Ácido Hialuronico vs Plasma Rico en Plaquetas en el manejo inicial de la Artrosis de Rodilla
DOI:
https://doi.org/10.55204/scc.v2i2.e37Palabras clave:
Ácido Hialurónico, Artrosis de Rodilla, Dolor Agudo, Inyecciones Intraarticulares, Plasma Rico en PlaquetasResumen
Introducción: la artrosis de rodilla, una enfermedad degenerativa crónica, es un problema de salud global que afecta a una población en diversas regiones del mundo, esta afección se manifiesta a través de síntomas como dolor, rigidez y una notable disminución de la movilidad articular.
Objetivo: Establecer la eficacia del Ácido hialurónico vs plasma rico en plaquetas en tratamiento de artrosis de rodilla.
Desarrollo: los estudios revisados indican que el plasma rico en plaquetas (PRP) supera al ácido hialurónico (HA) en el tratamiento de la artrosis de rodilla, ofreciendo un mayor alivio del dolor y mejorando significativamente la función y calidad de vida de los pacientes. Esta superioridad se mantiene en diferentes mediciones y a lo largo del tiempo.
Conclusiones: la revisión de estudios respalda el uso preferente del PRP en el tratamiento de la artrosis de rodilla debido a su eficacia superior en comparación con el HA. Ambos tratamientos tienen perfiles de seguridad similares, con eventos adversos principalmente leves o moderados. Estas conclusiones proporcionan una base sólida para la toma de decisiones clínicas en esta área médica.
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Fernández-Cuadros M, Pérez-Moro O, Albaladejo-Florín M, Álava-Rabasa S, López Muñoz M, Rodríguez de Cía J. Un nuevo paradigma para el tratamiento de la osteoartritis de rodilla: el papel del ácido hialurónico, el plasma rico en plaquetas (PRP) y el ozono en la modulación de la inflamación: una revisión. Rev la Soc Española del Dolor [Internet]. 2021;28(5):282–91. Available from: https://scielo.isciii.es/scielo.php?pid=S1134-80462021000600007&script=sci_arttext
Lamo J. Comparación de la inyección intraarticular de plasma rico en plaquetas (PRGF®) y ácido hialurónico (Hyalone®) en el tratamiento de las lesiones condrales: estudio clínico prospectivo aleatorizado. Rev Esp Artrosc Cir Articul [Internet]. 2021;28(1):3–9. Available from: https://fondoscience.com/sites/default/files/articles/pdf/reaca.28171.fs1909040-comparacion-inyeccion-intraarticular-plasma-rico-plaquetas.pdf
Gilat R, Haunschild E, Knapik D, Evuarherhe A, Parvaresh K, Cole B. Hyaluronic acid and platelet-rich plasma for the management of knee osteoarthritis. Int Orthop [Internet]. 2021;45:345–54. Available from: https://link.springer.com/article/10.1007/s00264-020-04801-9
Xu Z, He Z, Shu L, Li X, Ma M, Ye C. Intra-articular platelet-rich plasma combined with hyaluronic acid injection for knee osteoarthritis is superior to platelet-rich plasma or hyaluronic acid alone in inhibiting inflammation and improving pain and function. Arthrosc J Arthrosc Relat Surg [Internet]. 2021;37(3):903–15. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0749806320308434
Ling A, Jie J, Tao X, Rahmatullah H. Comparing the efficacy of dual platelet-rich plasma (PRP) and hyaluronic acid (HA) therapy with PRP-alone therapy in the treatment of knee osteoarthritis: a systematic review and meta-analysis. J Exp Orthop [Internet]. 2021;8:1–15. Available from: https://link.springer.com/article/10.1186/s40634-021-00415-1
Stagni C, Rocchi M, Mazzotta A, Del Piccolo N, Rani N, Govoni M, et al. Randomised, double-blind comparison of a fixed co-formulation of intra-articular polynucleotides and hyaluronic acid versus hyaluronic acid alone in the treatment of knee osteoarthritis: Two-year follow-up. BMC Musculoskelet Disord [Internet]. 2021;22:1–12. Available from: https://link.springer.com/article/10.1186/s12891-021-04648-0
Tan J, Chen H, Zhao L, Huang W. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis of 26 randomized controlled trials. Arthrosc J Arthrosc Relat Surg [Internet]. 2021;37(1):309–25. Available from: https://www.sciencedirect.com/science/article/pii/S0749806320306046
Ahmad S, Ghazi P, Hasan M, Salman R, Fathi M, Gharooee A, et al. The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial. BMC Musculoskelet Disord [Internet]. 2021;22:1–14. Available from: https://link.springer.com/article/10.1186/s12891-021-04017-x
Chavda S, Rabbani S, Wadhwa T. Role and effectiveness of intra-articular injection of hyaluronic acid in the treatment of knee osteoarthritis: A systematic review. Cureus [Internet]. 2022;14(4). Available from: https://assets.cureus.com/uploads/review_article/pdf/91533/20220526-31417-q70v98.pdf
Dulic O, Rasovic P, Lalic I, Kecojevic V, Gavrilovic G, Abazovic D, et al. Bone marrow aspirate concentrate versus platelet rich plasma or hyaluronic acid for the treatment of knee osteoarthritis. Medicina (B Aires) [Internet]. 2021;57(11):1193. Available from: https://www.mdpi.com/1648-9144/57/11/1193
Mayoral-Rojals V. Epidemiología, repercusión clínica y objetivos terapéuticos en la artrosis. Rev la Soc Española del Dolor [Internet]. 2021;28:4–10. Available from: https://scielo.isciii.es/scielo.php?pid=S1134-80462021000100004&script=sci_arttext&tlng=pt
Giorgino R, Albano D, Fusco S, Peretti G, Mangiavini L, Messina C. Knee Osteoarthritis: Epidemiology, Pathogenesis, and Mesenchymal Stem Cells: What Else Is New? An Update. Int J Mol Sci. 2023 Mar;24(7).
