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年龄、性别、体重指数和病程是否会影响接受系列自体富血小板血浆注射治疗的膝关节骨关节炎患者的临床疗效?

Do age, gender, BMI and disease duration influence the clinical outcomes in patients of knee osteoarthritis treated with serial injections of autologous platelet rich plasma?

作者信息

Saraf Amit, Hussain Altaf, Singhal Ayush, Arora Vaneet, Bishnoi Sandeep

机构信息

Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre, Delhi road. NH 24, Bagadpur, Moradabad, Uttar Pradesh, 244001, India.

出版信息

J Clin Orthop Trauma. 2023 Jul 16;43:102226. doi: 10.1016/j.jcot.2023.102226. eCollection 2023 Aug.

Abstract

PURPOSE

To study whether age, gender, body mass index(BMI) and disease duration influence the clinical outcomes in kellgren-Lawrence(K-L) grade II,III knee osteoarthritis(KOA) patients treated with serial injections of platelet rich plasma(PRP).

PATIENTS AND METHODS

65 patients were given three monthly intra-articular injections of PRP in this prospective interventional study. The patients were divided into subgroups depending on the factor studied: by age(in years) into young <45(n = 7), middle age 45-60(n = 35), and elderly >60(n = 23): by BMI(in kg/m) into; normal <25(n = 25), overweight 25-30(n = 27) and obese >30(n = 13) and disease duration; less(n = 32) or more than 1 year(n = 33) symptom duration. Visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used as outcome measures and assessed before each injection and then at 6 and 9 months post injection. Groups were homogenous with respect to baseline characteristics.

RESULTS

Mean VAS and WOMAC scores showed a statistically significant improvement (P < 0.0001) across all groups and subgroups (age,gender,BMI,disease duration) at follow up. On intra-subgroup comparison, we found no significant differences(P > 0.05) among age, BMI or gender subgroups, however the scores were significantly better in patients with disease duration of less than 1 year than those with more than 1 year duration at both 6 and 9 months[P < 0.001(RC = 9.630,95% CI = 4.037-15.222,P = 0.001)].

CONCLUSION

PRP injections if given serially can improve the short term subjective scores of VAS and WOMAC scores in patients with K-L grade II and III KOA irrespective of age, gender, BMI or disease duration, however, clinical benefits can be maximized if given early in the disease course.

摘要

目的

研究年龄、性别、体重指数(BMI)和病程是否会影响接受富血小板血浆(PRP)系列注射治疗的凯尔格伦-劳伦斯(K-L)分级为II级、III级的膝关节骨关节炎(KOA)患者的临床结局。

患者与方法

在这项前瞻性干预研究中,65例患者接受了每三个月一次的关节腔内PRP注射。根据所研究的因素将患者分为亚组:按年龄(岁)分为年轻组(<45岁,n = 7)、中年组(45 - 60岁,n = 35)和老年组(>60岁,n = 23);按BMI(kg/m²)分为正常组(<25,n = 25)、超重组(25 - 30,n = 27)和肥胖组(>30,n = 13)以及病程;症状持续时间少于1年(n = 32)或超过1年(n = 33)。采用视觉模拟量表(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)作为结局指标,在每次注射前以及注射后6个月和9个月进行评估。各亚组在基线特征方面具有同质性。

结果

在随访时,所有组和亚组(年龄、性别、BMI、病程)的平均VAS和WOMAC评分均显示出具有统计学意义的改善(P < 0.0001)。在亚组内比较中,我们发现年龄、BMI或性别亚组之间无显著差异(P > 0.05),然而,病程少于1年的患者在6个月和9个月时的评分均显著优于病程超过1年的患者[P < 0.001(RC = 9.630,95%CI = 4.037 - 15.222,P = 0.001)]。

结论

对于K-L分级为II级和III级的KOA患者,连续注射PRP可改善VAS和WOMAC评分的短期主观评分,无论年龄、性别、BMI或病程如何,然而,如果在疾病病程早期给予治疗,临床获益可最大化。

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