De Matthaeis Andrea, Bianchi Maria, Putzulu Rossana, Maccauro Giulio
Department of Orthopedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy.
J Clin Med. 2024 Aug 15;13(16):4816. doi: 10.3390/jcm13164816.
: Encouraging results have been reported for Platelet-Rich Plasma (PRP) treatment for knee osteoarthritis (KOA). This study reports the efficacy and safety of a high dose of neutrophile and red-blood-cell-depleted PRP to treat patients with KOA. : A total of 212 consecutive patients diagnosed with Kellgren-Lawrence (KL) grading 1-3 KOA chronic knee pain for at least 1 year were treated with three injections at 15-day intervals with a high dose of neutrophil-depleted PRP (4 billion platelets). Clinical outcomes were retrospectively recorded as the percentage of responders at 3-, 6-, and 12-month follow-up, following the OMERACT-OARSI criteria. Pain, through the VAS score and WOMAC score, was also been recorded. : A total of 4 mL of PRP containing 4 × 10 platelets was obtained by single-spin centrifugation and injected intra-articularly into each patient with no preactivation. The overall responder rate of patients responding to the OMERACT-OARSI criteria at 3, 6, and 12 months was 68.9%, 72.7%, and 70.6%, respectively. A significant improvement in VAS and WOMAC scores at 3-, 6-, and 12-month follow-up compared to the pretreatment value ( < 0.01) was observed. The lowest VAS score was observed at 6 months overall and in all three KL-graded groups. The KL2 groups showed the best results regarding pain reduction and their WOMAC score at 6 months ( < 0.01). : For KL1-3 KOA, a high dosage of neutrophil-depleted PRP is a successful treatment. It has long-lasting effects that last up to one year, relieves symptoms, and may slow the advancement of the disease.
已有报道称富血小板血浆(PRP)治疗膝关节骨关节炎(KOA)取得了令人鼓舞的结果。本研究报告了高剂量去除中性粒细胞和红细胞的PRP治疗KOA患者的疗效和安全性。
共有212例连续诊断为Kellgren-Lawrence(KL)分级为1-3级的KOA且慢性膝关节疼痛至少1年的患者,每隔15天接受三次高剂量去除中性粒细胞的PRP(40亿个血小板)注射治疗。按照OMERACT-OARSI标准,回顾性记录3个月、6个月和12个月随访时的应答者百分比作为临床结果。还通过视觉模拟评分(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分记录疼痛情况。
通过单步离心获得4毫升含4×10个血小板的PRP,在未预先激活的情况下将其关节内注射到每位患者体内。在3个月、6个月和12个月时符合OMERACT-OARSI标准应答的患者总体应答率分别为68.9%、72.7%和70.6%。与治疗前值相比,在3个月、6个月和12个月随访时VAS和WOMAC评分有显著改善(P<0.01)。总体及所有三个KL分级组在6个月时观察到最低的VAS评分。KL2组在6个月时疼痛减轻及WOMAC评分方面显示出最佳结果(P<0.01)。
对于KL1-3级KOA,高剂量去除中性粒细胞的PRP是一种成功的治疗方法。它具有长达一年的持久效果,可缓解症状,并可能减缓疾病进展。