Saraf Amit, Hussain Altaf, Singhal Ayush, Arora Vaneet, Bishnoi Sandeep
Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre, Delhi road. NH 24, Bagadpur, Moradabad, Uttar Pradesh, 244001, India.
J Clin Orthop Trauma. 2023 Jul 16;43:102226. doi: 10.1016/j.jcot.2023.102226. eCollection 2023 Aug.
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).
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.
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)].
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.
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。
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。
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)]。
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。