PRP與HA(玻尿酸)PK Round III: 針對膝關節退化的注射療效，PRP勝出!  

疼痛書房 Pain Studio

這篇由斯洛伐克研究團隊所發表的研究，隱隱地揭露出膝關節退化注射治療的未來之星: PRP!

(甚麼是PRP?)

以目前醫界針對退化性膝關節炎的標準治療流程而言，可以大略依據退化的嚴重程度，來選擇最適切的治療模式(如下表)

而經由此篇研究結論，應該會逐漸開啟了一個新的臨床適應症:

中重度的膝退化性關節炎，經保守治療與玻尿酸注射無效，且無法或不願接受手術治療者，可以考慮PRP注射。

這個全新的治療模式，應該會在近幾年經衛生署通過使用；然而由於注射的單價較高(每療程約新台幣30,000~80,000左右)，勢必需要一段時間才會在醫療市場上普及開來。

[延伸閱讀]

Round I: 期待已久的PK研究! 退化性膝關節炎療效 PRP vs 玻尿酸

Round II: PRP增生注射與HA(玻尿酸)的再次PK! 針對踝骨軟骨缺損OCD的療效，PRP勝出!

[研究論文摘要]

Am J Phys Med Rehabil. 2012 May;91(5):411-7.

Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic Acid.

Spaková T, Rosocha J, Lacko M, Harvanová D, Gharaibeh A.

Source

From the Associated Tissue Bank of Faculty of Medicine UPJS and University Hospital of L. Pasteur (TS, JR, DH); and Department of Orthopaedics and Traumatology, Faculty of Medicine, P. J. Safárik University and University Hospital of L. Pasteur, Kosice, Slovakia (ML, AG).

Abstract

OBJECTIVE:

This study aimed to find a simple, cost-effective, and time-efficient method for the preparation of platelet-rich plasma (PRP), so the acquired benefits will be readily available for multiple procedures in smaller outpatient clinics and to explore the safety and efficacy of the application of PRP in the treatment of degenerative lesions of articular cartilage of the knee.

DESIGN:

The study was designed as a prospective, cohort study with a control group. A total of 120 patients with Grade 1, 2, or 3 osteoarthritis according to the Kellgren and Lawrence grading scale were enrolled in the study. One group of patients was treated using three intra-articular applications of PRP, and the second group of patients was given three injections of hyaluronic acid. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index and the 11-point pain intensity Numeric Rating Scale.

RESULTS:

On average, a 4.5-fold increase in platelet concentration was obtained in the PRP group. No severe adverse events were observed. Statistically significantly better results in the Western Ontario and McMaster Universities Osteoarthritis Index and Numeric Rating Scale scores were recorded in a group of patients who received PRP injections after a 3- and 6-mo follow-up.

CONCLUSIONS:

Our preliminary findings support the application of autologous PRP as an effective and safe method in the treatment of the initial stages of knee osteoarthritis. Further studies are needed to confirm these results and to investigate the persistence of the beneficial effects observed.