摘要
目的采用前瞻性临床对比研究,探讨体外冲击波联合富血小板血浆(platelet-rich plasma,PRP)注射治疗膝关节骨关节炎(knee osteoarthritis,KOA)的疗效。方法以2015年6月-2018年6月收治且符合选择标准的180例KOA患者作为研究对象,随机分为3组,每组60例。A组膝关节腔穿刺注射自体PRP,B组体外冲击波治疗,C组膝关节腔穿刺注射自体PRP联合体外冲击波治疗;每周治疗1次,共5次。3组患者年龄、性别、病程、侧别及Kellgren-Lawrence分级比较,差异均无统计学意义(P>0.05)。治疗前及首次治疗后第1、3、5周,采用疼痛视觉模拟评分(VAS)、Lequesne指数评分、美国西部Ontario与McMaster大学骨关节炎指数评分(WOMAC)及膝关节活动度评定膝关节疼痛和功能情况。结果 3组治疗后第1、3、5周VAS评分、Lequesne指数评分、WOMAC评分及膝关节活动度与治疗前比较,差异均有统计学意义(P<0.05);随治疗时间延长,VAS评分、Lequesne指数评分和WOMAC评分逐渐降低(P<0.05),但膝关节活动度各时间点间差异均无统计学意义(P>0.05)。治疗前3组间VAS评分、Lequesne指数评分、WOMAC评分及膝关节活动度比较,差异均无统计学意义(P>0.05);治疗后第1、3、5周,C组上述3项评分明显优于A、B组(P<0.05),但3组间膝关节活动度差异均无统计学意义(P>0.05)。结论体外冲击波联合PRP注射治疗KOA具有协同作用,能进一步缓解关节疼痛。
Objective To investigate the effectiveness of extracorporeal shock wave therapy combined with platelet-rich plasma(PRP) injection in treatment of knee osteoarthritis(KOA) by prospective clinical study.Methods Between June 2015 and June 2018, 180 patients with KOA met the inclusion criteria were included in study and randomly allocated to group A(n=60), group B(n=60), and group C(n=60). The patients were treated with autologous PRP intra-articular injection in group A, extracorporeal shock wave therapy in group B, and extracorporeal shock wave therapy combined with autologous PRP intra-articular injection in group C, once a week and 5 times a duration of treatment. There was no significant difference in age, gender, disease duration, side of KOA, and KellgrenLawrence grading between groups(P>0.05). The pain and function of knee joint were assessed by visual analogue scale(VAS) score, Lequesne Index score, Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) score,and knee joint activity before treatment and at 1, 3, and 5 weeks after the first treatment. Results There were significant differences in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between pre-and post-treatment in all groups(P<0.05). VAS score, Lequesne Index score, and WOMAC score gradually decreased with the prolongation of treatment time(P<0.05);but there was no significant difference in knee joint activity between different time points(P>0.05). There was no significant difference in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between groups before treatment(P>0.05);the scores of group C were superior to groups A and B(P< 0.05) at different time points after treatment;while the knee joint activities of 3 groups were similar(P>0.05). Conclusion The extracorporeal shock wave therapy combined with PRP injection can relieve the pain synergistically for KOA.
作者
苏文珍
林永杰
王国伟
耿震
王正宇
侯大龙
索贝贝
SU Wenzhen;LIN Yongjie;WANG Guowei;GENG Zhen;WANG Zhengyu;HOU Dalong;SUO Beibei(Department of Orthopaedics,the Shandong Provincial Third Hospital,Jinan Shandong,250031,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2019年第12期1527-1531,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
膝关节
骨关节炎
体外冲击波
富血小板血浆
Knee
osteoarthritis
extracorporeal shock wave
platelet-rich plasma
