Effect of Autologous Conditioned Plasma Injections in Patients With Knee Osteoarthritis.

Autor:	Korpershoek JV; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands., Vonk LA; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands., Filardo G; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Kester EC; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands., van Egmond N; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands., Saris DBF; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands.; Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Department of Reconstructive Medicine, University of Twente, Enschede, the Netherlands., Custers RJH; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2023 Jul 28; Vol. 11 (7), pp. 23259671231184848. Date of Electronic Publication: 2023 Jul 28 (Print Publication: 2023).
DOI:	10.1177/23259671231184848
Abstrakt:	Background: Autologous conditioned plasma (ACP) is a commercially available platelet concentrate with promising results from clinical trials. Purpose: To evaluate the clinical outcome after 3 consecutive injections of ACP in patients with knee osteoarthritis (OA) and study the influence of ACP composition and different patient factors as predictors of treatment effect. Study Design: Case series; Level of evidence, 4. Methods: This prospective case series included 260 patients (307 knees) who received ACP treatment for knee OA. The mean patient age was 51 ± 10 years. Improvement up to 12 months' follow-up was measured using the Knee injury and Osteoarthritis Outcome Score (KOOS). ACP composition was analyzed in 100 patients. The predictive value of age, sex, history of knee trauma, Kellgren-Lawrence OA grade, body mass index, and ACP composition was evaluated using generalized estimating equations. Results: The mean overall KOOS improved from 38 ± 14 at baseline to 45 ± 18 at 3 months, 45 ± 18 at 6 months, and 43 ± 18 at 12 months (all P < .05); 40% of patients achieved an improvement above the minimal clinically important difference (MCID) of 8 after 6 months and 33% after 12 months. The variation in ACP composition did not correlate with KOOS ( P > .05). Older age led to a greater clinical benefit (β = 0.27; P = .05), whereas bilateral treatment predicted worse outcomes (β = -5.6; P < .05). Conclusion: The improvement in KOOS after treatment with ACP did not reach the MCID in most study patients. Older age was a predictor for better outcomes. The composition of ACP varied between patients but did not predict outcomes within the evaluated range. The study findings show the limited benefit of ACP treatment for knee OA and call for caution with routine use in clinical practice. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This research was supported by the Dutch Arthritis Foundation (grant No. LLP-12). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. (© The Author(s) 2023.)
Databáze:	MEDLINE
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