目的:本研究的目的是建立关于富血小板血浆(PRP)治疗肌肉骨骼疾病的共识声明。
方法:使用改良的Delphi技术对PRP的治疗进行了共识。35名骨科医生和运动医学医师参加了有关PRP的共识声明。参与者由生物协会的代表组成,代表九个国际骨科和肌肉骨骼专业协会,因为他们对直管生物学的研究有积极的兴趣而被邀请。共识被定义为达成80-89%的协议,强烈的共识被定义为90-99%的协议,与拟议的声明达成了100%的一致意见。
结果:对有关PRP的陈述有62%的共识。
结论:(1)PRP应根据血小板计数进行分类,白细胞计数,红血球计数,激活方法,和纯血浆vs.纤维蛋白基质,(2)研究报告的PRP特征是血小板计数,白细胞计数,中性粒细胞计数,红细胞计数,总体积,注射量,交货方式,以及注射次数,(3)接受PRP注射的患者的预后因素是年龄,BMI,病理的严重程度/等级,病理学的慢性,先前的注射和反应,主要诊断(主要与手术后vs.创伤后vs.银屑病),合并症,吸烟,(4)关于年龄和BMI,没有最小值或最大值,但是临床判断应该在任何一个极端的情况下使用,(5)PRP的理想剂量未确定,和(6)所需的最小体积不清楚,可能取决于病理。
To establish consensus statements on platelet-rich plasma (PRP) for the treatment of musculoskeletal pathologies.
A consensus process on the treatment of PRP using a modified Delphi technique was conducted. Thirty-five orthopaedic surgeons and sports medicine physicians participated in these consensus statements on PRP. The participants were composed of representatives of the Biologic Association, representing 9 international orthopaedic and musculoskeletal professional societies invited due to their active interest in the study of orthobiologics.
Consensus was defined as achieving 80% to 89% agreement, strong
consensus was defined as 90% to 99% agreement, and unanimous consensus was indicated by 100% agreement with a proposed statement.
There was
consensus on 62% of statements about PRP.
(1) PRP should be classified based on platelet count, leukocyte count, red blood count, activation method, and pure-plasma versus fibrin matrix; (2) PRP characteristics for reporting in research studies are platelet count, leukocyte count, neutrophil count, red blood cell count, total volume, the volume of injection, delivery method, and the number of
injections; (3) the prognostic factors for those undergoing PRP
injections are age, body mass index, severity/grade of pathology, chronicity of pathology, prior
injections and response, primary diagnosis (primary vs postsurgery vs post-trauma vs psoriatic), comorbidities, and smoking; (4) regarding age and body mass index, there is no minimum or maximum, but clinical judgment should be used at extremes of either; (5) the ideal dose of PRP is undetermined; and (6) the minimal volume required is unclear and may depend on the pathology.
Level V, expert opinion.