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A comparative Study of Functional Outcomes for the Treatment of Arthrosis of the Knee Joint Using Platelet-Rich Plasma Injections After or Without Arthroscopy

دراسة مقارنة للنتائج الوظيفية لعلاج الفصال العظمي بمفصل الركبة باستخدام حقن البلازما الغنية بالصفيحات بعد أو بدون التنظير المفصلي

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 Publication date 2020
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The research provides a comparison between two methods for treating osteoarthritis. In the knee joint using platelet-rich plasma injections after or without arthroscopy, the study included 100 cases every fifty of them were treated in one way and the results were evaluated after surgery and the researcher reached the following results. Treatment with platelet-rich plasma injections after arthroscopy provided an advantage in terms of pain reduction and reduced joint effusion in the knee, improvement of the ability to rest on the limb (walking), and a marked reduction in the severity of symptoms and signs of degeneration was noted.


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Research summary
تقدم هذه الدراسة مقارنة بين طريقتين لعلاج الفصال العظمي في مفصل الركبة باستخدام حقن البلازما الغنية بالصفيحات بعد أو بدون التنظير المفصلي. شملت الدراسة 100 حالة، تم تقسيمهم إلى مجموعتين: الأولى عولجت بحقن البلازما فقط، والثانية عولجت بحقن البلازما بعد إجراء التنظير المفصلي. أظهرت النتائج أن العلاج بحقن البلازما بعد التنظير المفصلي كان أكثر فعالية في تقليل الألم وتقليل الانصباب المفصلي وتحسين القدرة على الحركة والمشي. كانت الفروق واضحة بين المجموعتين، حيث كانت المجموعة الثانية تتمتع بتحسن أكبر في جميع المعايير المدروسة.
Critical review
تعتبر هذه الدراسة خطوة مهمة في مجال علاج الفصال العظمي، ولكن هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الممكن أن تكون فترة المتابعة أطول من ثلاثة أشهر لتقييم النتائج على المدى الطويل. ثانياً، لم يتم توضيح تفاصيل حول كيفية اختيار المرضى وتوزيعهم على المجموعتين، مما قد يؤثر على توازن العينة. ثالثاً، كان من الممكن تضمين مجموعة ضابطة لم تتلق أي علاج لمقارنة أفضل. وأخيراً، لم يتم التطرق إلى التكلفة الاقتصادية لكل من الطريقتين، وهو عامل مهم في اتخاذ القرارات العلاجية.
Questions related to the research
  1. ما هي الفروق الرئيسية بين الطريقتين المدروستين في علاج الفصال العظمي؟

    الفروق الرئيسية تشمل تقليل الألم، تقليل الانصباب المفصلي، وتحسين القدرة على الحركة والمشي، حيث كانت النتائج أفضل في المجموعة التي تلقت حقن البلازما بعد التنظير المفصلي.

  2. ما هي فترة المتابعة التي تم استخدامها في الدراسة؟

    فترة المتابعة كانت ثلاثة أشهر بعد أخذ آخر حقنة من البلازما.

  3. ما هي أهم النتائج التي توصلت إليها الدراسة؟

    أهم النتائج تشمل أن العلاج بحقن البلازما بعد التنظير المفصلي كان أكثر فعالية في تقليل الألم، تقليل الانصباب المفصلي، وتحسين القدرة على الحركة والمشي.

  4. ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟

    التوصيات تشمل استخدام العلاج بحقن البلازما المفصلية لعلاج الفصال العظمي في مراحله البدئية، ويفضل العلاج بحقن البلازما بعد التنظير المفصلي لتحقيق نتائج أفضل.


References used
Johnny, Ahmed. Stadium injuries. Tishreen University / Faculty of Physical Education/ Lattakia. Directorate of university books and publications. In 2003,381 p.
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This study is aimed to evaluate the role of Platelet Rich Plasma PRP on osteogensis in periosteal distraction. The sample consisted of 12 rabbits from local spices. The sample divided equally into two groups, titanium mesh with holes was used in to elevate the periosteum and the space between the surface of bone and the mesh was filled with collagen sponge, in the test group the sponge was injected with PRP. The rabbits were killed after eight weeks after operation and the samples were prepared for histological study. The histological study of specimens of control group showed formation of small island of osteoid with large areas of connective tissue. While, in test group there was an increasing in bone formation in form of wide area of woven bone and decreasing in connective tissue. We conclude that application of Platelet Rich Plasma PRP lead to improvement in bone formation in periosteal distraction.
The role of arthroscopic debridement in the treatment of osteoarthritis of the knee is still controversy. We present in this work a retrospective series including 22 cases of gonarthrosis treated with arthroscopic debridement of the knee in the Tr aumatology orthopedic service in Alassad hospital in Lattakia in 2013 -2015. Our objective through this small series was to show the interest of arthroscopic debridement in this type of knee pathology, improving quality of life for patients. This study included 12 men (55%),and 10 women (45%) with an average age of 50 years ,with extremes ranging from 44 to 65 years. Clinically ,our patients complained of mechanical pain in the majority of cases .And all our patients were benefice a clinical examination and radiological .The Lequesene score was used to assess the condition of the knee before and after surgery. The surgical procedure consisted of a joint lavage ,and gestures at the demand : synovectomy, debridement and excision of fragments meniscal, cartilage or osteophyte. The postoperative complications were marked by a single case of intra-articular breaking instrument during surgery. No cases of hematoma or phlebitis or sepsis have been reported . The clinical results after a decline of 12 months were satisfactory. The results depend on good pre-operative planning, and irreproachable technical gesture. The experience of operators and technologic advances in has extended its indication.
This study aims to know the effect of PRP on bone healing and regeneration after cystoectomy within studying clinical and radiological bone density changes. The research sample comprised 18 patients (14 males, 4 females) (20 cystic lesions in the upp er jaw,1-3 cm diameter). This sample was divided into 2 similar groups : The experimental group: Platelets-rich Plasma with Tri-Calcium Phosphate was applied. The control group: only Tri-Calcium Phosphate, without Platelets-rich Plasma, was applied. Both groups were observed clinically and radiologically. According to radiological observation, the digital panoramic radiographs were taken before, immediately after surgery, after 3 months, and after 6 months, respectively. Bone density measurements were done through Digora® digital program. The present study showed that there is no statistical difference between the experimental group & the control group, regarding Pain Index and Infection Index; while there was a statistical difference between the experimental group & the control group, regarding bone density after 3 and 6 months after surgery. Within the limitations of the present study, the application of autologous platelets-rich plasma (PRP) accelerates bone regeneration after cystoectomy.

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