Ka hoohana ana oPlatelet Rich Plasma (PRP)i loko o nā ʻano ʻano like ʻole a pehea e koho ai i ka PRP waiwai i nā keʻokeʻo koko keʻokeʻo (L-PRP) a me ka PRP Poor i nā ʻāpana koko keʻokeʻo (P-PRP)
ʻO ka loaʻa hou ʻana o kahi helu nui o nā hōʻike kiʻekiʻe e kākoʻo i ka hoʻohana ʻana i ka LR-PRP injection no ka mālama ʻana i ka Epicondylitis lateral a me LP-PRP no ka mālama ʻana i ka iwi Articular kuli.Kākoʻo nā hōʻike haʻahaʻa haʻahaʻa i ka hoʻohana ʻana i ka LR-PRP injection no ka patellar tendinosis a me ka PRP injection no Plantar fasciitis a me ka ʻeha o ka wahi hāʻawi i ka hoʻololi ʻana o ka tendon patellar BTB ACL reconstruction.ʻAʻole lawa nā hōʻike e ʻōlelo mau ai i ka PRP no ka rotator cuff tendinosis, hip Articular bone osteoarthritis a i ʻole nā wāwae wāwae kiʻekiʻe.Hōʻike nā hōʻike o kēia manawa ʻaʻole pono ka PRP i ka mālama ʻana i ka maʻi tendon Achilles, ka ʻeha ʻiʻo, ka haʻihaʻi a i ʻole ka hui ʻole o ka iwi, hoʻomaikaʻi ʻia ka hoʻoponopono ʻana i ka rotator cuff, ka hoʻoponopono ʻana i ka tendon Achilles, a me ka hana hou ʻana o ACL.
ʻO Platelet Rich plasma (PRP) kahi hoʻomākaukau plasma kanaka autologous e hoʻonui i ka platelet concentration ma ka centrifuging i ka nui o ke koko ponoʻī o ka mea maʻi.ʻO nā platelets i loko o kāna mau α Particles (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) he nui ka nui o nā mea ulu a me nā mea hoʻolaha, i hoʻopaʻa ʻia ma o ke kaʻina centrifugation e hoʻokuʻu i nā helu suprabiological o kēia mau mea ulu a me nā cytokines. i ka wahi iʻeha a hoʻonui i ka hana ho'ōla kūlohelohe.
ʻO ka helu platelet maʻamau he 150000 a hiki i ka 350000 / μ L. Ua hōʻike ʻia ka hoʻomaikaʻi ʻana i ka iwi a me ka hoʻōla ʻana o ka ʻiʻo palupalu, me nā platelet concentrated a hiki i 1000000 / μ L. Hōʻike i ka piʻi ʻana o ʻekolu a ʻelima mau mea ulu.Hoʻokaʻawale ʻia nā hoʻomākaukau PRP i ka PRP waiwai i nā keʻokeʻo keʻokeʻo (LR-PRP), i wehewehe ʻia ʻo ka neutrophil concentration ma luna aʻe o ka palena, a me ka PRP ʻilihune i loko o nā keʻokeʻo keʻokeʻo (LP-PRP), i wehewehe ʻia ʻo ke ʻano o ke koko keʻokeʻo (neutrophil) ma lalo o ka palena. .
Lapaʻau ʻana i nā ʻeha Tendon
ʻO ka hoʻohanaʻana i ka PRP no ka mālamaʻana i kaʻeha tendon a iʻole ka maʻi tendon i lilo i kumuhana o nā haʻawina he nui, a he nui nā cytokines i loaʻa i ka PRP e komo i nā ala hōʻailona e hiki mai ana i ka wā o ka ho'ōla o ka mumū, ka hoʻonuiʻana o ka cell, a me ka hoʻololi houʻana o nā kiko.Hiki i ka PRP ke hoʻoikaika i ke kūkulu ʻia ʻana o nā kīʻaha koko hou, hiki ke hoʻonui i ke koko a me ka meaʻai e pono ai no ka hoʻolaʻa hou ʻana o ke kelepona o nā ʻiʻo i hōʻino ʻia, a me ka lawe ʻana mai i nā pūnaewele hou a hoʻoneʻe i nā ʻōpala mai ka ʻiʻo i hōʻino ʻia.ʻO kēia mau hana o ka hana e pili pono ana i ka tendinosis maʻi, kahi i kūpono ʻole nā kūlana olaola i ka hoʻōla ʻana o ka ʻiʻo.Ua hoʻoholo ʻia kahi loiloi ʻōnaehana hou a me ka meta-analysis e hiki i ka injecting PRP ke mālama pono i ka symptomatic tendinosis.
Epicondylitis Lateral
Ua loiloi ʻia ʻo PRP ma ke ʻano he koho lapaʻau kūpono no nā poʻe maʻi me ka Epicondylitis lateral ʻaʻole kūpono i ka physiotherapy.Ma ka nui loa o ia noiʻi, ʻo Mishra et al.Ma kahi noiʻi Cohort, 230 nā mea maʻi i pane ʻole i ka mālama Conservative o lateral Epicondylitis no ka liʻiliʻi o 3 mau mahina i loiloi ʻia.Ua loaʻa i ka mea maʻi ka mālama LR-PRP, a ma nā wiki 24, ua pili ka LR-PRP injection me ka hoʻomaikaʻi nui ʻana i ka ʻeha i hoʻohālikelike ʻia i ka pūʻulu mana (71.5% vs 56.1%, P = 0.019), a me ka emi nui o ka pākēneka o nā mea maʻi e hōʻike ana i ke koena o ke kuʻekuʻe lima (29.1% vs 54.0%, P=0.009).Ma nā pule he 24, ua hōʻike ka poʻe maʻi i mālama ʻia me LR-PRP i nā hoʻomaikaʻi koʻikoʻi a me ka helu helu i hoʻohālikelike ʻia i nā injections mana ikaika o nā anesthetics kūloko.
