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关节内注射自体脂肪组织或富含血小板血浆对膝骨关节炎患者的临床和功能结局改善相当。

Intra-Articular Injections of Autologous Adipose Tissue or Platelet-Rich Plasma Comparably Improve Clinical and Functional Outcomes in Patients with Knee Osteoarthritis.

作者信息

Kaszyński Jakub, Bąkowski Paweł, Kiedrowski Bartosz, Stołowski Łukasz, Wasilewska-Burczyk Anna, Grzywacz Kamilla, Piontek Tomasz

机构信息

Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland.

Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznań, Poland.

出版信息

Biomedicines. 2022 Mar 16;10(3):684. doi: 10.3390/biomedicines10030684.

Abstract

The use of biologic therapies for the management of knee osteoarthritis (OA) has largely increased in recent years. The purpose of this study was to evaluate the efficiency and the therapeutic potential of platelet-rich plasma (PRP) and autologous adipose tissue (AAT) injections as a treatment for knee OA. Sixty participants were enrolled in the study: 20 healthy ones and 40 with minimal to moderate knee OA (KL I-III). The OA patients were randomly assigned either to the PRP or to the AAT group. The PRP samples showed a low expression level of NF-κB-responsive gene CCL5 and high expression levels of classic inflammatory and TNF-l INF responses. The AAT injection product was prepared using a Lipogems device, and its regenerative potential as well as the ability for expansion of mesenchymal stem cells were tested in the cell culture conditions. The patient assessments were carried out five times. Significant improvement was observed regardless of the treatment method in the VAS, KOOS, WOMAC and IKDC 2000 subjective evaluations as well as in the functional parameters. Intra-articular injections of AAT or PRP improved pain, symptoms, quality of life and functional capacity with a comparable effectiveness in the patients with mild to moderate knee osteoarthritis.

摘要

近年来,生物疗法在膝关节骨关节炎(OA)治疗中的应用大幅增加。本研究的目的是评估富血小板血浆(PRP)和自体脂肪组织(AAT)注射治疗膝关节OA的疗效和治疗潜力。60名参与者被纳入研究:20名健康者和40名轻度至中度膝关节OA(KL I-III)患者。OA患者被随机分配到PRP组或AAT组。PRP样本显示NF-κB反应基因CCL5的低表达水平以及经典炎症和TNF-l INF反应的高表达水平。AAT注射产品使用Lipogems设备制备,并在细胞培养条件下测试其再生潜力以及间充质干细胞的扩增能力。对患者进行了五次评估。在VAS、KOOS、WOMAC和IKDC 2000主观评估以及功能参数方面,无论采用何种治疗方法,均观察到显著改善。在轻度至中度膝关节骨关节炎患者中,关节内注射AAT或PRP可改善疼痛、症状、生活质量和功能能力,且疗效相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79e7/8945733/36ff78d28e60/biomedicines-10-00684-g001.jpg

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