| Autor: |
Ivković A; Department of Orthopaedics and Trauma Surgery, University Hospital 'Sveti Duh', 10000 Zagreb, Croatia.; School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.; Department of Clinical Medicine, University of Applied Health Sciences, 10000 Zagreb, Croatia., Glavčić M; Department of Orthopaedic and Trauma Surgery, University Hospital 'Dubrava', 10000 Zagreb, Croatia., Vuletić F; Department of Orthopaedics and Trauma Surgery, University Hospital 'Sveti Duh', 10000 Zagreb, Croatia., Janković S; Department of Orthopaedics and Trauma Surgery, University Hospital 'Sveti Duh', 10000 Zagreb, Croatia.; Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia. |
| Abstrakt: |
The purpose of this prospective case series was to determine the effectiveness of using a combination of the core decompression and injection of autologous conditioned plasma (ACP) for the treatment of symptomatic knee bone marrow lesions (BML), as well as to report on the preliminary clinical results based on magnetic resonance imaging (MRI) and patient-reported outcomes (PROMs). Patients with OA-related BML who failed to improve on conservative treatment for three months underwent an identical procedure consisting of arthroscopy, core decompression, and the intraosseous injection of ACP and were followed up for 12 months. A statistically significant reduction in pain and an improvement in function, as measured by the Numeric Pain Rating Scale (NPRS) and Knee Injury and Osteoarthritis Outcome Score (KOOS), was observed at one-week follow-up (8.3 ± 0.8 to 1.5 ± 1.0; p ≤ 0.001 and 33.4 ± 10.6 to 53.9 ± 13.6; p ≤ 0.001 respectively). After six weeks, weight-bearing was allowed, but the trend did not change-the NPRS continued to be low (average 1.4 on 12-month follow-up) and the total KOOS increased 44.6 points from the baseline (average 78.0 on 12-month follow-up). The Whole-Organ Magnetic Resonance Imaging Score improved from 66.1 ± 19.4 prior to surgery to 58.0 ± 15.9 ( p < 0.001) after 3 months. In our study, there was no control group, randomisation was not performed, and the sample size was relatively small. A combination of core decompression and the intraosseous injection of ACP into the affected subchondral area proved to be a safe and effective procedure that provides rapid pain relief and a significant increase in joint function up to one year postoperatively. |
