Coşkun Hüseyin Sina, Yurtbay Alparslan, Say Ferhat
Orthopaedics and Traumatology, Ondokuz Mayıs University, Samsun, TUR.
Orthopaedics and Traumatology, Samsun Education and Research Hospital, Samsun, TUR.
Cureus. 2022 Apr 26;14(4):e24500. doi: 10.7759/cureus.24500. eCollection 2022 Apr.
There is no consensus on the effectiveness of platelet-rich plasma (PRP) and autologous conditioned serum (ACS) in the treatment of knee osteoarthritis (OA). Also, the group of patients who will benefit most from this treatment is not clear. This study aims to understand the effects of two treatment modalities: ACS and PRP on pain and clinical scores in the treatment of OA. For this reason, we compared the long-term (five-year follow up) clinical results of the patients to whom these two treatment methods were applied.
Eighty-two knee osteoarthritis cases, selected from a database prospectively maintained in our tertiary university hospital after institutional ethics committee approval, examined between January 2013 and September 2020 and treated with ACS and PRP by the same orthobiological treatment team, were retrospectively analyzed. The clinical results of group A (n=40) treated with ACS and group B (n=42) treated with PRP were statistically analyzed. Clinical evaluations were made pre-injection and at one, six, 12, 24 and 60 months post-treatment, using the knee injury and osteoarthritis result score (KOOS) for the evaluation of function and a visual analog scale (VAS) for the evaluation of pain.
Side effects were noted in two patients (5%) in group A and 16 patients (38.1%) in group B. More side effects were seen in group B compared to group A (p<0.001). The better VAS scores in both groups were detected in the sixth and 12th months. When VAS scores were examined, better results were obtained in group A in the 12th and 24th months (p<0.05). When KOOS scores were examined, the superiority of ACS to PRP at 12 and 24 months was shown in KOOS.S, KOOS.P and KOOS.ADL scores (p<0.05). There was no statistically significant difference between the two groups in terms of all scores and baseline scores at 60 months.
The effectiveness of ACS and PRP treatments can last up to two years. After two years, the effectiveness of both treatments decreases. Comparing the two treatments, ACS treatment showed better results on VAS and KOOS scores compared to PRP treatment.
关于富血小板血浆(PRP)和自体条件血清(ACS)治疗膝骨关节炎(OA)的有效性尚无共识。此外,最能从这种治疗中获益的患者群体也不明确。本研究旨在了解两种治疗方式,即ACS和PRP对OA治疗中疼痛和临床评分的影响。因此,我们比较了应用这两种治疗方法的患者的长期(五年随访)临床结果。
回顾性分析了82例膝骨关节炎病例,这些病例选自我们三级大学医院前瞻性维护的数据库,经机构伦理委员会批准,于2013年1月至2020年9月期间接受检查,并由同一骨科生物治疗团队采用ACS和PRP进行治疗。对接受ACS治疗的A组(n = 40)和接受PRP治疗的B组(n = 42)的临床结果进行了统计分析。在注射前以及治疗后1个月、6个月、12个月、24个月和60个月进行临床评估,使用膝关节损伤和骨关节炎结果评分(KOOS)评估功能,使用视觉模拟量表(VAS)评估疼痛。
A组有2例患者(5%)出现副作用,B组有16例患者(38.1%)出现副作用。与A组相比,B组出现的副作用更多(p < 0.001)。两组在第6个月和第12个月时VAS评分均较好。检查VAS评分时,A组在第12个月和第24个月时获得了更好的结果(p < 0.05)。检查KOOS评分时,在KOOS.S、KOOS.P和KOOS.ADL评分方面,ACS在第12个月和第24个月时优于PRP(p < 0.05)。两组在60个月时的所有评分和基线评分方面无统计学显著差异。
ACS和PRP治疗的有效性可持续长达两年。两年后,两种治疗的有效性均降低。比较两种治疗方法,ACS治疗在VAS和KOOS评分方面比PRP治疗显示出更好的结果。