2016/4最新研究證明葡萄糖增生療法可以幫助膝蓋「生軟骨」 @ 博昌復健 ― 增生療法與運動傷害治療中心 Bo Chung Prolotherapy and Rehabilitation Clinic

proloknee

美國復健醫學會期刊 American Academy of Physical Medicine and Rehabilitation

2016/4最新研究證明葡萄糖增生療法可以幫助膝蓋「生軟骨」！

6位膝蓋退化性關節炎，最嚴重者第四期患者，施打葡萄糖增生療法，經切片組織學證實，有軟骨增生（chondrogenic）的效果！

Topol-180x180 本篇論文研究者 Topol GA

The Chondrogenic Effect of Intra-articular Hypertonic-dextrose (prolotherapy) in Severe Knee Osteoarthritis.

Topol GA, et al. PM R. 2016.

Abstract

BACKGROUND: Dextrose injection is reported to improve KOA-related clinical outcomes, but its effect on articular cartilage is unknown. A chondrogenic effect of dextrose injection has been proposed.

OBJECTIVE: To assess biological and clinical effects of intra-articular hypertonic dextrose injections (prolotherapy) in painful knee osteoarthritis (KOA).

DESIGN: Case series with blinded arthroscopic evaluation before and after treatment.

SETTING: Physical medicine and day surgery practice.

PARTICIPANTS: Symptomatic KOA for at least 6 months, arthroscopy-confirmed medial compartment exposed subchondral bone, and temporary pain relief with intra-articular lidocaine injection.

INTERVENTION: Four to six monthly 10 mL intra-articular injections with 12.5% dextrose.

MAIN OUTCOME MEASURES: Visual cartilage growth assessment of 9 standardized medial condyle zones in each of 6 participants by three arthroscopy readers masked to pre/post injection status (total 54 zones evaluated per reader); biopsy of a cartilage growth-area post-treatment, evaluated using H&E and Safranin-O stains, quantitative polarized light microscopy, and immunohistologic cartilage typing; self-reported knee specific quality of life using the Western Ontario McMaster University Osteoarthritis Index (WOMAC, 0-100 points).

RESULTS: Six participants (1 female) with median age of 71, WOMAC composite score of 57.5 points and a 9-year pain duration received a median 6 dextrose injections and follow-up arthroscopy at 7.75 (4.5-9.5) months. In 19 of 54 zone comparisons all three readers agreed that the post-treatment zone showed cartilage growth compared with the pre-treatment zone. Biopsy specimens showed metabolically active cartilage with variable cellular organization, fiber parallelism, and cartilage typing patterns consistent with fibro- and hyaline-like cartilage. Compared with baseline status, the median WOMAC score improved 13 points (p=.013). Self-limited soreness after methylene-blue instillation was noted.

CONCLUSIONS: Positive clinical and chondrogenic effects were seen after prolotherapy with hypertonic dextrose injection in symptomatic grade IV KOA participants suggesting disease-modifying effects and the need for confirmation in controlled studies. Minimally invasive arthroscopy (single-compartment, single-portal) enabled collection of robust intra-articular data.

http://www.ncbi.nlm.nih.gov/m/pubmed/27058744/#fft

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