[1]鞠昌军,姜红江,高广凌,等.体外人工膝支具辅助血小板裂解液治疗膝关节骨性关节炎的临床疗效分析[J].中华老年骨科与康复电子杂志,2018,(04):224-230.[doi:10.3877/cma.j.issn.2096-0263.2018.04.007]
　Ju Changjun,Jiang Hongjiang,Gao Guangling,et al.Clinical analysis of treatment of knee osteoarthritis with external artificial knee joint assisted platelet lysate[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(04):224-230.[doi:10.3877/cma.j.issn.2096-0263.2018.04.007]
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体外人工膝支具辅助血小板裂解液治疗膝关节骨性关节炎的临床疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年04期
页码:
224-230
栏目:
膝关节
出版日期:
2018-07-30

文章信息/Info

Title:
Clinical analysis of treatment of knee osteoarthritis with external artificial knee joint assisted platelet lysate
作者:
鞠昌军; 姜红江; 高广凌; 严伟; 余昕; 邹德宝; 李磊
264400 威海，山东省文登整骨医院关节科
Author(s):
Ju Changjun;  Jiang Hongjiang;  Gao Guangling;  Yu Xin;  Zou Debao;  Yan Wei;  Li Lei.
Department of Orthopaedics, the Wendeng Osteopath Hospital of Shandong Provincial, Weihai 264400, China
关键词:
骨关节炎;  矫正装置;  注射; 关节内;  血小板裂解液
Keywords:
Osteoarthritis;  Orthotic devices;  Injections;  intra-articular;  Platelet lysate
DOI:
10.3877/cma.j.issn.2096-0263.2018.04.007
文献标志码:
A
摘要:
目的 评价体外人工膝关节支（EAKJ）具辅助下行血小板裂解液关节腔注射治疗膝关节骨性关节炎（KOA）的临床疗效。方法 采用前瞻性随机对照研究的方法，选取2015年1月至2016年9月山东省文登整骨医院收治的100例KOA患者（100膝），通过随机数字表法分为血小板裂解液（PL）组（n=50）、EAKJ支具联合血小板裂解液（EAKJ+PL）组（n=50）。平均年龄为（57±8）岁，男性43例（43%），女性57例（57%）。两组关节腔注射PL每周2次，每次5 ml，连续注射5次。EAKJ+PL组治疗开始后每天佩戴EAKJ支具时间不少于4 h，连续佩戴不少于6个月。分别于治疗前1 d、治疗开始后1 d、1个月、3个月及6个月，记录并比较两组患者VAS疼痛评分、WOMAC评分及膝关节HSS评分，在治疗前1 d和治疗开始后6个月分别拍摄患膝负重位X线正侧位平片，分别测量股胫角、内侧关节间隙宽度。结果 PL组47例、EAKJ+PL组46例成功完成治疗及6个月以上随访。治疗开始后1个月、3个月及6个月时EAKJ+PL组VAS[（3.0±0.4，2.6±0.4，2.2±0.4）分]及WOMAC评分[（32±6，29±5，28±5）分]均低于PL组[（3.5±0.4，3.1±0.4，2.7±0.4；35.0±5.8，28.7±4.7，28.4±4.6）分]，差异均有统计学意义（F=6.924，F=6.015，F=6.163；F=2.214，F=3.428，F=5.314，P＜0.05）；HSS评分差异无统计学意义；与治疗前相比，EAKJ+PL组和PL组患者的VAS、WOMAC评分均明显改善，差异有统计学意义（F=428.638，F=58.761，P＜0.05）。治疗后6个月，EAKJ+PL组股胫角[（177.0±2.5）°]小于PL组[（179.2±2.4）°]，差异有统计学意义（t=4.231，P＜0.05）；内侧关节间隙宽度[（3.24±0.27）mm]大于PL组[（2.56±0.32）mm]，差异有统计学意义（t=-11.175，P＜0.05）。EAKJ+PL组股胫角和内侧间室宽度治疗后6个月与治疗前相比明显改善（t=-14.201，t=8.571，P＜0.05），PL组改善不明显（均P＞0.05）。结论 EAKJ支具辅助血小板裂解液治疗KOA在缓解症状、改善下肢力线方面能够取得较好的临床效果，是值得推广的治疗方法。
Abstract:
Objective To evaluate the clinical effect of intra-articular platelet lysat injection in the treatment of knee osteoarthritis (OA) assist with external artificial knee joint (EAKJ) . Methods This prospective randomized controlled clinical trial involved 100 patients admitted in Shandong Wendeng orthopaedic hospital from January 2012 to September 2016. The patients were randomly divided into two groups: PL group and EAKJ+PL group (n=50). There were 43 males (43%) and 57 females (57%) with an average age of (57±8) years. All patients received PL 2 times a week, 5 ml per time and continue for 5 times. The EAKJ+PL group wore a brace at least 4 hours a day for no less than 6 months. The visual analogue scale/score (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and the Hospital for Special Surgery (HSS) score were recorded and compared 1 day before the treatment, 1 day, 1 month, 3 months and 6 months after the treatment. Femur?tibia angle (FTA) and width of medial knee joint space were documented through a load bearing X-ray 1 day before the treatment and 6 months after the treatment. Results 47 cases in PL group and 46 cases in EAKJ+PL group successfully completed the treatment and followed for more than 6 months. The VAS and WOMAC scores in EAKJ+PL group (3.0±0.4, 2.6±0.4, 2.2±0.4; 32±6, 29±5, 28±5) were lower than those in PL group (3.5±0.4, 3.1±0.4, 2.7±0.4; 35.0±5.8, 28.7±4.7, 28.4±4.6) (F=6.924, F=6.015, F=6.163; F=2.214, F=3.428, F=5.314, P<0.05) at 1 month, 3 months and 6 months after treatment (P<0.05). HSS scores between two groups has no statistically significant. After 6 months treatment, the FTAs of EAKJ+PL group (177.0±2.5)° were less than that of PL group (179.2±2.4)°(t=4.231, P<0.05), and the width of medial tibiofemoral joint space (3.24±0.27) mm were greater than those of PL group (2.56±0.32) mm (t=-11.175, P<0.05). Compared with pre-treatment, width of medial tibiofemoral joint space and FTA were significantly improved in EAKJ+PL group (t=-14.201, t=8.571, P<0.05), but there was no significant improvement in PL group. Conclusion EAKJ assisted platelet lysate injection in the treatment of knee osteoarthritis can achieve a good clinical effect in relieving symptoms and improving the force line of lower limb, which is worth promoting.

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备注/Memo

备注/Memo:
基金项目：山东省威海市科技发展计划项目（2015GNS048）
更新日期/Last Update: 2018-07-30