Ua hōʻike ʻia nā haʻawina mua e hiki nō i ka LR-PRP ke hāʻawi i kahi hōʻoluʻolu lōʻihi no nā hōʻailona o ka Epicondylitis lateral i hoʻohālikelike ʻia me ka hoʻokele Corticosteroid, no laila ua loaʻa ka hopena therapeutic hoʻomau.ʻO ka PRP he ala kūpono no ka mālama ʻana i ka Epicondylitis waho.Hōʻike nā hōʻike kiʻekiʻe i ka maikaʻi no ka wā pōkole a me ka lōʻihi.ʻO nā hōʻike maikaʻi loa i loaʻa e hōʻike maopopo ana ʻo LR-PRP ke ʻano hana lapaʻau mua.
Patellar Tendinosis
Kākoʻo nā haʻawina i hoʻopaʻa ʻia i ka hoʻohana ʻana i ka LR-PRP no ka mālama ʻana i ka maʻi maʻi patellar tendon refractory.ʻO Draco et al.He iwakāluakūmākolu mau maʻi me ka patellar tendinosis i hāʻule i ka hoʻokele Conservative i loiloi ʻia.Ua hāʻawi ʻia nā poʻe maʻi e loaʻa i nā nila maloʻo i alakaʻi ʻia e ka ultrasound a i ʻole ka injection o LR-PRP, a ua ukali ʻia no nā pule he 26.Ma o ke ana VISA-P, ua hōʻike ka hui lapaʻau PRP i ka hoʻomaikaʻi nui ʻana i nā hōʻailona ma 12 wiki (P=0.02), akā ʻaʻole i koʻikoʻi ka ʻokoʻa ma> 26 wiki (P=0.66), e hōʻike ana i nā pono o PRP no ka maʻi tendon patellar. he hoʻomaikaʻi paha i nā hōʻailona mua.ʻO Vitrano et al.Ua hōʻike pū ʻia nā pōmaikaʻi o ka PRP injection i ka mālama ʻana i ka maʻi tendon patellar refractory maʻi i hoʻohālikelike ʻia me ka extracorporeal shock wave therapy (ECSWT).ʻOiai ʻaʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka wā o ka hahai ʻana o 2 mau mahina, ua hōʻike ka pūʻulu PRP i ka hoʻomaikaʻi nui ʻana i ka helu ma 6 a me 12 mau mahina o ka hahai ʻana, ʻoi aku ma mua o ECSWT e like me ke ana ʻana e VISA-P a me VAS, a me ke ana ʻana i ka Blazina. helu pālākiō ma 12 mahina o ka hahai ʻana (nā P<0.05 āpau).
Ke loiloi nei kēia loiloi i nā palapala lapaʻau o kēia manawa e pili ana i ka hoʻohana ʻana i ka platelet-rich plasma (PRP), me ka leukocyte rich PRP (LR PRP) a me ka leukocyte poor PRP (LP PRP), i mea e hoʻomohala ai i nā ʻōlelo hōʻike no nā maʻi musculoskeletal like ʻole.
ʻO ka loaʻa hou ʻana o kahi helu nui o nā hōʻike kiʻekiʻe e kākoʻo i ka hoʻohana ʻana i ka LR-PRP injection no ka mālama ʻana i ka Epicondylitis lateral a me LP-PRP no ka mālama ʻana i ka iwi Articular kuli.Kākoʻo nā hōʻike haʻahaʻa haʻahaʻa i ka hoʻohana ʻana i ka LR-PRP injection no ka patellar tendinosis a me ka PRP injection no Plantar fasciitis a me ka ʻeha o ka wahi hāʻawi i ka hoʻololi ʻana o ka tendon patellar BTB ACL reconstruction.ʻAʻole lawa nā hōʻike e ʻōlelo mau ai i ka PRP no ka rotator cuff tendinosis, hip Articular bone osteoarthritis a i ʻole nā wāwae wāwae kiʻekiʻe.Hōʻike nā hōʻike o kēia manawa ʻaʻole pono ka PRP i ka mālama ʻana i ka maʻi tendon Achilles, ka ʻeha ʻiʻo, ka haʻihaʻi a i ʻole ka hui ʻole o ka iwi, hoʻomaikaʻi ʻia ka hoʻoponopono ʻana i ka rotator cuff, ka hoʻoponopono ʻana i ka tendon Achilles, a me ka hana hou ʻana o ACL.
Hoʻolauna
ʻO Platelet Rich plasma (PRP) kahi hoʻomākaukau plasma kanaka autologous e hoʻonui i ka platelet concentration ma ka centrifuging i ka nui o ke koko ponoʻī o ka mea maʻi.ʻO nā platelets i loko o kāna mau α Particles (TGF- β 1. PDGF, bFGF, VEGF, EGF, IGF-1) he nui ka nui o nā mea ulu a me nā mea hoʻolaha, i hoʻopaʻa ʻia ma o ke kaʻina centrifugation e hoʻokuʻu i nā helu suprabiological o kēia mau mea ulu a me nā cytokines. i ka wahi iʻeha a hoʻonui i ka hana ho'ōla kūlohelohe.ʻO ka helu platelet maʻamau he 150000 a hiki i ka 350000 / μ L. Ua hōʻike ʻia ka hoʻomaikaʻi ʻana i ka iwi a me ka hoʻōla ʻana o ka ʻiʻo palupalu, me nā platelet concentrated a hiki i 1000000 / μ L. Hōʻike i ka piʻi ʻana o ʻekolu a ʻelima mau mea ulu.
