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富含血小板血浆治疗骨关节炎的210例膝关节临床反应相关的预后因素

Prognostic Factors Related to Clinical Response in 210 Knees Treated by Platelet-Rich Plasma for Osteoarthritis.

作者信息

Chopin Clément, Geoffroy Marion, Kanagaratnam Lukshe, Dorilleau Claire, Ecarnot Fiona, Siboni Renaud, Salmon Jean-Hugues

机构信息

Department of Rheumatology, University of Reims Champagne-Ardenne (URCA), Reims University Hospital, 51100 Reims, France.

Department of Rheumatology, Reims University Hospital, 51100 Reims, France.

出版信息

Diagnostics (Basel). 2023 Feb 17;13(4):760. doi: 10.3390/diagnostics13040760.

Abstract

Many studies have shown the effectiveness of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis. We aimed to determine the factors associated with good or poor response to PRP injections in knee osteoarthritis. This was a prospective observational study. Patients with knee osteoarthritis were recruited from a university hospital. PRP was injected twice at a one-month interval. Pain was assessed on a visual analog scale (VAS) and function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic stage was collected and defined according to the Kellgren-Lawrence classification. Patients were classified as responders if they met the OMERACT-OARSI criteria at 7 months. We included 210 knees. At 7 months, 43.8% were classified as responders. Total WOMAC and VAS were significantly improved between M0 and M7. Physical therapy and a heel-buttock distance >35 cm were the two criteria associated with poor response at M7 by multivariate analysis. Pain VAS at M7 appeared to be lower in patients with osteoarthritis for less than 24 months. No adverse effects were reported. PRP treatment in knee osteoarthritis appears to be well-tolerated and effective, even in patients who reacted poorly to hyaluronic acid. Response was not associated with radiographic stage.

摘要

许多研究已表明富血小板血浆(PRP)在治疗膝关节骨关节炎方面的有效性。我们旨在确定与膝关节骨关节炎患者对PRP注射反应良好或不佳相关的因素。这是一项前瞻性观察性研究。膝关节骨关节炎患者从一家大学医院招募。PRP每隔一个月注射两次。疼痛采用视觉模拟量表(VAS)进行评估,功能采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)进行评估。收集并根据Kellgren-Lawrence分类法定义影像学分期。如果患者在7个月时符合OMERACT-OARSI标准,则被分类为反应者。我们纳入了210个膝关节。在7个月时,43.8%被分类为反应者。M0和M7之间,WOMAC总分和VAS均有显著改善。多因素分析显示,物理治疗和足跟-臀部距离>35 cm是与M7时反应不佳相关的两个标准。骨关节炎病程小于24个月的患者M7时的疼痛VAS似乎更低。未报告不良反应。膝关节骨关节炎的PRP治疗似乎耐受性良好且有效,即使是对透明质酸反应不佳的患者。反应与影像学分期无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68e3/9956000/7347777cce37/diagnostics-13-00760-g001.jpg

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