Inyección de plasma rico en plaquetas y hexadecilamida de hialuronato sódico, por separado y en combinación, para la osteoartritis de rodilla. Estudio controlado aleatorizado en condiciones de práctica clínica real

  1. Luis Miguel Torres Morera 1
  2. Tatiana Gómez Sánchez 2
  3. Francisco Arroyo 2
  4. Diego Benítez 2
  5. José Manuel Trinidad 2
  6. Rogelio Sánchez de la Mata 3
  7. Enrique Calderón 2
  1. 1 Universidad de Cádiz
    info

    Universidad de Cádiz

    Cádiz, España

    ROR https://ror.org/04mxxkb11

  2. 2 Hospital Puerta del Mar
  3. 3 Hospital Universitario de Puerto Real
    info

    Hospital Universitario de Puerto Real

    Puerto Real, España

    ROR https://ror.org/04fbqvq73

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Revue:
MPJ Multidisciplinary Pain Journal

ISSN: 2697-2263

Année de publication: 2022

Número: 1

Type: Article

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D'autres publications dans: MPJ Multidisciplinary Pain Journal

Résumé

Introduction: Osteoarthritis (OA) is a degenerative joint disease that often affects the knees. In Spain almost 5 million people have been diagnosed with knee OA. Hyaluronic acid (AH) injections are clinically used to mitigate decreased endogenous AI functions of OA patients, where condral degeneration predominates. Platelet Rich Plasma (PRP) considered as a drug, by the Spanish Medicines Agency, is the most commonly drug related to AH in the treatment of OA, which has been shown to recruit endogenous stem cells and allow the regeneration of de novo tissue. Method: The purpose of the study has been to first compare the therapeutic efficacy of autologous PRP, sodium hyaluronate hexadecilamide (Hymovis®), or a combination of both (PRP+AH) in knee OA, under real clinical conditions. Results: Patients suffering from knee OA with a pain intensity at the beginning of >40 were included on a visual analog scale (VAS) of 100 mm. 109 patients (62 women and 47 men) between the age of 35 and 81 were included, of whom 101 ended the 1-year follow-up. All were treated on an outpatient basis. The groups were homogeneous. The primary goal outcome measure was a change in pain intensity evaluated by VAS at 2, 6 and 12 months after treatment. Secondary results were the result of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Womac rigidity (0-10) Womac functional capacity (0-68) test. Measurements were performed double-blindly. In the 3 groups positive results were obtained, in the PRP+AH group the largest reductions in pain and the highest of functional capacity were obtained. Discussion: Our results indicate that intraarticular injections of PRP and hexadecilamide of sodium hyaluronate, alone or in combination, offer significant clinical improvement in knee OA patients with no relevant side effects. The benefit was significantly stable in all 3 groups during the 12 months of follow-up. The combination of PRP + AH led to the best results in pain and mobility.

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