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关节内富血小板血浆与内侧副韧带射频热凝术治疗慢性膝关节骨关节炎的疗效比较:一项单盲随机临床试验。

Efficacy of Genicular Nerve Radiofrequency Ablation Versus Intra-Articular Platelet Rich Plasma in Chronic Knee Osteoarthritis: A Single-Blind Randomized Clinical Trial.

机构信息

Department of Anesthesia and Intensive Care, Faculty of Medicine, Assuit University, Assiut, Egypt.

Assiut University, Assiut, Egypt.

出版信息

Pain Physician. 2021 Mar;24(2):127-134.

Abstract

BACKGROUND

Chronic knee osteoarthritis is a common problem with increasing of the aging population. Pulsed radiofrequency and intraarticular platelet rich plasma injection are well evidenced beneficial modalities for pain alleviation in such groups of patients.

OBJECTIVE

The primary goal in this study was to compare the 2 modalities regarding pain alleviation evaluated by visual analog scale. The secondary goal focused upon the change of the Index of Severity for Osteoarthritis of the Knee by Lequesne.

STUDY DESIGN

Single-blind randomized interventional clinical trial.

SETTING

University hospitals.

METHODS

Two hundred patients with chronic knee osteoarthritis were equally and randomly distributed into 2 groups. Group PRF received pulsed radiofrequency, whereas the group PRP received intraarticular platelet-rich plasma. The visual analog scale and index of severity of osteoarthritis were evaluated before intervention, after one week (for visual analog scale only), then after 3, 6, and 12 months.

RESULTS

Visual analog scale was significantly lower in the PRF group compared to the PRP group at 6 and 12 months with P-values of 0.01 and 0.04, respectively. Regarding to the postinterventional index of severity of osteoarthritis, it was significantly lower in the PRF group than the PRP group with P-values of 0.001 at 3, 6, and 12 months follow-up.

LIMITATIONS

Physical and analgesic therapy were not included in data collection, and there was no control group.

CONCLUSION

Pulsed radiofrequency of the genicular nerves can be considered superior to knee intraarticular platelet-rich plasma injection for sustained pain relief and the lower severity index in patients with chronic knee osteoarthritis.

摘要

背景

慢性膝骨关节炎是一个常见的问题,随着人口老龄化的增加而增加。脉冲射频和关节内富血小板血浆注射是缓解此类患者疼痛的有效方法。

目的

本研究的主要目的是通过视觉模拟量表比较两种方法的镇痛效果。次要目标集中在通过 Lequesne 膝关节骨关节炎严重程度指数来评估疼痛缓解的变化。

研究设计

单盲随机干预临床试验。

设置

大学医院。

方法

将 200 例慢性膝骨关节炎患者平均随机分为 2 组。PRF 组接受脉冲射频治疗,PRP 组接受关节内富血小板血浆治疗。在干预前、干预后 1 周(仅用于视觉模拟量表)、3、6 和 12 个月评估视觉模拟量表和骨关节炎严重程度指数。

结果

PRF 组的视觉模拟量表评分在 6 个月和 12 个月时明显低于 PRP 组,P 值分别为 0.01 和 0.04。关于术后骨关节炎严重程度指数,PRF 组在 3、6 和 12 个月的随访中明显低于 PRP 组,P 值分别为 0.001。

局限性

未将物理和镇痛治疗纳入数据收集,且无对照组。

结论

对于慢性膝骨关节炎患者,与关节内富血小板血浆注射相比,脉冲射频治疗可以更好地缓解持续性疼痛,并降低严重程度指数。

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