亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis

医学 骨关节炎 富血小板血浆 沃马克 随机对照试验 透明质酸 可视模拟标度 滑液 临床试验 膝关节痛 内科学 外科 物理疗法 血小板 病理 替代医学 解剖
作者
Brian J. Cole,Vasili Karas,Kristen Hussey,David Merkow,Kyle Pilz,Lisa A. Fortier
出处
期刊:American Journal of Sports Medicine [SAGE Publishing]
卷期号:45 (2): 339-346 被引量:322
标识
DOI:10.1177/0363546516665809
摘要

Background: The use of platelet-rich plasma (PRP) for the treatment of osteoarthritis (OA) has demonstrated mixed clinical outcomes in randomized controlled trials when compared with hyaluronic acid (HA), an accepted nonsurgical treatment for symptomatic OA. Biological analysis of PRP has demonstrated an anti-inflammatory effect on the intra-articular environment. Purpose: To compare the clinical and biological effects of an intra-articular injection of PRP with those of an intra-articular injection of HA in patients with mild to moderate knee OA. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 111 patients with symptomatic unilateral knee OA received a series of either leukocyte-poor PRP or HA injections under ultrasound guidance. Clinical data were collected before treatment and at 4 time points across a 1-year period. Synovial fluid was also collected for analysis of proinflammatory and anti-inflammatory markers before treatment and at 12 and 24 weeks after treatment. Several measures were used to assess results: (1) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale; (2) International Knee Documentation Committee (IKDC) subjective knee evaluation, visual analog scale (VAS) for pain, and Lysholm knee score; and (3) difference in intra-articular biochemical marker concentrations. Results: There were 49 patients randomized to treatment with PRP and 50 randomized to treatment with HA. No difference was seen between the groups in the primary outcome measure (WOMAC pain score). In the secondary outcome measure, linear contrasts identified a significantly higher IKDC score in the PRP group compared with the HA group at 24 weeks (mean ± standard error [SE], 65.5 ± 3.6 vs 55.8 ± 3.8, respectively; P = .013) and at final follow-up (52 weeks) (57.6 ± 3.37 vs 46.6 ± 3.76, respectively; P = .003). Linear contrasts also identified a statistically lower VAS score in the PRP group versus the HA group at 24 weeks (mean ± SE, 34.6 ± 3.24 vs 48.6 ± 3.7, respectively; P = .0096) and 52 weeks (44 ± 4.6 vs 57.3 ± 3.8, respectively; P = .0039). An examination of fixed effects showed that patients with mild OA and a lower body mass index had a statistically significant improvement in outcomes. In the biochemical analysis, differences between groups approached significance for interleukin-1β (mean ± SE, 0.14 ± 0.05 pg/mL [PRP] vs 0.34 ± 0.16 pg/mL [HA]; P = .06) and tumor necrosis factor α (0.08 ± 0.01 pg/mL [PRP] vs 0.2 ± 0.18 pg/mL [HA]; P = .068) at 12-week follow-up. Conclusion: We found no difference between HA and PRP at any time point in the primary outcome measure: the patient-reported WOMAC pain score. Significant improvements were seen in other patient-reported outcome measures, with results favoring PRP over HA. Preceding a significant difference in subjective outcomes favoring PRP, there was a trend toward a decrease in 2 proinflammatory cytokines, which suggest that the anti-inflammatory properties of PRP may contribute to an improvement of symptoms. Registration: ClinicalTrials.gov (Identifier: NCT02588872).
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
科研通AI5应助Ma采纳,获得10
11秒前
忧伤的绍辉完成签到 ,获得积分10
12秒前
隐形曼青应助易四夕采纳,获得10
16秒前
55秒前
易四夕发布了新的文献求助10
1分钟前
1分钟前
1分钟前
Ma发布了新的文献求助10
1分钟前
1分钟前
随机子发布了新的文献求助10
1分钟前
1分钟前
Ava应助科研通管家采纳,获得10
1分钟前
科目三应助科研通管家采纳,获得10
1分钟前
科研通AI2S应助科研通管家采纳,获得10
1分钟前
Ma发布了新的文献求助10
2分钟前
Ma完成签到,获得积分10
2分钟前
2分钟前
易四夕发布了新的文献求助10
3分钟前
3分钟前
3分钟前
英姑应助王大壮采纳,获得10
3分钟前
SciGPT应助科研通管家采纳,获得10
3分钟前
3分钟前
4分钟前
4分钟前
Mine发布了新的文献求助10
4分钟前
王大壮发布了新的文献求助10
4分钟前
Mine完成签到,获得积分10
4分钟前
郗妫完成签到,获得积分10
4分钟前
王大壮发布了新的文献求助10
4分钟前
科研通AI5应助Mine采纳,获得30
4分钟前
4分钟前
852应助美好颜采纳,获得10
4分钟前
纯情女大完成签到 ,获得积分10
5分钟前
5分钟前
5分钟前
FashionBoy应助科研通管家采纳,获得30
5分钟前
丘比特应助科研通管家采纳,获得10
5分钟前
斯文败类应助科研通管家采纳,获得10
5分钟前
赘婿应助科研通管家采纳,获得10
5分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968492
求助须知:如何正确求助?哪些是违规求助? 3513278
关于积分的说明 11167214
捐赠科研通 3248660
什么是DOI,文献DOI怎么找? 1794386
邀请新用户注册赠送积分活动 875030
科研通“疑难数据库(出版商)”最低求助积分说明 804638