Hoʻokaʻawale pinepine ʻia nā hoʻomākaukau PRP i nā hoʻomākaukau PRP waiwai i nā keʻokeʻo keʻokeʻo (LR-PRP), i wehewehe ʻia ʻo ka neutrophil ʻoi aku ma luna o ka palena, a me ka PRP hoʻomākaukau ʻilihune i nā keʻokeʻo keʻokeʻo (LP-PRP), i wehewehe ʻia ʻo ke koko keʻokeʻo (neutrophil). ma lalo o ka papa kuhikuhi.
Ka Hoʻomākaukau a me ka Hoʻohui
ʻAʻohe manaʻo manaʻo nui e pili ana i ka hoʻokumu ʻana o ka PRP maikaʻi loa no ka neʻe ʻana o ke koko, a i kēia manawa he nui nā ʻōnaehana PRP pāʻoihana ma ka mākeke.No laila, e like me nā ʻōnaehana pāʻoihana like ʻole, aia nā ʻokoʻa i nā protocols hōʻiliʻili PRP a me nā hiʻohiʻona hoʻomākaukau, e hāʻawi ana i kēlā me kēia ʻōnaehana PRP i nā ʻano ʻokoʻa.ʻOkoʻa nā ʻōnaehana kalepa i ka pono hopu platelet, ke ʻano kaʻawale (hoʻokahi a i ʻole ʻelua ʻanuʻu centrifugation), ka wikiwiki centrifugation, a me ke ʻano o ka ʻōnaehana ohi a me ka hana.ʻO ka mea maʻamau, ma mua o ka centrifugation, e hōʻiliʻili ʻia ke koko holoʻokoʻa a hui pū ʻia me nā mea anticoagulant e hoʻokaʻawale i ke koko ʻulaʻula (RBCs) mai ka platelet-poor plasma (PPP) a me ka "erythrocyte sedimentation brown layer" i loaʻa nā platelet concentrated a me nā keʻokeʻo keʻokeʻo.Hoʻohana ʻia nā ʻano hana like ʻole e hoʻokaʻawale i nā platelets, hiki ke hoʻokomo pololei ʻia i loko o ke kino o ka mea maʻi a i ʻole "hoʻoulu ʻia" ma ka hoʻohui ʻana i ka calcium chloride a i ʻole thrombin, e alakaʻi ana i ka platelet degranulation a me ka hoʻokuʻu ʻana i nā kumu ulu.ʻElua mau mea maʻi maʻi, e like me ka hoʻoponopono lāʻau a me nā ʻōnaehana hoʻomākaukau ʻana i nā ʻōnaehana kalepa, e hoʻopili i ke ʻano kikoʻī o ka PRP, a me kēia hoʻololi ʻana i ka hoʻohui ʻana o nā formulations PRP i ka wehewehe ʻana i ka pono lapaʻau o PRP.
ʻO kā mākou ʻike i kēia manawa ʻo ka PRP me ka hoʻonui ʻana i ke koko keʻokeʻo keʻokeʻo, ʻo ia hoʻi ʻo PRP waiwai i nā keʻokeʻo keʻokeʻo (neutrophils), pili me nā hopena pro-inflammatory.ʻO ka piʻi nui ʻana o ke koko keʻokeʻo (neutrophils) ma LR-PRP pili pū me ka piʻi ʻana o nā cytokines catabolic, e like me interleukin-1 β, Tumor Necrosis Factor α A me metalloproteinases, hiki ke hoʻohālikelike i nā cytokines anabolic i loko o nā platelets.ʻO nā hopena lapaʻau a me nā hopena cellular o kēia mau ʻano PRP like ʻole, me ka ʻike o ke koko keʻokeʻo keʻokeʻo, ke wehewehe ʻia nei.Ke manaʻo nei kēia loiloi e loiloi i nā hōʻike maikaʻi loa i loaʻa no nā hōʻailona lapaʻau like ʻole o nā ʻano PRP like ʻole.
ʻO ka maʻi achles tendon
ʻAʻole i hōʻike ʻia kekahi mau hoʻokolohua mōʻaukala i nā ʻokoʻa o nā hopena lapaʻau ma waena o PRP a me placebo wale nō i ka mālama ʻana i ka Achilles tendinitis.Ua hoʻohālikelike ʻia kahi hoʻāʻo hoʻokele Randomized hou i kahi pūʻulu o ʻehā LP-PRP injection me kahi placebo injection i hui pū ʻia me kahi papahana hoʻoponopono hoʻihoʻi centrifugal.Ke hoʻohālikelike ʻia me ka hui placebo, ua hōʻike ka pūʻulu lapaʻau PRP i nā hoʻomaikaʻi koʻikoʻi i ka ʻeha, ka hana, a me nā helu hana i nā manawa āpau i ka manawa o ka 6 mau mahina.Ua ʻike pū ʻia ka haʻawina he hoʻokahi hoʻokahi injection volume nui (50 mL) o 0.5% Bupivacaine (10 mL), methylprednisolone (20 mg) a me physiological saline (40 mL) i like me ka hoʻomaikaʻi ʻana, akā i ka wā e noʻonoʻo ai i kēia lāʻau, pono e mālama ʻia. ʻike i ka piʻi nui ʻana o ka haki ʻana o ka tendon ma hope o ka hoʻokele steroid.
