Platelet Lysate and Osteoarthritis of the Knee: A Review of Current Clinical Evidence.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2024-12-01 Epub Date: 2024-09-28 DOI:10.1007/s40122-024-00661-y

Ashim Gupta, Nicola Maffulli

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引用次数: 0

Abstract

Introduction: Osteoarthritis (OA) of the knee affects millions of people with sizable socioeconomic burden. Conventional treatment modalities are prioritized, turning to surgical intervention only when they have failed. However, these traditional modalities have shortcomings, only aiming to reduce pain rather than targeting the underlying pathophysiology. Recently, the use of biologics, including autologous peripheral blood-derived orthobiologics (APBOs), has increased and demonstrated great promise for the management of knee OA. Platelet-rich plasma (PRP) is the most widely used APBO, but its efficacy is still uncertain, attributed to lack of standardized formulation protocols, characterization, and patient variables. To overcome the limitations posed by PRP, the use of other APBOs such as platelet lysate (PL) has been considered. This review summarizes the outcomes of clinical studies involving PL to manage OA of the knee.

Methods: Multiple databases (Scopus, Embase, PubMed, and Web of Science) were searched employing terms "platelet lysate" and "knee osteoarthritis" for articles published in the English language to August 15, 2024, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: Only three clinical studies fulfilled our search and inclusion criteria. Intra-articular injection of three doses of PL injected every 3-4 weeks is safe and efficacious, resulting in statistically significant improvements in different patient-reported outcome measures at 6-12 months follow-up.

Conclusion: The existing published peer-reviewed literature suggests that intra-articular injection of PL is safe and can decrease pain and increase function in patients with knee OA. Nonetheless, given the dearth of pertinent literature, more adequately powered, multicenter, prospective, non-randomized and randomized controlled studies with extended follow-up are needed to confirm the effectiveness of PL in knee OA. Further comparative studies to help clinicians in choosing the best APBO for knee OA treatment are also warranted.

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血小板溶解物与膝关节骨性关节炎：当前临床证据综述》（Platelet Lysate and Osteoarthritis of the Knee: A Review of Current Clinical Evidence.

导言：膝关节骨性关节炎（OA）影响着数百万人，给社会经济带来沉重负担。传统的治疗方式是优先考虑的，只有在治疗失败后才会转向手术干预。然而，这些传统治疗方法存在缺陷，其目的只是减轻疼痛，而不是针对潜在的病理生理学。最近，包括自体外周血衍生骨生物制剂（APBOs）在内的生物制剂的使用越来越多，并显示出治疗膝关节 OA 的巨大前景。富血小板血浆（PRP）是应用最广泛的自体外周血生物制剂，但由于缺乏标准化的配制方案、特征描述和患者变量，其疗效仍不确定。为了克服 PRP 的局限性，人们考虑使用其他 APBO，如血小板裂解液（PL）。本综述总结了使用血小板溶液治疗膝关节 OA 的临床研究结果：在多个数据库（Scopus、Embase、PubMed 和 Web of Science）中以 "血小板溶液 "和 "膝关节骨关节炎 "为关键词，检索截至 2024 年 8 月 15 日以英语发表的文章，并遵循《系统综述和元分析首选报告项目》指南：结果：只有三项临床研究符合我们的搜索和纳入标准。每3-4周注射3次PL的关节内注射安全有效，在6-12个月的随访中，患者报告的不同结果指标均有统计学意义的改善：现有已发表的同行评审文献表明，关节内注射聚乳酸是安全的，可减轻膝关节 OA 患者的疼痛并增强其功能。尽管如此，鉴于相关文献的匮乏，还需要更多有充分证据支持的多中心、前瞻性、非随机和随机对照研究，并延长随访时间，以证实 PL 对膝关节 OA 的疗效。此外，还需要进一步开展比较研究，以帮助临床医生选择治疗膝关节 OA 的最佳 APBO。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.