目的评价关节腔内注射富血小板血浆(PRP)相对于透明质酸(HA)钠治疗Ⅱ、Ⅲ期膝骨关节炎的临床疗效。方法选择2013年2月至2014年5月山东大学附属省立医院和威海市立医院门诊收治的126例Keligren Lawrence分级(K-L分级)Ⅱ、Ⅲ期膝骨关节炎...目的评价关节腔内注射富血小板血浆(PRP)相对于透明质酸(HA)钠治疗Ⅱ、Ⅲ期膝骨关节炎的临床疗效。方法选择2013年2月至2014年5月山东大学附属省立医院和威海市立医院门诊收治的126例Keligren Lawrence分级(K-L分级)Ⅱ、Ⅲ期膝骨关节炎的患者,采用随机数字表法将患者分为HA组63例63膝,男性18例,女性45例,平均年龄(61±10)岁;PRP组63例63膝,男性12例,女性51例,年龄(61±10)岁。分别采用2 ml HA(施沛特,共5次,分别在第0、1、2、3、4周注射)和3.5 ml PRP(威高富血小板血浆制备套装,共3次,分别在第0、2、4周注射)关节腔内注射进行治疗。患者在治疗前和完成全部注射后的1、3、6、12个月进行复诊并记录视觉模拟评分(VAS)值、国际膝关节文献委员会(IKDC)评分、美国西部Ontario与Mc Master大学骨关节炎指数(WOMAC)评分等。采用单因素方差分析对两组患者的性别、年龄、体重指数、K-L分级、VAS评分、IKDC评分、WOMAC评分进行分析,采用重复测量的方差分析比较治疗后的疗效以及PRP及HA治疗的效果。结果 PRP组58例、HA组55例患者获得随访12个月,平均随访(14±2)个月和(16±3)个月。通过分析,两组在性别、年龄、体重指数、K-L分级、VAS、IKDC评分、WOMAC评分的比较中,差异均无统计学意义(P>0.05),具有可比性。PRP组患者16例40次出现不良反应,HA组14例37次出现不良反应;两组不良反应起始时间、终止时间及持续时间比较,差异均无统计学意义(P>0.05)。两组治疗后VAS评分、IKDC评分及WOMAC评分与治疗前比较,差异均有统计学意义(P<0.05);HA组治疗后6、12个月各评价指标治疗后较1、3个月差,差异有统计学意义(P<0.05)。两组治疗后1、3个月后,VAS评分、IKDC评分及WOMAC评分比较差异无统计学意义(P>0.05);但是治疗后6、12个月时,PRP组各指标均优于HA组(P<0.05)。结论关节内注射PRP治疗膝关节软骨退行性变安全有效,可缓解展开更多
Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeli...Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.展开更多
Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surge...Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.展开更多
文摘目的评价关节腔内注射富血小板血浆(PRP)相对于透明质酸(HA)钠治疗Ⅱ、Ⅲ期膝骨关节炎的临床疗效。方法选择2013年2月至2014年5月山东大学附属省立医院和威海市立医院门诊收治的126例Keligren Lawrence分级(K-L分级)Ⅱ、Ⅲ期膝骨关节炎的患者,采用随机数字表法将患者分为HA组63例63膝,男性18例,女性45例,平均年龄(61±10)岁;PRP组63例63膝,男性12例,女性51例,年龄(61±10)岁。分别采用2 ml HA(施沛特,共5次,分别在第0、1、2、3、4周注射)和3.5 ml PRP(威高富血小板血浆制备套装,共3次,分别在第0、2、4周注射)关节腔内注射进行治疗。患者在治疗前和完成全部注射后的1、3、6、12个月进行复诊并记录视觉模拟评分(VAS)值、国际膝关节文献委员会(IKDC)评分、美国西部Ontario与Mc Master大学骨关节炎指数(WOMAC)评分等。采用单因素方差分析对两组患者的性别、年龄、体重指数、K-L分级、VAS评分、IKDC评分、WOMAC评分进行分析,采用重复测量的方差分析比较治疗后的疗效以及PRP及HA治疗的效果。结果 PRP组58例、HA组55例患者获得随访12个月,平均随访(14±2)个月和(16±3)个月。通过分析,两组在性别、年龄、体重指数、K-L分级、VAS、IKDC评分、WOMAC评分的比较中,差异均无统计学意义(P>0.05),具有可比性。PRP组患者16例40次出现不良反应,HA组14例37次出现不良反应;两组不良反应起始时间、终止时间及持续时间比较,差异均无统计学意义(P>0.05)。两组治疗后VAS评分、IKDC评分及WOMAC评分与治疗前比较,差异均有统计学意义(P<0.05);HA组治疗后6、12个月各评价指标治疗后较1、3个月差,差异有统计学意义(P<0.05)。两组治疗后1、3个月后,VAS评分、IKDC评分及WOMAC评分比较差异无统计学意义(P>0.05);但是治疗后6、12个月时,PRP组各指标均优于HA组(P<0.05)。结论关节内注射PRP治疗膝关节软骨退行性变安全有效,可缓解
文摘Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.
文摘Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.
