BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Ke...BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.展开更多
目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病...目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。展开更多
文摘BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.
文摘目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。
