Eklem İçi Uygulanan Trombositten Zengin Plazmanın (TZP) Etkisinin Diz Osteoartritinin Şiddeti ile İlişkisi

Öz

Objective: Platelet-rich plasma applications have recently become one of the non-surgical treatments in knee osteoarthritis. It has been shown to be superior to treatments such as placebo and prolotherapy. However, it is not entirely clear whether its effect on early or late knee osteoarthritis varies. In this study, we aimed to compare the effectiveness of single dose platelet-rich plasma administration in patients with different stages of knee osteoarthritis. 

Material and Methods: A total of 80 patients who received a single dose of platelet-rich plasma to a single knee joint and whose Lysholm knee functionality score questionnaires were filled before injection were included in the study. Knee radiographies of all patients were evaluated according to Kellgren-Lawrence classification. Stage I and II osteoarthritic patients were included in Group 1 whereas Stage III and IV osteoarthritic patients were included in Group 2. Knee scores of all patients acquired before and after injection therapies were evaluated. Demographic data were also evaluated. All data obtained were compared between two groups using statistical analysis ANOVA. 

Results: Scores of both groups were increased as compared to pre-injection scores. Better results were obtained in both groups in terms of pain and functionality. When the changes in scores before and after injection of both groups were compared, the first group had a better result statistically (p<0,05). 

Conclusion: Platelet-rich plasma application was more effective in early stage osteoarthritic patients. Single dose administration has been found to be effective in pain control and functionality. However, in case of late stage osteoarthritis, a minimum dose of 3 injections should be administered or other treatment modalities can be tried.

Anahtar Kelimeler

• Osteoarthritis
• knee
• platelet-rich plasma
• Lysholm knee score

Proje Numarası

yoktur

THE RELATIONSHIP OF THE EFFECT OF INTRA-ARTICULAR PLATELET-RICH PLASMA (PRP) ADMINISTRATION WITH THE SEVERITY OF KNEE OSTEOARTHRITIS

Öz

Amaç: Trombositten zengin plazma uygulamaları son dönemde diz osteoartritinde cerrahi dışı tedaviler arasında yer almaya başlamıştır. Plasebo ve proloterapi gibi tedavilere üstünlüğü gösterilmiştir. Ancak halen erken dönem ve geç dönem diz osteoartriti üzerine etkisinin değişiklik gösterip göstermediği tam net değildir. Biz bu çalışmamızda farklı evredeki diz osteoartriti olan hastalarda tek doz trombositten zengin plazma uygulamasının etkinliğini karşılaştırmayı amaçladık. 

Gereç ve Yöntemler: Tek dizine tek doz trombositten zengin plazma uygulanmış ve enjeksiyon öncesi Lysholm diz fonksiyonelliği skoru anketi doldurulmuş olan toplam 80 hasta çalışmaya dahil edildi. Bu hastaların daha önce çekilmiş grafileri üzerinden Kallgren-Lawrence osteoartrit sınıflaması kullanılarak sınıflama yapıldı. Evre I ve II osteoartriti olanlar 1. gruba dahil edilirken, evre III ve IV osteoartriti olanlar 2. gruba dahil edildi. Bu hastaların enjeksiyon öncesi ve sonrasında doldurulmuş olan Lysholm diz fonksiyonelliği anketleri değerlendirildi. Elde edilen veriler her iki grup arasında varyans analizi kullanılarak (ANOVA) karşılaştırıldı.

Bulgular: Her iki grubun Lysholm skorlarında enjeksiyon sonrası iyileşme mevcuttu. Her iki grupta da hem ağrı hem fonksiyonellik açısından daha iyi sonuçlar elde edildi. Enjeksiyon öncesi ve sonrası skorlardaki değişim ele alındığında, birinci gruptaki değişim ikinci gruba göre anlamlı olarak daha fazlaydı. (p<0,05)

Sonuç: Trombositten zengin plazma uygulaması erken evre diz osteoartritli hastalarda daha etkili idi. Tek doz uygulama hem ağrının azaltılmasında hem de fonksiyonelliğin artırılmasında yeterli bulunmuştur. Ancak ileri evre osteoartritli hastalarda en az 3 doz yapılması, cevap alınamadığında bir sonraki tedavi yöntemlerinin düşünülmesi gereklidir.

Anahtar Kelimeler

• Osteoartrit
• diz
• trombositten zengin plazma
• Lysholm diz skoru

Destekleyen Kurum

yoktur

Proje Numarası

yoktur

Teşekkür

Yazının dizaynındaki, verilerin yorumlanmasındaki ve son halinin verilmesindeki yardımlarından dolayı Doç. Dr. Meriç Çırpar'a teşekkür ederiz.

Kaynakça

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