Rotator Cuff Tendinosis
He liʻiliʻi nā haʻawina kiʻekiʻe e pili ana i ka PRP injection i ka mālama ʻole ʻana i ka maʻi o ka rotator cuff tendon.Ua hoʻohālikelike kekahi mau haʻawina i paʻi ʻia i nā hopena lapaʻau o ka subacromial injection o PRP me kahi placebo a me Corticosteroid, a ʻaʻohe haʻawina i loiloi i ka hoʻokomo pololei ʻana o PRP i loko o ka tendon ponoʻī.ʻO Casey Buren et al.Ua ʻike ʻia ʻaʻohe ʻokoʻa o nā helu hopena lapaʻau i hoʻohālikelike ʻia me ka hoʻokomo ʻana i ka saline physiological ma lalo o ka piko poʻohiwi.Eia nō naʻe, ua ʻike ʻia kahi hoʻāʻo hoʻokele Randomized ʻelua mau inikini o LR-PRP i kēlā me kēia pule ʻehā i hoʻomaikaʻi i ka ʻeha i hoʻohālikelike ʻia me nā injections placebo.ʻO Shams et al.Ua hōʻike ʻia ka hoʻomaikaʻi hoʻohālikelike ʻana o ka subacromial PRP a me Corticosteroid injection ma waena o Xiʻan Ontario RC index (WORI), poʻohiwi hōʻeha disability index (SPDI) a me VAS ʻeha poʻohiwi a me ka hōʻike ʻo Neer.
I kēia manawa, ua hōʻike ʻia ka noiʻi ʻana i ka hoʻokomo ʻana i ka PRP ma lalo o ka piko poʻohiwi he hoʻomaikaʻi nui i nā hopena i hōʻike ʻia o nā maʻi me ka maʻi rotator cuff tendon.ʻO nā haʻawina ʻē aʻe e koi ana i ka hahai lōʻihi, me ka loiloi ʻana i ka hoʻokomo pololei ʻana o PRP i loko o nā tendon.Ua hōʻike ʻia kēia mau inikini PRP he palekana a he mea ʻē aʻe paha ia i nā injections Corticosteroid i ka rotator cuff tendinosis.
Plantar Fasciitis
Ua loiloi ʻia kekahi mau hoʻokolohua hoʻāʻo ʻia ʻo PRP no ka maʻi Plantar fasciitis.ʻO ka hiki o ka PRP ma ke ʻano he lāʻau inikini kūloko e hoʻopau i nā hopohopo e pili ana i ka injection o Corticosteroid, e like me ka atrophy o nā pad fashion a i ʻole ka haki ʻana o ka fascia plantar.ʻElua mau meta-analyses hou i loiloi i ka hoʻohālikelike ma waena o PRP injection a me Corticosteroid injection, a ua hoʻoholo ʻo PRP injection he mea hiki ke hoʻololi i ka injection Corticosteroid ma ke ʻano o ka pono.Ua hōʻike kekahi mau haʻawina i ka maikaʻi o PRP.
ʻO ka ʻokiʻoki i hui pū ʻia me PRP
Hoʻoponopono lima poʻohiwi
Ua loiloi kekahi mau noiʻi lapaʻau kiʻekiʻe i ka hoʻohana ʻana i nā huahana PRP i ka hoʻoponopono Arthroscopy o nā waimaka rotator cuff.Nui nā haʻawina i aʻo pono i ka hoʻohana ʻana i ka platelet rich fibrin matrix preparations for enhancement (PRFM), aʻo nā haʻawina ʻē aʻe i hoʻokomo pololei i ka PRP i loko o ke kahua hoʻoponopono.Loaʻa ka heterogeneity nui i ka PRP a i ʻole PRFM formulations.Ua loaʻa nā hopena pili i nā mea maʻi, e like me ke Kulanui o Kaleponi, Los Angeles (UCLA), American Shoulder and Elbow Association (ASES), Constant Shoulder Score, Simple Shoulder Test (SST) score, a me ka helu ʻeha VAS, a me ka maʻi maʻi. Ua hōʻiliʻili ʻia nā ʻikepili e like me ka rotator cuff strength a me ka poʻohiwi ROM e ana i nā ʻokoʻa o nā hopena hana.Ua hōʻike ka hapa nui o nā haʻawina hoʻokahi i ka ʻokoʻa liʻiliʻi o nā ana no kēia mau hopena i ka PRP i hoʻohālikelike ʻia me ka hoʻoponopono hoʻokahi [e like me nā pads no ka Arthroscopy rotator cuff repair.Eia kekahi, ua hōʻike ka meta-analysis nui a me ka loiloi koʻikoʻi hou i ka hoʻoponopono ʻana o Arthroscopy o ka puʻupuʻu poʻohiwi [PRP] ʻaʻohe pōmaikaʻi nui i ka hoʻonui ʻana i ka umauma.Eia naʻe, hōʻike ka ʻikepili liʻiliʻi he hopena ia i ka hōʻemi ʻana i ka ʻeha perioperative, ʻo ia paha ma muli o nā waiwai anti-inflammatory o PRP.
