背景:关节内(IA)注射富血小板血浆(PRP)和透明质酸(HA)是治疗髋关节骨关节炎(OA)的新方法。这项研究的目的是比较IA注射PRP的有效性,HA及其组合在髋关节OA患者中的应用。HA和PRP是两种IA干预措施,可用于术前阶段的OA。由于作用机制的不同,建议两者结合起来具有协同作用。
方法:这是一项随机临床试验,有三个平行组。在这项研究中,包括2级和3级髋关节OA患者,并随机分为三个注射组:PRP,HA和PRP+HA。在任何一组中,在超声引导下向髋关节进行两次注射,间隔2周.在干预前对患者进行评估,第二次注射后2个月和6个月,使用视觉模拟量表(VAS),西安大略省和麦克马斯特大学骨关节炎指数(WOMAC),和Lequesne问卷。
结果:在HA中随机招募了105名患者,PRP和PRP+HA组。3组均显示WOMAC有显著改善,VAS,与基线相比,2个月和6个月时的Lequesne。3组的比较表明,在WOMAC和Lequesne总分以及Lequesne的日常生活活动能力(ADL)子量表方面存在显着差异(分别为P=0.041、0.001和0.002),其中PRP+HA和PRP组6个月时观察到的改善显著高于HA组.
结论:尽管所有3种干预措施均与髋部OA患者疼痛和功能的改善有关,PRP和PRP+HA注射的治疗效果持续时间更长(6个月),以及这两种干预措施对患者表现的影响,残疾,从长远来看,ADL优于HA。此外,在PRP中加入HA与治疗结果的显著增加无关.
背景:该研究在伊朗临床试验注册中心(IRCT)网站http://www注册。irct.ir/,世卫组织初级登记册设置,2019年11月29日,注册号为IRCT20130523013442N30。
BACKGROUND: Intra articular (IA) injection of platelet-rich plasma (PRP) and hyaluronic acid (HA) are of the new methods in the management of hip osteoarthritis (OA). The aim of this
study was to compare the effectiveness of IA injections of PRP, HA and their combination in patients with hip OA. HA and PRP are two IA interventions that can be used in OA in the preoperative stages. Due to the different mechanisms of action, these two are proposed to have a synergistic effect by combining.
METHODS: This is a randomized clinical
trial with three parallel groups. In this
study, patients with grade 2 and 3 hip OA were included, and were randomly divided into three injection groups: PRP, HA and PRP + HA. In either group, two injections with 2 weeks\' interval were performed into the hip joint under ultrasound guidance. Patients were assessed before the intervention, 2 months and 6 months after the second injection, using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne questionnaires.
RESULTS: One hundred five patients were enrolled randomly in HA, PRP and PRP + HA groups. All three groups showed significant improvement in WOMAC, VAS, and Lequesne at 2 months and 6 months compared with baseline. Comparison of the 3 groups demonstrated significant differences regarding WOMAC and Lequesne total scores and the activities of daily living (ADL) subscale of Lequesne (P = 0.041, 0.001 and 0.002, respectively), in which the observed improvement at 6th month was significantly higher in the PRP + HA and PRP groups compared to the HA group.
CONCLUSIONS: Although all 3 interventions were associated with improvement of pain and function in patients with hip OA, the therapeutic effects of PRP and PRP + HA injections lasted longer (6 months), and the effects of these two interventions on patients\' performance, disability, and ADL were superior to HA in the long run. Moreover, the addition of HA to PRP was not associated with a significant increase in the therapeutic results.
BACKGROUND: The
study was registered at Iranian Registry of Clinical Trials (IRCT) website http://www.irct.ir/ , a WHO Primary Register setup, with the registration number of IRCT20130523013442N30 on 29/11/2019.