Rev. Soc. Esp. Dolor. 2024; 31(3): 141-149 / DOI: 10.20986/resed.2025.4112/2023
José Cortell, Luis Alberto García, Rosa María Izquierdo, Ruth Robledo, María Pilar Argente, María de los Ángeles Canos
RESUMEN
Introducción: La artrosis de rodilla es un trastorno musculoesquelético frecuente que reduce considerablemente la calidad de vida. Las inyecciones de plasma rico en plaquetas (PRP) son muy empleadas, pero se desconoce el número, la duración y los métodos óptimos para aplicar las inyecciones.
Objetivos: Determinar el efecto de las infiltraciones de PRP mediante la administración de 3 dosis de PRP en intervalos de 3 semanas en la disminución del dolor (medido con escala EVA) y la mejora de la funcionalidad (medido con escala WOMAC).
Pacientes y metodología: Se revisaron las historias clínicas de 31 pacientes, 8 hombres y 23 mujeres, desde enero de 2018 a enero de 2022, diagnosticados de gonalgia crónica por artrosis. A los pacientes se les había administrado 3 sesiones de infiltración de PRP espaciadas cada 3 semanas, con una duración total del tratamiento de 9 semanas y un seguimiento de la escala EVA y WOMAC hasta los 24 meses.
Resultados: Todos los pacientes presentaron mejoría en las escalas EVA y WOMAC tras cada una de las inyecciones de PRP, siendo estadísticamente significativa en la semana 9 (3ª inyección). Objetivamos que, de manera estadísticamente significativa, los pacientes obesos tienen una peor evolución del resultado del tratamiento. Se produjo un cambio en la distribución porcentual de las modalidades de tratamiento analgésico, aunque este cambio no alcanzó significación estadística. La duración del efecto del tratamiento tuvo una mediana de 8 meses [P25: 4 meses; P75: 13 meses] (IC 95 % de la media = 6,78 a 11,61) después de la última infiltración.
Conclusiones: El tratamiento con PRP en los pacientes con artrosis de rodilla resulta eficaz en la disminución del dolor objetivado con las escalas EVA, WOMAC y la disminución en la ingesta de analgésicos. La obesidad es un factor predictor de peor resultado en los pacientes tratados con PRP.
ABSTRACT
Background: Knee osteoarthritis is a frequent musculoskeletal disorder that considerably reduces the quality of life, due to pain, decreased mobility and independence of the people affected. Platelet-rich plasma (PRP) injections are increasingly used to manage osteoarthritis, but the optimal number, duration, and methods of delivering PRP injections and defining their clinical benefit are unknown.
Objectives: To determine the effect of PRP infiltrations by administering a total of three doses of PRP at three-week intervals in reducing pain (measured with the VAS scale) and improving functionality (measured with the WOMAC scale) in patients with knee pain due to osteoarthritis.
Patients and methods: The medical records of 31 patients, 8 men and 23 women, from January 2018 to January 2022, diagnosed with chronic knee pain due to osteoarthritis treated with PRP were reviewed. The patients had been administered three PRP infiltration sessions with 3 weeks intervals, in a total treatment duration of 9 weeks and a follow-up on the VAS and WOMAC scale for up to 24 months.
Results: All patients showed improvement in the VAS and WOMAC scores after each PRP injection, with statistical significance observed at week 9 (third injection). We found that, in a statistically significant manner, obese patients had a worse progression in treatment outcomes. There was a change in the percentage distribution of analgesic treatment modalities, although this change did not reach statistical significance. The duration of the treatment effect had a median of 8 months [P25: 4 months; P75: 13 months] (95 % CI of the mean = 6.78 to 11.61) after the last injection.
Conclusions: Treatment with PRP in patients with knee osteoarthritis is effective in reducing pain measured with the VAS and WOMAC scales and reducing the intake of analgesics. Obesity is a predictor of worse outcome in patients treated with PRP. Further studies are needed to confirm these results and understand the mechanism of action, with different administration protocols and preparation of PRP to obtain better and more durable results.
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