Ua hōʻike ʻia ka hōʻike ʻana o ka subgroup i ka waimaka waena a me nā waimaka liʻiliʻi i mālama ʻia me ka Arthroscopy hoʻoponopono lālani pālua, hiki ke hoʻoemi ʻia ka PRP i ka nui o ka haehae hou ʻana, no laila e loaʻa ai nā hopena maikaʻi aʻe.Qiao et al.Ua ʻike ʻia he pōmaikaʻi ka PRP i ka hōʻemi ʻana i ka nui o ka uhae hou ʻana o nā waimaka rotator cuff haʻahaʻa a nui hoʻi i hoʻohālikelike ʻia me ka ʻoki wale ʻana.
Hōʻike ʻia nā hoʻokolohua lapaʻau like ʻole a me ka meta-analysis nui i ka nele o ka hōʻike no ka hoʻohana ʻana i ka PRP a me PRFM i mea hoʻoikaika no ka hoʻoponopono ʻana i ka rotator cuff.Manaʻo kekahi mau loiloi pūʻulu e loaʻa i ka hoʻoponopono lālani pālua kekahi mau pōmaikaʻi no ka mālama ʻana i nā waimaka liʻiliʻi.Hiki i ka PRP ke kōkua i ka hoʻopau koke ʻana i ka ʻeha postoperative.
Hoʻoponopono ʻana i ka ʻāʻī ʻo Achilles
Ua hōʻike ʻia nā haʻawina preclinical he hopena hoʻohiki ka PRP i ka hoʻolaʻa ʻana i ka haki ʻana o ka tendon Achilles.Eia nō naʻe, ke kāohi nei nā hōʻike kū'ē i ka hoʻololi ʻana o ka PRP ma ke ʻano he adjuvant therapy no ka haki ʻana o ka tendon Achilles i ke kanaka.No ka laʻana, i loko o hoʻokahi haʻawina, ua like nā hopena hoʻolālā a me nā hana o nā poʻe maʻi me Achilles tendon rupture i mālama ʻia me ka PRP ʻole.ʻO ka hoʻohālikelike, Zou et al.I loko o kahi haʻawina i hoʻopaʻa ʻia i koho ʻia, ua kiʻi ʻia nā maʻi 36 i hana i ka hoʻoponopono ʻana i ka ʻāʻī ʻana o Achilles tendon me ka ʻole o ka injection intraoperative o LR-PRP.ʻO nā maʻi ma ka hui PRP iʻoi aku ka maikaʻi o nāʻiʻo isokinetic i nā mahina 3, a uaʻoi aku ka kiʻekiʻe o SF-36 a me nā helu Leppilahti ma 6 a me 12 mau mahina, i kēlā me kēia (P<0.05 a pau).Eia kekahi, ua hoʻomaikaʻi maikaʻi ʻia ka hui kuʻekuʻe wāwae o ka hui PRP i nā manawa āpau ma 6, 12, a me 24 mahina (P<0.001).ʻOiai ʻoi aku ka nui o nā hoʻokolohua lapaʻau kiʻekiʻe e pono ai, ʻo ka hoʻokomo ʻana i ka PRP ma ke ʻano he hoʻomaikaʻi ʻana no ka hoʻoponopono ʻana i ka tendon Achilles acute ʻaʻole ia he pono.
ʻO ka ʻoki ʻana i ka ligament cruciate mua
ʻAʻole pili ka kūleʻa o ka ʻoki ʻana i ka ligament cruciate mua (ACL) i nā mea ʻenehana wale nō (e like me ka hoʻokomo ʻana i ka tunnel graft a me ka hoʻoponopono ʻana), akā ma ka hoʻōla ola ʻana o nā grafts ACL.ʻO ka noiʻi e pili ana i ka hoʻohana ʻana i ka PRP i ke kaʻina hana hou ʻana o ACL e pili ana i ʻekolu mau kaʻina olaola: (1) ka hoʻohui ʻana o nā ligaments iwi ma waena o ka grafft a me ka tibial a me ka femoral tunnels, (2) ka maturation o ka ʻāpana hui o ka graft, a ( 3) ka ho'ōla a me ka hōʻemi ʻana i ka ʻeha ma ke kahua ʻohi.
ʻOiai ua nānā nui nā haʻawina i ka hoʻohana ʻana i ka PRP injection i ke kaʻina ACL i nā makahiki ʻelima i hala iho nei, ʻelua wale nō mau haʻawina kiʻekiʻe.Ua hōʻike ʻia nā haʻawina mua e kākoʻo ana nā hōʻike hui i ka hoʻohui ʻana o ka transplant a i ʻole graft Osteoligamous cell me ka hoʻohana ʻana i ka PRP injection, akā ua hōʻike ʻia kekahi mau hōʻike e kākoʻo i ka ʻeha ma ka pūnaewele hāʻawi.E pili ana i ka hoʻohana ʻana i ka hoʻonui PRP no ka hoʻomaikaʻi ʻana i ka hoʻopaʻa ʻana o nā iwi iwi, hōʻike nā ʻikepili hou ʻaʻohe pono lapaʻau ʻo PRP i ka hoʻonui ʻana i ka tunnel a i ʻole ka hoʻohui ʻana i nā iwi o nā grafts.
