Negrini Francesco, De Lucia Francesco, Negrini Stefano, Tornese Davide, Facchini Francesca, Vecchio Michele, de Girolamo Laura
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Front Pharmacol. 2021 Aug 23;12:718060. doi: 10.3389/fphar.2021.718060. eCollection 2021.
Knee osteoarthritis (KOA) is a chronic progressive disease that can cause pain, functional impairment, and ultimately disability. A novel and promising therapeutic approach to KOA is the so-called regenerative medicine, a set of procedures designed to harness tissue regenerative capacity and optimize functional recovery. Increasing evidence points out that platelet-rich plasma (PRP) intra-articular injections can decrease pain and improve functional abilities in KOA patients. In the present case reports, we analyze two patients who were treated with PRP injections coupled with a posttreatment home-based rehabilitation program. The two patients were selected to represent two different populations: patient 1 was an 85-year-old with severe impairment of functional abilities, while patient 2 was a younger (59 years old) and more active patient. The protocol consisted in a series of exercise to be performed at home, during the five days following PRP injection for two consecutive weeks (10 days in total). The exercises were designed to reduce the inflammation after the injection, enhance the proprioceptive control of the treated lower limb, and strengthen hip and knee flexors and extensors, mainly by isometric work. Results were evaluated at two time points: before and 2 months after the first PRP injection. The outcomes considered were as follows: visual analog scale for pain, EuroQol 5 dimensions questionnaire, Tegner Activity Scale for functioning, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Both patients did not report any side effects from the treatment. Improvement in patient 1 was drastic at the two months follow-up as far as pain and functional abilities are concerned. Patient 2's improvement was less evident, probably due to the higher starting point in both pain and functionality. Overall, the developed program seemed safe and was tolerated by the patients analyzed in the study, who performed it with good compliance.
膝骨关节炎（KOA）是一种慢性进行性疾病，可导致疼痛、功能障碍，并最终导致残疾。一种针对KOA的新颖且有前景的治疗方法是所谓的再生医学，这是一组旨在利用组织再生能力并优化功能恢复的程序。越来越多的证据表明，富血小板血浆（PRP）关节内注射可减轻KOA患者的疼痛并改善其功能能力。在本病例报告中，我们分析了两名接受PRP注射并结合家庭康复计划治疗的患者。选择这两名患者代表两个不同的人群：患者1是一名85岁的功能严重受损者，而患者2是一名较年轻（59岁）且更活跃的患者。该方案包括在PRP注射后的连续两周内（共10天），在家中进行一系列运动。这些运动旨在减轻注射后的炎症，增强治疗下肢的本体感觉控制，并主要通过等长运动来增强髋部和膝部的屈肌和伸肌。在两个时间点进行结果评估：首次PRP注射前和注射后2个月。所考虑的结果如下：疼痛视觉模拟量表、欧洲五维健康量表、功能Tegner活动量表以及膝关节损伤和骨关节炎结局评分（KOOS）。两名患者均未报告治疗有任何副作用。就疼痛和功能能力而言，患者1在两个月的随访中改善显著。患者2的改善不太明显，可能是由于其疼痛和功能的起始水平较高。总体而言，所制定的方案似乎是安全的，并且在研究中分析的患者中可以耐受，患者执行该方案的依从性良好。