Katz JN, Arant KR, Loeser RF. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA. 2021 Feb;325(6):568–78.
Perez M, Wayne J. Bone, Cartilage, and Joint Function. In: Foot and Ankle Biomechanics [Internet]. Elsevier; 2023. p. 89–102. Available from: https://www.sciencedirect.com/science/article/abs/pii/B9780128154496000287
Gad H, Abdelrazek H. Knee joint abnormalities and cartilage osteoarthritis. In: Cartilage Tissue and Knee Joint Biomechanics [Internet]. Elsevier; 2024. p. 75–86. Available from: https://www.sciencedirect.com/science/article/abs/pii/B9780323905978000426
Primorac D, Molnar V, Rod E, Jeleč Ž, Čukelj F, Matišić V, et al. Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes (Basel) [Internet]. 2020 Jul;11(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464436/
Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar;22(5).
Komarraju A, Goldberg-Stein S, Pederson R, McCrum C, Chhabra A. Spectrum of common and uncommon causes of knee joint hyaline cartilage degeneration and their key imaging features. Eur J Radiol [Internet]. 2020;129:109097. Available from: https://www.sciencedirect.com/science/article/pii/S0720048X20302862
Bacon K, LaValley M, Jafarzadeh R, Felson D. Does cartilage loss cause pain in osteoarthritis and if so, how much? Ann Rheum Dis [Internet]. 2020;79(8):1105–10. Available from: https://ard.bmj.com/content/79/8/1105
Dainese P, Wyngaert K V, De Mits S, Wittoek R, Van Ginckel A, Calders P. Association between knee inflammation and knee pain in patients with knee osteoarthritis: a systematic review. Osteoarthr Cartil [Internet]. 2022;30(4):516–34. Available from: https://www.oarsijournal.com/article/S1063-4584(21)01003-7/fulltext
Price LL, Harkey M, Ward R, MacKay J, Zhang M, Pang J, et al. Role of magnetic resonance imaging in classifying individuals who will develop accelerated radiographic knee osteoarthritis. J Orthop Res [Internet]. 2019;37(11):2420–8. Available from: https://pubmed.ncbi.nlm.nih.gov/31297900/
Liu W, Feng M, Jayasuriya C, Peng H, Zhang L, Guan Y, et al. Human osteoarthritis cartilage-derived stromal cells activate joint degeneration through TGF-beta lateral signaling. FASEB J Off Publ Fed Am Soc Exp Biol [Internet]. 2020;34(12):16552. Available from: https://pubmed.ncbi.nlm.nih.gov/33118211/
Du X, Liu Z, Tao X, Mei Y, Zhou D, Cheng K, et al. Research progress on the pathogenesis of knee osteoarthritis. Orthop Surg [Internet]. 2023;15(9):2213–24. Available from: https://pubmed.ncbi.nlm.nih.gov/33118211/
Hall A. The role of chondrocyte morphology and volume in controlling phenotype—implications for osteoarthritis, cartilage repair, and cartilage engineering. Curr Rheumatol Rep [Internet]. 2019;21:1–13. Available from: https://link.springer.com/article/10.1007/s11926-019-0837-6
Yu M, Wang D, Chen X, Zhong D, Luo J. BMSCs-derived mitochondria improve osteoarthritis by ameliorating mitochondrial dysfunction and promoting mitochondrial biogenesis in chondrocytes. Stem Cell Rev Reports. 2022;18(8):3092–111.
