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富血小板血浆注射治疗髋骨关节炎:证据回顾。

Platelet-rich plasma injections for hip osteoarthritis: a review of the evidence.

机构信息

University Hospital Limerick, Limerick, Ireland.

University Limerick Graduate Entry Medical School, Limerick, Ireland.

出版信息

Ir J Med Sci. 2021 Aug;190(3):1021-1025. doi: 10.1007/s11845-020-02388-z. Epub 2020 Oct 5.

Abstract

Osteoarthritis is a significant cause of chronic pain in the elderly population with hip osteoarthritis as one of the main causes of functional disability and joint pain in adults older than 55 years. Recently, platelet rich plasma (PRP) injections have been introduced for treatment of osteoarthritis. The aim of this systematic review is to assess its effectiveness in the management of hip osteoarthritis. We performed a search of the literature for published prospective studies that assessed the effectiveness of PRP injections in the treatment of hip osteoarthritis, with a minimum follow-up of 3 months. Primary outcome measures were WOMAC and VAS scores. Five trials were identified with 185 patients undergoing treatment with ultrasound-guided intra-articular injections of PRP, compared with patients treated with hyaluronic acid alone (n = 148) or hyaluronic acid combined with PRP (n = 31) in one study. PRP was shown to improve patient outcome scores at follow-up at 6 and 12 months; however, there was no significant difference seen between patients treated with PRP or hyaluronic acid alone. Following this systematic review, we cannot currently recommend the use of intra-articular injections of PRP for the treatment of hip OA. Given that intra-articular steroid injections are the only such injection recommended by international guidelines for the treatment of hip OA, further studies comparing PRP to steroid would be of benefit to determine the value of PRP injections in hip OA.

摘要

骨关节炎是老年人群慢性疼痛的一个重要原因,髋骨关节炎是 55 岁以上成年人功能障碍和关节疼痛的主要原因之一。最近,富血小板血浆(PRP)注射已被引入用于治疗骨关节炎。本系统评价的目的是评估其在髋骨关节炎治疗中的有效性。我们对已发表的前瞻性研究进行了文献检索,这些研究评估了 PRP 注射治疗髋骨关节炎的有效性,随访时间至少为 3 个月。主要结局指标为 WOMAC 和 VAS 评分。确定了五项试验,共有 185 例患者接受了超声引导下关节内 PRP 注射治疗,与接受单独透明质酸治疗的患者(n = 148)或一项研究中接受透明质酸联合 PRP 治疗的患者(n = 31)进行了比较。PRP 显示在 6 个月和 12 个月的随访中改善了患者的预后评分;然而,接受 PRP 或单独透明质酸治疗的患者之间没有显著差异。经过这项系统评价,我们目前不能推荐使用关节内注射 PRP 治疗髋骨关节炎。鉴于关节内类固醇注射是国际指南推荐的唯一用于治疗髋骨关节炎的此类注射,比较 PRP 与类固醇的进一步研究将有助于确定 PRP 注射在髋骨关节炎中的价值。

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