Ua hōʻike ʻia nā hoʻokolohua lapaʻau hou i nā hopena mua i ka ʻeha a me ka ho'ōla ʻana o ka pūnaewele hāʻawi me ka PRP.Sajas et al.Ke nānā nei i ka ʻeha o ke kuli mua ma hope o ka hana hou ʻana o ka iwi patella iwi (BTB) autologous ACL, ua ʻike ʻia ua hoʻohālikelike ʻia me ka pūʻulu mana, ua hoʻemi ʻia ka ʻeha o ke kuli mua i ka wā o 2 mau mahina.
Pono ka noiʻi hou aʻe no ka noiʻi ʻana i nā hopena o ka PRP ma ka hoʻohui ʻana o ACL graft, maturation, a me ka ʻeha pūnaewele hāʻawi.Eia nō naʻe, i kēia manawa, ua hōʻike nā haʻawina ʻaʻohe hopena koʻikoʻi koʻikoʻi o ka PRP i ka hoʻohui ʻana a i ʻole ka maturation, akā ua hōʻike nā haʻawina liʻiliʻi i nā hopena maikaʻi i ka hōʻemi ʻana i ka ʻeha ma ka wahi hāʻawi o ka tendon patellar.
Osteoarthritis
ʻOi aku ka makemake o ka poʻe i ka pono o ka PRP intra-articular injection i ka non-surgical treatment of knee Articular bone osteoarthritis.Shen et al.Ua alakaʻi ʻia kahi meta-analysis o 14 randomized clinical trials (RCTs) me 1423 maʻi e hoʻohālikelike i ka PRP me nā mana like ʻole (me kahi placebo, hyaluronic acid, corticosteroid injection, lāʻau lapaʻau waha a me ka mālama ʻana i ka Homeopathy).Ua hōʻike ʻia ka meta analysis i ka wā o ka hahai ʻana o 3, 6 a me 12 mau mahina, ʻoi aku ka maikaʻi o ka helu o ka Osteoarthritis index (WOMAC) o ke Kulanui o Western Ontario a me ke Kulanui ʻo McMaster (= 0.02, 0.04, <0.001, kēlā me kēia).Ua hōʻike ʻia kahi loiloi subgroup o ka PRP efficacy ma muli o ke koʻikoʻi o ka osteoarthritis kuli i ʻoi aku ka maikaʻi o ka PRP i nā maʻi me ka OA haʻahaʻa a haʻahaʻa.Manaʻo ka mea kākau ma ke ʻano o ka hōʻoluʻolu ʻeha a me nā hopena i hōʻike ʻia e ka mea maʻi, ʻoi aku ka maikaʻi o ka hoʻokele PRP intra articular ma mua o nā injections ʻē aʻe i ka mālama ʻana i ka osteoarthritis kuli.
Riboh et al.Ua hana ʻia kahi meta-analysis e hoʻohālikelike i ke kuleana o LP-PRP a me LR-PRP i ka mālama ʻana i ka Osteoarthritis o ke kuli, a ʻike i ka hoʻohālikelike ʻia me HA a i ʻole placebo, hiki i ka LP-PRP injection ke hoʻomaikaʻi nui i ka helu WOMAC.ʻO Ferrado et al.ua aʻo i ka LR-PRP injection, a i ʻole ʻike ʻia ʻaʻohe ʻokoʻa helu helu i hoʻohālikelike ʻia me ka injection HA, e hōʻoia hou ana ʻo LP-PRP paha ke koho mua no ka mālama ʻana i nā hōʻailona Osteoarthritis.Aia paha kona kumu olaola i nā pae pili o ka mumū a me nā mediators anti-inflammatory i loaʻa ma LR-PRP a me LP-PRP.Ma ke alo o LR-PRP, ua hoʻonui nui ʻia ka mea hoʻolaha inflammatory TNF-α, IL-6, IFN- ϒ A me IL-1 β, ʻoiai ʻo ka hoʻokomo ʻana o LP-PRP e hoʻonui i ka IL-4 a me IL-10, he mau anti-inflammatory. mea uwao.Ua ʻike ʻia he kōkua nui ka IL-10 i ka mālama ʻana i ka osteoarthritis hip, a hiki nō hoʻi ke kāohi i ka mediator inflammatory TNF-α, IL-6 a me IL-1 β Hoʻokuʻu a pale i ke ala ʻeha ma ka hoʻokaʻawale ʻana i ka hana nuclear factor kB.Ma waho aʻe o kona mau hopena ʻino i nā chondrocytes, ʻaʻole hiki i ka LR-PRP ke kōkua i ka mālama ʻana i nā hōʻailona Osteoarthritis ma muli o kona hopena i nā pūnaewele synovial.ʻO Braun et al.Ua ʻike ʻia ʻo ka mālama ʻana i nā cell synovial me LR-PRP a i ʻole nā ʻulaʻula ʻulaʻula hiki ke alakaʻi i ka hana mediator pro-inflammatory nui a me ka make cell.
He ʻano lapaʻau palekana ʻo Intra articular injection o LP-PRP, a aia nā hōʻike Level 1 e hiki ke hōʻemi i nā hōʻailona ʻeha a hoʻonui i ka hana o nā mea maʻi i loaʻa i ke kuli Articular bone osteoarthritis.Pono nā haʻawina ʻoi aku ka nui a me ka lōʻihi o ka hahai ʻana no ka hoʻoholo ʻana i kona pono no ka wā lōʻihi.
