富含血小板血浆单独使用与联合体外冲击波疗法治疗髌腱病和膝关节疼痛运动员的比较分析：一项随机对照试验。
A comparative analysis of platelet-rich plasma alone versus combined with extracorporeal shockwave therapy in athletes with patellar tendinopathy and knee pain: a randomized controlled trial.
作者信息
Jhan Shun-Wun, Wu Kuan-Ting, Chou Wen-Yi, Chen Po-Cheng, Wang Ching-Jen, Huang Wen-Chiung, Cheng Jai-Hong
机构信息
Department of Orthopedic Surgery, Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.
Center for Shockwave Medicine and Tissue Engineering, Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.
出版信息
Knee Surg Relat Res. 2024 Dec 17;36(1):47. doi: 10.1186/s43019-024-00252-3.
BACKGROUND
Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic, and serum cytokine markers in patellar tendinopathy of athletes following platelet-rich plasma (PRP) or PRP with extracorporeal shockwave therapy (ESWT) treatments. Our aims to investigate and compare therapeutic effects of PRP versus a combination of PRP with ESWT for treating patellar tendinopathy.
METHODS
A total of 33 athletes with patellar tendinopathy were randomized into two groups. PRP + Sham (PS) group received intraarticular injection of autologous PRP (5 mL) once and sham ESWT. PRP + ESWT (PE) group received intraarticular injection of autologous PRP once and after 1 week ESWT (0.2 mJ/mm energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for 1 year.
RESULTS
Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the 1-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of interleukin (IL)-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments.
CONCLUSIONS
The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study. Trial registration Research registry and the registration number is researchregistry9518. Registered 14 September 2023. https://www.researchregistry.com/browse-the-registry#home/registrationdetails/650263e4f549fd00282a338c/ . The level of evidence is level II.
背景
髌腱炎，也称为跳跃膝，由于相关疼痛会显著影响患者的日常生活质量。一项随机对照试验研究了富含血小板血浆（PRP）或PRP联合体外冲击波疗法（ESWT）治疗后运动员髌腱炎的临床、超声和血清细胞因子标志物。我们的目的是研究和比较PRP与PRP联合ESWT治疗髌腱炎的疗效。
方法
总共33名患有髌腱炎的运动员被随机分为两组。PRP+假治疗（PS）组接受一次关节内注射自体PRP（5毫升）和假ESWT。PRP+ESWT（PE）组接受一次关节内注射自体PRP，并在1周后接受一次ESWT（能量通量密度0.2毫焦/平方毫米，1350次脉冲，4赫兹）。所有患者随访1年。
结果
自体PRP注射及其与ESWT的联合应用都是治疗运动员慢性髌腱炎的有效方法。在1个月的随访中，PRP联合ESWT比单独使用PRP能更快减轻膝关节疼痛。在12个月的随访中，血清IL-33无显著差异。在12个月的随访中，白细胞介素（IL）-6、IL-15和IL-17水平升高，可能是由于额外的训练。然而，运动员没有报告任何不适或损伤，研究后超声检查未发现异常。我们证明了在接受PRP和PRP联合ESWT治疗12个月后，运动员的疼痛和功能评分有所改善，膝关节损伤得到了保护。
结论
该研究分析了单独PRP注射以及PRP注射与ESWT联合治疗慢性髌腱炎的疗效。我们的结果表明，联合治疗比单独使用PRP能更早地缓解疼痛，是一种安全的治疗方式。我们的研究中未观察到不良反应。试验注册：研究注册库，注册号为researchregistry9518。于2023年9月14日注册。https://www.researchregistry.com/browse-the-registry#home/registrationdetails/650263e4f549fd00282a338c/ 。证据级别为II级。
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