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自体富血小板血浆 (PRP) 在治疗肘外侧炎和足底筋膜炎中的应用:中至长期临床疗效。

Autologous Platelet Rich Plasma (PRP) in the treatment of elbow epicondylitis and plantar fasciitis: medium to long term clinical outcome.

机构信息

Orthopaedics and Traumatology, A.O.U. "Maggiore d.c."Universiy of Eastern Piedmont, Novara.

Department of Orthopaedics and Traumatology, "Maggiore della Carità" Hospital, Department of Health Sciences, University of Piemonte Orientale (UPO), Novara, Italy. Specialization School in Orthopaedics and Traumatology, University of Pavia, Pavia, Italy..

出版信息

Acta Biomed. 2020 Dec 30;91(14-S):e2020029. doi: 10.23750/abm.v91i14-S.11002.

Abstract

BACKGROUND AND AIM

Platelet-Rich-Plasma (PRP) is a popular biological therapy especially used to regenerate different musculoskeletal tissues by releasing growth-factors and cytokines promoting cell proliferation, chemotaxis, differentiation, and angiogenesis. The aim was to evaluate the clinical effectiveness and safety of PRP for Lateral-Epicondylitis (LE) of the elbow and Plantar-Fasciitis (PF).

METHODS

A retrospective study was conducted including patients treated with a single topic autologous-PRP-injection between 1-1-2009 and 7-18-2019 for LE or PF at our institution; patients operated for the same problem, patients refusing the study or not traceable were excluded. Patients were assessed with VAS for pain and clinical scales.

RESULTS

33 patients were treated with PRP and 13 (8F, 5M) included: 4LE and 9PF for a total of 16 cases. The average pain level was 0.61±0.63: 1±1.41 for LE and 0,44±0 for PF. No significant side effect was reported. 4 PRP-treatments failed: 2LE and 2PF. OES and PRTEE gave excellent results for elbow. Average foot scores were AOFAS 98.2±5 and FADI 91.3±1. Patients were stratified and compared according to plantar arch conformation, follow-up length, healing time, time from diagnosis to PRP-treatment, therapies before PRP (physiotherapy, steroid infiltration or shock-waves), risk factors (standing work, sport, age, sex).

CONCLUSIONS

As in other studies, our results do not allow to draw sufficiently valid conclusions regarding the effectiveness and safety of PRP in the treatment of LE and PF: in particular the statistical significance is limited by the small sample size. PRP can be chosen as a non-first-line treatment for LE and PF.

摘要

背景与目的

富血小板血浆(PRP)是一种流行的生物治疗方法,特别用于通过释放生长因子和细胞因子来促进细胞增殖、趋化、分化和血管生成,从而再生不同的肌肉骨骼组织。目的是评估 PRP 治疗肘外侧肌腱炎(LE)和足底筋膜炎(PF)的临床效果和安全性。

方法

对 2009 年 1 月 1 日至 2019 年 7 月 18 日期间在我院接受单次自体 PRP 注射治疗的 LE 或 PF 患者进行回顾性研究;排除接受相同治疗的患者、拒绝研究或无法追踪的患者。患者通过视觉模拟评分(VAS)评估疼痛和临床评分。

结果

33 例患者接受了 PRP 治疗,其中 13 例(8 例女性,5 例男性)包括:4 例 LE 和 9 例 PF,共 16 例。平均疼痛水平为 0.61±0.63:LE 为 1±1.41,PF 为 0.44±0。未报告明显的副作用。4 例 PRP 治疗失败:2 例 LE 和 2 例 PF。OES 和 PRTEE 对肘部获得了极好的效果。平均足部评分 AOFAS 为 98.2±5,FADI 为 91.3±1。根据足底弓形态、随访时间、愈合时间、从诊断到 PRP 治疗的时间、PRP 治疗前的治疗(物理治疗、皮质类固醇浸润或冲击波)、危险因素(站立工作、运动、年龄、性别)对患者进行分层和比较。

结论

与其他研究一样,我们的结果不能充分有效地得出关于 PRP 治疗 LE 和 PF 的有效性和安全性的结论:特别是统计意义受到样本量小的限制。PRP 可以作为 LE 和 PF 的非一线治疗选择。

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