ʻO ka maʻi ʻeha o ka ʻūhā
ʻEhā wale nō nā hoʻokolohua lapaʻau i hoʻohālikelike ʻia i ka PRP injection a me ka hyaluronic acid (HA) injection no ka mālama ʻana i ka osteoarthritis hip.ʻO nā hōʻailona hopena he helu ʻeha VAS, WOMAC score, a me Harris hip joint score (HHS).
Batalya et al.loaʻa nā hoʻomaikaʻi nui i nā helu VAS a me HHS ma 1, 3, 6, a me 12 mahina.Loaʻa ka hoʻomaikaʻi kiʻekiʻe ma 3 mau mahina, a ua nāwaliwali ka hopena ma hope [72].Ua hoʻomaikaʻi maikaʻi ʻia ka helu ma nā mahina 12 i ka hoʻohālikelike ʻana i ka helu kumu (P<0.0005);Eia naʻe, ʻaʻohe ʻokoʻa koʻikoʻi i ka helu ʻana i nā hopena ma waena o nā pūʻulu PRP a me HA.
ʻO Di Sante et al.ʻike i ka maikaʻi o ka helu VAS o ka pūʻulu PRP i nā wiki 4, akā ua hoʻihoʻi hou i ka baseline ma 16 mau pule.ʻAʻohe ʻokoʻa koʻikoʻi ma nā helu VAS ma waena o ka hui HA ma nā wiki 4, akā aia kahi hoʻomaikaʻi nui i nā wiki 16.Dalari et al.Ua loiloi mākou i ka hopena o ka PRP ma ka haʻi ʻana o HA, akā ua hoʻohālikelike ʻia ka hui pū ʻana o HA a me PRP injection no nā hihia ʻelua.Ua ʻike ʻia ka pūʻulu PRP i ka loaʻa ʻana o ka helu VAS haʻahaʻa loa ma waena o nā pūʻulu ʻekolu i nā helu manawa hahai (2 mahina, 6 mahina, a me 12 mahina).Ua ʻoi aku ka maikaʻi o nā helu WOMAC ma ka PRP ma 2 a me 6 mahina, akā ʻaʻole ma 12 mahina.ʻO Doria et al.Ua mālama ʻia kahi hoʻokolohua lapaʻau pālua-makapō e hoʻohālikelike i nā poʻe maʻi i loaʻa i ʻekolu mau hoʻopaʻa ʻana i kēlā me kēia pule o ka PRP a me ʻekolu mau injections o HA.Ua loaʻa i kēia haʻawina ka hoʻomaikaʻi ʻana i nā helu HHS, WOMAC, a me VAS ma nā pūʻulu HA a me PRP ma ka hahai ʻana o 6 a me 12 mahina.Eia naʻe, i nā manawa a pau, ʻaʻohe ʻokoʻa koʻikoʻi ma waena o nā hui ʻelua.ʻAʻohe noiʻi i hōʻike ʻia he hopena ʻino ka intra-articular injection o PRP i loko o ka ʻūhā, a ua manaʻo nā mea a pau he palekana ka PRP.
ʻOiai ua kaupalena ʻia ka ʻikepili, intra-articular injection o PRP i ka mālama ʻana i ka hip Articular iwi osteoarthritis ua hōʻoia ʻia he palekana, a ua loaʻa kekahi efficacy i ka hōʻemi ʻana i ka ʻeha a me ka hoʻomaikaʻi ʻana i ka hana, e like me ke ana ʻana i nā helu hopena i hōʻike ʻia e nā maʻi.Ua hōʻike nā haʻawina he nui e hiki i ka PRP ke hoʻohaʻahaʻa mua i ka ʻeha ma mua o HA;Eia nō naʻe, ʻoiai he like like ka PRP a me HA i nā mahina 12, ʻike ʻia ka nāwaliwali o ka pono mua i ka manawa.Ma muli o ka loiloi ʻana o kekahi mau noiʻi lapaʻau i ka hoʻohana ʻana o PRP i ka hip OA, pono nā hōʻike kiʻekiʻe kiʻekiʻe e hoʻoholo ai inā hiki ke hoʻohana ʻia ka PRP ma ke ʻano he ʻokoʻa i ka hoʻokele Conservative e hoʻopaneʻe i ka hana o ka osteoarthritis iwi āpau.
Kuʻekuʻe wāwae
ʻElua wale nō hoʻokolohua lapaʻau randomized i hoʻokō i kā mākou mau pae hoʻohui i loiloi i ka hoʻohana ʻana o PRP i ka wāwae kuʻekuʻe wāwae.ʻO Roden et al.Ua mālama ʻia kahi hoʻāʻo hoʻāʻo hoʻāʻo ʻokoʻa ʻelua makapō placebo ma luna o nā poʻe maʻi me nā kuʻekuʻe wāwae ma ED, e hoʻohālikelike ana i ka hoʻokele ultrasound alakaʻi ʻia o ka LR-PRP anesthetic kūloko me ka saline a me ka hoʻokele anesthetic kūloko.ʻAʻole lākou i ʻike i ka ʻokoʻa koʻikoʻi ma ka helu ʻeha VAS a i ʻole ka pālākiō hana limb haʻahaʻa (LEFS) ma waena o nā hui ʻelua.
