought to assess early clinical outcomes for knee osteoarthritis (OA) patients undergoing bone marrow aspirate concentrate (BMAC) treatment using a novel closed-end, fenestrated trocar (FT) that does not require centrifugation.

METHODS

A prospective cohort of 17 knee OA patients undergoing BMAC treatment with the FT system from March 2018 to March 2019 was retrospectively evaluated. Approximately 10 mL of BMAC was harvested, no centrifugation was performed, and the BMAC was injected into the affected knee. Clinical outcomes were assessed at baseline, six weeks, and 12 weeks. This study has no affiliation with/vested-interest in the FT system.

RESULTS

There were significant improvements in nearly all outcomes from baseline to 12 weeks. Specific improvements included Knee Injury and OA Outcome Score (KOOS) activities-of-daily-living (61.1 ± 9.2 [mean ± 95% confidence interval] to 89.3 ± 6, p = 0.001), quality-of-life (32.7 ± 9.3 to 66.1 ± 17.9, p = 0.003), sports/recreation (36.9 ± 10.6 to 72.6 ± 26.3, p = 0.006), and pain (53.8 ± 9.3 to 83 ± 10.2, p = 0.001); Lysholm scores (55.5 ± 8.4 to 77.3 ± 10.5, p = 0.009); and visual analog pain scores (5.68 ± 1.14 to 2.07 ± 1.86, p = 0.003). Individually, at least 75% of patients exhibited improvement in all KOOS categories at six weeks and at least 85% at 12 weeks.

CONCLUSIONS

BMAC treatment with an FT system that does not require centrifugation resulted in significant improvements in early pain and function scores for knee OA. The symptomatic improvements in this study were similar to or greater than what has been reported using traditional needles. These data may provide clinicians with comfort in using an FT system and provide motivation for future randomized-controlled trials comparing aspiration techniques.

摘要

背景

本研究旨在评估使用新型封闭式、有孔套管(FT)进行骨髓抽吸浓缩(BMAC)治疗的膝骨关节炎(OA)患者的早期临床结果,该套管无需离心。

方法

回顾性评估了 2018 年 3 月至 2019 年 3 月期间使用 FT 系统接受 BMAC 治疗的 17 例膝 OA 患者的前瞻性队列。大约采集了 10ml 的 BMAC,未进行离心,将 BMAC 注入受影响的膝关节。在基线、6 周和 12 周评估临床结果。本研究与 FT 系统没有关联/无既得利益。

结果

从基线到 12 周,几乎所有结果都有显著改善。具体改善包括膝关节损伤和骨关节炎结果评分(KOOS)的日常生活活动(61.1±9.2[平均值±95%置信区间]至 89.3±6,p=0.001)、生活质量(32.7±9.3 至 66.1±17.9,p=0.003)、运动/娱乐(36.9±10.6 至 72.6±26.3,p=0.006)和疼痛(53.8±9.3 至 83±10.2,p=0.001);Lysholm 评分(55.5±8.4 至 77.3±10.5,p=0.009)和视觉模拟疼痛评分(5.68±1.14 至 2.07±1.86,p=0.003)。个别而言,至少 75%的患者在 6 周时所有 KOOS 类别均有改善,至少 85%的患者在 12 周时均有改善。

结论

无需离心的 FT 系统进行 BMAC 治疗可显著改善膝 OA 的早期疼痛和功能评分。本研究中症状的改善与或优于传统针使用的报告。这些数据可为临床医生使用 FT 系统提供舒适感,并为比较抽吸技术的未来随机对照试验提供动力。

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