Diz Osteoartriti Olan Hastalarda Trombositten Zengin Plazma Enjeksiyonları Sonrası Klinik Sonuçlar ve Keşifsel MRG T2 Haritalama Bulguları: Retrospektif Bir Olgu Serisi

Öz

Bu çalışmanın amacı, diz osteoartriti (OA) olan hastalarda trombositten zengin plazma (PRP) enjeksiyonları sonrasındaki klinik sonuçları ve keşifsel MRG T2 haritalama değişikliklerini değerlendirmekti. Bu retrospektif vaka serisine, Kellgren–Lawrence evre 2–3 diz osteoartriti olan ve intraartiküler PRP enjeksiyonu uygulanarak 6 ay takip edilen 47 hasta dahil edildi. Hastaların tedavi öncesi ve 6. ay verileri; ağrı (VAS), fonksiyonel durum (WOMAC), yaşam kalitesi (SF-36), diz eklem hareket açıklığı (fleksiyon) ve Timed Up and Go testi açısından değerlendirildi. Ayrıca menisküs yapısına ait manyetik rezonans görüntüleme (MRG) T2 haritalama ölçümleri analiz edildi. Altıncı ay sonunda VAS, WOMAC, SF-36 fiziksel fonksiyon, ağrı, fiziksel rol kısıtlılığı, sosyal fonksiyon ve diz fleksiyon açısında istatistiksel olarak anlamlı iyileşmeler saptandı (p<0,05). Timed Up and Go testi ve bazı SF-36 alt parametrelerinde anlamlı değişiklik izlenmedi. MRI T2 haritalaması, medial menisküs anterior horn T2 relaksasyon süresinde bir azalma gösterdi (p=0.047); ancak bu bulgu, çoklu karşılaştırmalar için Bonferroni düzeltmesinden sonra istatistiksel olarak anlamlılığını korumadı (Bonferroni düzeltmeli p-değeri = 0.188). PRP enjeksiyonları, diz osteoartritli hastalarda ağrı, fonksiyon ve bazı yaşam kalitesi parametrelerinde iyileşme ile ilişkili bulunmuştur. MR T2 haritalama bulguları keşifsel olarak değerlendirilmelidir ve menisküs dokusunun onarımı veya rejenerasyonuna dair kesin kanıt sağlamaz. Ayrıca retrospektif tasarım ve kontrol grubunun olmaması nedeniyle nedensel bir ilişki kurulamaz. Bulguların doğrulanması için prospektif kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Ağrı
• Diz Osteoartriti
• Enjeksiyon
• Magnetic Rezonans
• Menisküs
• T2 Relaksasyon
• T2 Haritalama
• Trombositten Zengin Plazma
• Yaşam Kalitesi

Clinical Outcomes and Exploratory MRI T2 Mapping Findings Following Platelet-Rich Plasma Injections in Patients with Knee Osteoarthritis: A Retrospective Case Series

Öz

This study aimed to assess clinical outcomes and exploratory MRI T2 mapping changes following platelet-rich plasma (PRP) injections in patients with knee osteoarthritis (OA). This retrospective case series included 47 patients with Kellgren–Lawrence stage 2–3 knee osteoarthritis who underwent intraarticular PRP injection and were followed for 6 months. Clinical outcomes, including pain (VAS), functional status (WOMAC), quality of life (SF-36), knee range of motion (flexion), and the Timed Up and Go test, were obtained from medical records before and after treatment. Magnetic resonance imaging (MRI) T2 mapping of the meniscus was also analyzed. At 6 months, significant improvements were observed in VAS, WOMAC, SF-36 physical function, pain, physical role limitation, social function, and knee flexion (p<0.05). No significant changes were found in the Timed Up and Go test, or several SF-36 subdomains. MRI T2 mapping showed a decrease in T2 relaxation time in the medial meniscus anterior horn (p=0.047); however, this finding did not remain statistically significant after Bonferroni correction for multiple comparisons (Bonferroni-adjusted p=0.188). PRP injections were associated with improvements in pain, functional outcomes, and selected quality-of-life parameters in patients with knee OA. MRI T2 mapping findings should be considered exploratory and do not provide conclusive evidence of meniscal tissue repair or regeneration. Furthermore, due to the retrospective design and lack of a control group, a causal relationship cannot be established. Prospective controlled studies are required to confirm these findings.

Anahtar Kelimeler

• Intra-Articular; Magnetic Resonance Imaging; T2 Mapping; Menisci; Pain; Quality of Life.
• Osteoarthritis
• Knee; Platelet-Rich Plasma; Injections

Kaynakça

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