Ríos Luna Antonio, Fahandezh-Saddi Díaz Homid, Villanueva Martínez Manuel, Iglesias Roberto, Prado Roberto, Padilla Sabino, Anitua Eduardo
Department of Traumatology and Orthopedic Surgery, Clínica Orthoindal, 04004 Almería, Spain.
Department of Orthopedic Surgery, Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Spain.
J Clin Med. 2023 Jul 6;12(13):4512. doi: 10.3390/jcm12134512.
The aim of this study was to explore and assess office-based ultrasound-guided intraosseous and intra-articular infiltrations of plasma rich in growth factors (PRGF) in patients with moderate and severe knee osteoarthritis (KOA). Seventy-nine patients (30 women and 49 men) with grade 3-4 KOA according to the Kellgren-Lawrence classification participated in the study. All patients were treated with a minimally invasive technique using local anesthesia WALANT (wide-awake local anesthesia no tourniquet) in the ambulatory setting. A PRGF intra-articular infiltration and two intraosseous infiltrations in the tibial plateau and femoral condyle were performed weekly for a total of three sessions. The evaluation of the results was carried out using knee injury and osteoarthritis outcome score (KOOS) at baseline and post-treatment. After a follow-up period of 11 months (median) [interquartile range, 7-14], all the KOOS domains showed statistically significant improvement ( < 0.001). Moreover, 88% of the patients showed a pain reduction of at least 10 points (minimally clinically important improvement) from pre- to post-treatment. Our retrospective study using the in-office procedure of ultrasound-guided combination of intra-articular and intraosseous infiltrations of PRGF is a safe and efficacious approach for the treatment of grade 3-4 knee osteoarthritis.
本研究的目的是探索和评估在中度和重度膝骨关节炎(KOA)患者中,基于门诊的超声引导下富含生长因子的血浆(PRGF)骨内和关节内注射情况。根据Kellgren-Lawrence分类,79例3-4级KOA患者(30例女性和49例男性)参与了本研究。所有患者均在门诊环境中采用局部麻醉WALANT(清醒局部麻醉无止血带)的微创技术进行治疗。每周进行一次PRGF关节内注射以及在胫骨平台和股骨髁进行两次骨内注射,共进行三个疗程。在基线和治疗后使用膝关节损伤和骨关节炎疗效评分(KOOS)对结果进行评估。经过11个月(中位数)[四分位间距,7-14]的随访期后,所有KOOS领域均显示出统计学上的显著改善(<0.001)。此外,88%的患者从治疗前到治疗后疼痛减轻至少10分(最小临床重要改善)。我们采用门诊超声引导下PRGF关节内和骨内联合注射程序的回顾性研究是治疗3-4级膝骨关节炎的一种安全有效的方法。