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单、三、五次关节内注射富血小板血浆治疗膝骨关节炎的临床疗效差异。

The varying clinical effectiveness of single, three and five intraarticular injections of platelet-rich plasma in knee osteoarthritis.

机构信息

Department of Rehabilitation Medicine, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China.

Department of Rehabilitation, The First People's Hospital of Zhengzhou, Zhengzhou, Henan, 450003, China.

出版信息

J Orthop Surg Res. 2024 May 8;19(1):284. doi: 10.1186/s13018-024-04736-6.

Abstract

OBJECTIVE

To investigate the variations in clinical effectiveness among patients diagnosed with knee osteoarthritis who underwent intra-articular administration of platelet-rich plasma using single, triple, or quintuple injections.

METHODS

One hundred twenty patients with grade I-III knee osteoarthritis were randomly assigned to three groups: PRP1 group, who received a single injection of platelet-rich plasma; PRP3 group, who received three PRP injections one week apart; PRP5 group, who received five PRP injections one week apart. The patients' conditions were evaluated using the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index-VA3.1 version (WOMAC-VA3.1) at baseline and 6, 12, 24, and 52 weeks 52 weeks follow up.

RESULTS

Out of the total participants, 106 patients (30 males and 76 females) completed the study. The primary outcome measure, WOMAC pain score, registered significant improvements across all groups when compared to pre-treatment levels. However, the application of 3 and 5 injections of platelet-rich plasma was substantially more effective than that of a single injection in reducing knee pain and stiffness, as well as enhancing physical function in patients with knee osteoarthritis. No statistically discernable difference was observed between PRP3 and PRP5 at all follow-up intervals, and there was no discernable difference between 3 and 5 PRP injections either. Mild side effects occurred in all three groups.

CONCLUSIONS

The administration of three or five injections of platelet-rich plasma is safe, substantially more effective than single injections, and leads to remarkable clinical improvement by significantly reducing knee pain, improving joint stiffness, and enhancing physical function in patients with grade I-III knee osteoarthritis. Furthermore, no significant difference was observed in the efficacy of three or five injections. Therefore, we recommend using three injections of PRP in the treatment of patients with knee osteoarthritis of grade I-III.

摘要

目的

探讨膝关节骨关节炎患者接受富血小板血浆关节内注射治疗时,单次、三次和五次注射的临床疗效差异。

方法

将 120 例 I-III 级膝关节骨关节炎患者随机分为三组:PRP1 组单次注射富血小板血浆;PRP3 组每周注射 3 次,连续 3 周;PRP5 组每周注射 5 次,连续 5 周。在基线和 6、12、24 和 52 周时,采用视觉模拟评分(VAS)和 Western Ontario and McMaster Universities Arthritis Index-VA3.1 版(WOMAC-VA3.1)评估患者病情。

结果

共有 106 例患者(30 例男性,76 例女性)完成了研究。主要结局指标 WOMAC 疼痛评分显示,与治疗前相比,所有组的评分均显著降低。然而,与单次注射相比,3 次和 5 次富血小板血浆注射在减轻膝关节疼痛、改善关节僵硬和增强膝关节骨关节炎患者的身体功能方面更为有效。在所有随访时间点,PRP3 组和 PRP5 组之间均无统计学差异,且 3 次和 5 次 PRP 注射之间也无差异。三组均出现轻度不良反应。

结论

3 次或 5 次富血小板血浆注射是安全的,明显优于单次注射,可显著改善临床疗效,显著减轻膝关节疼痛,改善关节僵硬,增强 I-III 级膝关节骨关节炎患者的身体功能。此外,三次和五次注射的疗效无显著差异。因此,我们建议在治疗 I-III 级膝关节骨关节炎患者时使用三次 PRP 注射。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0492/11077828/f87690775034/13018_2024_4736_Fig1_HTML.jpg

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