松质骨内注射富血小板血浆治疗中晚期膝关节骨性关节炎的临床效果

Clinical effect of intraspecular injection of platelet-rich plasma in the treatment of advanced knee osteoarthritis

目的 探索膝关节松质骨及关节腔注射富血小板血浆治疗中晚期膝关节骨性关节炎的临床效果。方法 选取2019年1月至2020年12月首都医科大学附属北京康复医院和山东大学齐鲁医院德州医院收治膝关节骨性关节炎患者72例,根据随机数字表法将其分为两组,各36例。关节腔注射组进行富血小板血浆关节腔内注射,关节腔+松质骨注射组进行富血小板血浆关节腔联合松质骨注射。比较两组治疗前,治疗后第1个月、3个月、6个月、12个月膝关节视觉模拟评分法(VAS)评分、美国西大略和麦克马斯特大学骨关节炎指数评分(WOMAC)。结果 两组治疗后第3、6、12个月时VAS和WOMAC评分均低于治疗前,差异有统计学意义(P<0.05)。治疗后第1个月时关节腔+松质骨注射组WOMAC评分低于关节腔注射组,差异有统计学意义(P<0.05)。治疗后第3、6、12个月时关节腔+松质骨注射组VAS和WOMAC评分均低于关节腔注射组,差异有统计学意义(P<0.05)。结论 关节腔联合松质骨注射富血小板血浆能够有效减轻中晚期膝关节骨性关节炎患者疼痛,改善膝关节功能,有望在临床上推广使用。

Objective To explore and analyze the clinical effect of injecting platelet-rich plasma into subchondral cancellous bone and articular cavity for advanced knee osteoarthritis. Methods A total of 72 patients with knee osteoarthritis admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University and Dezhou Hospital of Qilu Hospital of Shandong University from January 2019 to December 2020 were selected and they were divided into two groups according to random number table method, with 36 cases in each group. The articular injection group received intra articular injection of platelet-rich plasma and the articular + cancellous bone injection group received intra articular injection of plaletet plasmas combined with cancellous bone injection. Visual analogue scale(VAS) scores, Western Ontario and Mc Master University osteoarthritis index scores(WOMAC) were compared between the two groups before treatment and one, three, six, and twelve months after treatment. Results VAS and WOMAC scores at three, six and twelve months after treatment in the two group were lower than before treatment, and the differences were statistically significant(P<0.05). One month after treatment, the WOMAC score of the articular + cancellous bone injection group was lower than that of the articular injection group, and the difference was statistically significant(P<0.05). At three, six and twelve months after treatment, VAS and WOMAC scores in thearticular + cancellousboneinjection group were lower than those in the articular injection group, with statistical significances(P<0.05). Conclusion PRP combined with cancellous bone injection can effectively delay the development of severe knee osteoarthritis, reduce pain and improve knee function without serious side effects. It is expected to be widely used in clinical practice, but further clinical trials are needed.