Thielen N, Neefjes M, Vitters E, van Beuningen H, Blom A, Koenders M, et al. Identification of transcription factors responsible for a transforming growth factor-β-driven hypertrophy-like phenotype in human osteoarthritic chondrocytes. Cells [Internet]. 2022;11(7):1232. Available from: https://pubmed.ncbi.nlm.nih.gov/35406794/
Brophy RH, Fillingham YA. AAOS clinical practice guideline summary: management of osteoarthritis of the knee (nonarthroplasty). JAAOS-Journal Am Acad Orthop Surg [Internet]. 2022;30(9):e721–9. Available from: https://journals.lww.com/jaaos/fulltext/2022/05010/aaos_clinical_practice_guideline_summary_.10.aspx
Zhao J, Huang H, Liang G, Zeng L, Yang W, Liu J. Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord [Internet]. 2020;21(1):1–12. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03262-w
Jones IA, Togashi R, Wilson ML, Heckmann N, Vangsness CTJ. Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol. 2019 Feb;15(2):77–90.
Bennell KL, Paterson KL, Metcalf BR, Duong V, Eyles J, Kasza J, et al. Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA. 2021 Nov;326(20):2021–30.
Tang JZ, Nie MJ, Zhao JZ, Zhang GC, Zhang Q, Wang B. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis. J Orthop Surg Res [Internet]. 2020;15(1):1–15. Available from: https://josr-online.biomedcentral.com/articles/10.1186/s13018-020-01919-9
Chen Z, Wang C, You D, Zhao S, Zhu Z, Xu M. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: A meta-analysis. Medicine (Baltimore) [Internet]. 2020;99(11). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220139/
Park Y-B, Kim J-H, Ha C-W, Lee D-H. Clinical efficacy of platelet-rich plasma injection and its association with growth factors in the treatment of mild to moderate knee osteoarthritis: a randomized double-blind controlled clinical trial as compared with hyaluronic acid. Am J Sports Med [Internet]. 2021;49(2):487–96. Available from: https://journals.sagepub.com/doi/abs/10.1177/0363546520986867
Belk J, Kraeutler M, Houck D, Goodrich J, Dragoo J, McCarty E. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med [Internet]. 2021;49(1):249–60. Available from: https://journals.sagepub.com/doi/full/10.1177/0363546520909397
Gong H, Li K, Xie R, Du G, Li L, Wang S, et al. Clinical therapy of platelet-rich plasma vs hyaluronic acid injections in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized double-blind controlled trials. Medicine (Baltimore) [Internet]. 2021;100(12). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281903/
Jivan S, Monzavi S, Zargaran B, Alamdari D, Afshari J, Etemad-Rezaie A, et al. Comparative analysis of the effectiveness of intra-articular injection of platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: results of an open-label trial. Arch Bone Jt Surg [Internet]. 2021;9(5):487. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503763/
Wang Y-C, Lee C-L, Chen Y-J, Tien Y-C, Lin S-Y, Chen C-H, et al. Comparing the efficacy of intra-articular single platelet-rich plasma (PRP) versus novel crosslinked hyaluronic acid for early-stage knee osteoarthritis: A prospective, double-blind, randomized controlled trial. Medicina (B Aires) [Internet]. 2022;58(8):1028. Available from: https://www.mdpi.com/1648-9144/58/8/1028
Lu M, Jin Y. Efficacy evaluation of the combined platelet-rich plasma and hyaluronic acid after arthroscopic joint debridement in treating knee osteoarthritis. Scanning [Internet]. 2022;2022. Available from: https://www.hindawi.com/journals/scanning/2022/6994017/
Wang Z, Wang R, Xiang S, Gu Y, Xu T, Jin H, et al. Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial. Front Bioeng Biotechnol [Internet]. 2022;10:1062371. Available from: https://www.frontiersin.org/articles/10.3389/fbioe.2022.1062371/full
Wang L, Wei L, Ma H, Wang M, Rastogi S. Is platelet-rich plasma better than hyaluronic acid in the treatment of knee osteoarthritis? A meta-analysis of RCTs. Videosurgery Other Miniinvasive Tech [Internet]. 2022;17(4):611–23. Available from: https://www.termedia.pl/Is-platelet-rich-plasma-better-than-hyaluronic-acid-in-the-treatment-of-knee-osteoarthritis-A-meta-analysis-of-RCTs,42,47649,0,1.html
Szwedowski D, Mobasheri A, Moniuszko A, Zabrzyński J, Jeka S. Intra-articular injection of platelet-rich plasma is more effective than hyaluronic acid or steroid injection in the treatment of mild to moderate knee osteoarthritis: a prospective, randomized, triple-parallel clinical trial. Biomedicines [Internet]. 2022;10(5):991. Available from: https://www.mdpi.com/2227-9059/10/5/991
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Derechos de autor 2023 Carlos Steeven Calle Tandazo, Pedro Martin Flores Flores
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