Laval et al.koho 'ia 'o 16 elite 'âlapa 'ike me ke kiʻekiʻe kuʻekuʻe wāwae sprains e loaʻa ultrasound-alakaʻi LP-PRP injection lapaʻau ma ka mua lapaʻau kahua, a me ka hou injections o ka hui hoʻoponopono hoʻolālā a okoa hoʻolaʻa papahana 7 lā ma hope.Ua loaʻa i nā maʻi a pau ka protocol lapaʻau hoʻoponopono like a me nā pae hoʻihoʻi.Ua ʻike ka haʻawina ua hoʻomaka hou ka hui LP-PRP i ka hoʻokūkū ma kahi manawa pōkole (40.8 mau lā vs. 59.6 lā, P<0.006).
Me he mea lā ʻaʻole pono ka PRP no ka maʻi kuʻekuʻe wāwae.ʻOiai ua hōʻike ʻia nā hōʻike liʻiliʻi e pili ana ka LP-PRP injection i ka kuʻekuʻe wāwae kiʻekiʻe o nā mea haʻuki elite.
ʻEha ʻiʻo
ʻO ka hoʻohana ʻana i ka PRP no ka mālama ʻana i ka ʻeha o ka ʻiʻo ua hōʻike ʻia nā hōʻike lapaʻau ambiguous.E like me ka ho'ōla ʻana o ka tendon, ʻo nā ʻanuʻu o ka hoʻōla ʻana i ka ʻiʻo e komo i ka pane inflammatory mua, a ukali ʻia e ka hoʻonui ʻana o ka cell, ka ʻokoʻa, a me ka hoʻoponopono hou ʻana o ka ʻiʻo.Hamid et al.Ua mālama ʻia kahi noiʻi makapō hoʻokahi ma luna o nā maʻi 28 me ka ʻeha hamstring grade 2, e hoʻohālikelike ana i ka injection o LR-PRP me nā hoʻolālā hoʻoponopono a me ka hoʻoponopono wale ʻana.ʻO ka hui i loaʻa i ka lāʻau LR-PRP ua hiki ke hoʻōla wikiwiki mai ka hoʻokūkū (ka manawa maʻamau i nā lā, 26.7 vs. 42.5, P = 0.02), akā ʻaʻole i hoʻokō i ka hoʻomaikaʻi ʻana i ka hoʻolālā.Eia hou, hiki i nā hopena placebo koʻikoʻi i ka hui lapaʻau ke hoʻohālikelike i kēia mau hopena.I loko o kahi ho'āʻo hoʻokolokolo ʻelua makapō Randomized, Reurink et al.Ua loiloi mākou i nā maʻi he 80 a ua hoʻohālikelike mākou i ka hoʻoheheʻe PRP me ka paʻakai placebo.Ua loaʻa i nā maʻi a pau ka lāʻau hoʻoponopono maʻamau.Ua ukali ʻia ka mea maʻi no 6 mau mahina a ʻaʻohe ʻokoʻa koʻikoʻi ma ke ʻano o ka manawa hoʻihoʻi a i ʻole ka helu hōʻeha.ʻO ke kumu PRP maikaʻi loa no ka hoʻomaikaʻi ʻana i ka hoʻōla ʻana i ka ʻiʻo ma nā ʻano pili pili i ka lāʻau lapaʻau he paʻakikī a pono e mālama ʻia ka noiʻi e hiki mai ana.
Ka hooponopono ana i na haki a me ka hui ole
ʻOiai aia nā hōʻike mua kūpono e kākoʻo i ka hoʻohana ʻana i ka PRP no ka hoʻomaikaʻi ʻana i ka hoʻōla iwi, ʻaʻohe manaʻo hoʻomaʻamaʻa e kākoʻo i ka hoʻohana maʻamau o PRP e hāpai i ka hoʻōla iwi.ʻO kahi loiloi hou e pili ana i ka PRP a me ka hoʻomaʻamaʻa haʻihaʻi koʻikoʻi i hōʻike i ʻekolu RCT i hōʻike ʻole i nā pōmaikaʻi e pili ana i nā hopena hana, ʻoiai ʻelua mau haʻawina i hōʻike i nā hopena lapaʻau kiʻekiʻe.ʻO ka hapa nui o nā hoʻāʻo ma kēia loiloi (6/8) i aʻo i ka pono o ka PRP i hui pū ʻia me nā mea ola ola ʻē aʻe (e like me nā mesenchymal stem cell a/a i ʻole nā iwi grafts) e hoʻoikaika i ka hoʻōla ʻana.
ʻO ke kumu hana o ka platelet-rich plasma (PRP) ʻo ia ka hāʻawi ʻana i nā mea ulu a me nā cytokines i loko o nā platelets me ka nui o ka physiological nui.I loko o ka lāʻau musculoskeletal, ʻo PRP kahi ala lapaʻau maikaʻi me nā hōʻike palekana palekana.Eia nō naʻe, ua hui pū ʻia nā hōʻike o kona pono a hilinaʻi nui ʻia i nā mea hana a me nā hōʻailona kikoʻī.ʻO nā hoʻokolohua lapaʻau kiʻekiʻe a nui aʻe i ka wā e hiki mai ana he mea koʻikoʻi no ka hana ʻana i kā mākou hiʻohiʻona ma PRP.
（Paʻi hou ʻia nā mea o kēia ʻatikala, ʻaʻole mākou e hāʻawi i ka hōʻoiaʻiʻo a i ʻole ka hōʻoia ʻana no ka pololei, hilinaʻi a i ʻole ka piha o nā mea i loko o kēia ʻatikala, a ʻaʻole kuleana no nā manaʻo o kēia ʻatikala, e ʻoluʻolu e hoʻomaopopo.)
Ka manawa hoʻouna: Iulai-24-2023