对于重度膝关节骨关节炎患者，自体蛋白溶液注射的临床效果不如轻度或中度患者。

Clinical results of autologous protein solution injection for knee osteoarthritis with severe disease grade is inferior to mild or moderate grade.

机构信息

Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831, Japan.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, 162-8666, Japan.

出版信息

Sci Rep. 2023 Apr 19;13(1):6404. doi: 10.1038/s41598-023-33659-1.

DOI:10.1038/s41598-023-33659-1

PMID:37076698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10115806/

Abstract

Autologous protein solution (APS) is made from platelet-rich plasma that extracts high-concentration growth factors and cytokines. Intra-articular APS injection was reported to improve knee osteoarthritis (KOA) pain and function. However, efficacy differences regarding osteoarthritis severity remained unknown. This retrospective study clinically assessed 220 knees with KOA in the Kellgren-Lawrence (KL) grades 2-4 that underwent APS injection using the Knee Injury and Osteoarthritis Outcome Score (KOOS). A telephone survey was performed for patients who dropped out to check symptom changes. The recalculated estimated responder rate included the telephone survey results. The 12-month follow-up was completed with 148 knees (67%), whereas 72 knees dropped out. The follow-up rate was significantly lower in KL4 than KL2 and 3. The KOOS significantly improved in 148 knees, whereas the KOOS was lower in KL4 than in KL2. The responder rate was 55% total, 58% in KL2, 57% in KL3, and 47% in KL4; however, the estimated responder rate, including the telephone survey, was 49% total, 55% in KL2, 54% in KL3, and 36% in KL4. This study showed improved clinical symptoms 1-year after APS injections for KOA, with a lower responder rate in KL4 than in KL2 or KL3.

摘要

自体蛋白溶液（APS）由富含血小板的血浆提取，其中含有高浓度的生长因子和细胞因子。关节内 APS 注射被报道可改善膝骨关节炎（KOA）疼痛和功能。然而，关于骨关节炎严重程度的疗效差异尚不清楚。本回顾性研究对 220 例 KL 分级 2-4 的 KOA 患者的膝关节进行了 APS 注射，采用膝关节损伤和骨关节炎结果评分（KOOS）进行临床评估。对退出的患者进行电话调查以检查症状变化。重新计算的应答率包括电话调查结果。148 例（67%）完成了 12 个月的随访，72 例退出。KL4 的随访率明显低于 KL2 和 KL3。148 例膝关节的 KOOS 显著改善，而 KL4 的 KOOS 低于 KL2。总应答率为 55%，KL2 为 58%，KL3 为 57%，KL4 为 47%；然而，包括电话调查在内的估计应答率为 49%，KL2 为 55%，KL3 为 54%，KL4 为 36%。本研究显示 APS 注射治疗 KOA 后 1 年临床症状改善，KL4 的应答率低于 KL2 或 KL3。