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富血小板血浆关节内注射治疗血友病伴膝关节软骨退变疼痛患者。

Intra-articular injection of platelet-rich plasma in patients with hemophilia and painful knee joint cartilage degeneration.

机构信息

Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain.

Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Autonomous University of Madrid), Madrid, Spain.

出版信息

Expert Rev Hematol. 2023 Jun;16(6):407-416. doi: 10.1080/17474086.2023.2166922. Epub 2023 Jan 12.

Abstract

INTRODUCTION

Knee arthropathy causes pain to people with hemophilia (PWH). One of the current controversies is whether injections of intra-articular platelet-rich plasma (PRP) are effective in relieving the knee pain of PWH.

AREAS COVERED

A narrative literature review was conducted on the efficacy of PRP injections in the knees of PWH.

EXPERT OPINION

Intra-articular PRP knee injections are widely used in patients with knee osteoarthritis to relieve pain and delay total knee arthroplasty. Although numerous publications have supported the use of PRP in knee osteoarthritis, there is still major controversy regarding its true usefulness, given that a number of studies with a high degree of evidence have failed to show the efficacy of PRP. With respect to painful hemophilic arthropathy, the use of PRP injections is even more controversial, as there are only four publications on the subject supporting the use of PRP in hemophilia, all of them with a low degree of evidence. A publication with grade 1 evidence recommended against the use of PRP in hemophilic arthropathy because its efficacy has not been demonstrated. My opinion is that intra-articular PRP injections should not be used in hemophilia until there is more evidence of its benefits.

摘要

简介

膝关节关节炎会给血友病患者(PWH)带来疼痛。目前存在的一个争议是,关节内注射富含血小板的血浆(PRP)是否能有效缓解 PWH 的膝关节疼痛。

涵盖领域

对 PRP 注射治疗 PWH 膝关节疼痛的疗效进行了叙述性文献回顾。

专家意见

关节内 PRP 膝关节注射广泛用于膝关节骨关节炎患者,以缓解疼痛和延迟全膝关节置换术。尽管有大量的出版物支持 PRP 在膝关节骨关节炎中的应用,但由于一些具有高度证据的研究未能显示 PRP 的疗效,因此其真正的用处仍存在很大争议。对于疼痛性血友病性关节炎,PRP 注射的使用甚至更具争议性,因为仅有四项关于该主题的出版物支持在血友病中使用 PRP,且均为低证据等级。一项证据等级为 1 的出版物建议不要在血友病中使用 PRP,因为其疗效尚未得到证实。我的意见是,在有更多证据表明 PRP 有益之前,不应在血友病中使用关节内 PRP 注射。

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