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富血小板血浆单次关节内注射治疗踝骨关节炎患者疼痛和身体功能的疗效和安全性:一项前瞻性研究。

Efficacy and Safety of a Single Intra-articular Injection of Platelet-rich Plasma on Pain and Physical Function in Patients With Ankle Osteoarthritis-A Prospective Study.

机构信息

Associate Professor, Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Associate Professor, National Yang-Ming University School of Medicine, Taipei, Taiwan.

Associate Professor, National Yang-Ming University School of Medicine, Taipei, Taiwan; Associate Professor, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Associate Professor, School of Nursing, Fooyin University, Kaohsiung, Taiwan.

出版信息

J Foot Ankle Surg. 2021 Jul-Aug;60(4):676-682. doi: 10.1053/j.jfas.2020.12.003. Epub 2021 Feb 3.

Abstract

Ankle osteoarthritis (OA) can cause disabling symptoms, and some patients prefer to be treated with minimally invasive procedures. The aim was to evaluate the efficacy and safety of a single intraarticular injection of platelet-rich plasma (PRP) for patients with ankle OA. In a prospective study done in a university-affiliated tertiary care medical center, 44 patients with symptomatic ankle OA for at least 6 months were recruited. Patients received a single injection of PRP (3 mL) into symptomatic ankles. The primary outcome was the change from baseline in the visual analog scale (VAS) pain (0-10 cm) at 6 months. Secondary outcomes included the Ankle Osteoarthritis Scale (AOS) score, American Orthopedic Foot and Ankle Society (AOFAS) hindfoot-ankle score, single-leg stance test (SLS), rescue analgesics consumption and patient satisfaction. Thirty-nine participants (88.64%) completed the study. Significantly improvement in the VAS and AOS was noted at 1-, 3-, and 6-month follow-ups (p < .001). The mean VAS pain decreased significantly from 4.1 ± 1.7 at baseline to 2.2 ± 1.9, 1.7 ± 1.5, and 1.8 ± 1.6 at 1, 3, and 6 months (p < .001). The mean total AOS score reduced by 1.5, 2.2, and 2.1 from baseline respectively postinjection (p < .001). The mean AOFAS hindfoot-ankle score improved from 80.3 points at baseline to 87.2, 91.6, and 89.7 points at 1, 3, and 6 months (p < .001). SLS tests improved significantly (p < .001) at each follow-up. Acetaminophen consumption dropped significantly (p < .001) and no serious adverse events occurred. The study showed promise for a single intraarticular injection of PRP in the treatment of ankle OA.

摘要

踝骨关节炎(OA)可引起致残性症状,有些患者更愿意接受微创治疗。本研究旨在评估关节内注射富含血小板血浆(PRP)治疗踝骨关节炎患者的疗效和安全性。在一家大学附属医院的三级医疗中心进行的前瞻性研究中,招募了 44 名患有症状性踝骨关节炎至少 6 个月的患者。患者接受了关节内注射 3 毫升富含血小板血浆(PRP)的治疗。主要结局是治疗后 6 个月时视觉模拟量表(VAS)疼痛(0-10cm)的基线变化。次要结局包括踝骨关节炎量表(AOS)评分、美国矫形足踝协会(AOFAS)后足-踝关节评分、单腿站立测试(SLS)、止痛药物的使用和患者满意度。39 名参与者(88.64%)完成了研究。治疗后 1、3 和 6 个月,VAS 和 AOS 评分显著改善(p <.001)。VAS 疼痛从基线时的 4.1 ± 1.7 显著降低至治疗后 1、3 和 6 个月时的 2.2 ± 1.9、1.7 ± 1.5 和 1.8 ± 1.6(p <.001)。总 AOS 评分分别从基线时的 1.5、2.2 和 2.1 降低(p <.001)。AOFAS 后足-踝关节评分从基线时的 80.3 分提高至治疗后 1、3 和 6 个月时的 87.2、91.6 和 89.7 分(p <.001)。SLS 测试在每次随访时均显著改善(p <.001)。扑热息痛的使用显著减少(p <.001),且未发生严重不良事件。该研究表明,关节内注射富含血小板血浆治疗踝骨关节炎具有一定前景。

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