17)脊椎々間板手術症例の検討 : とくに椎間板障害例における手術適応について(第399回千葉医学会整形外科例会,第8回千葉整形外科災害外科臨床懇談会,千葉県労災指定医集談会)

<p>Data are expressed as medians and interquartile ranges; comparisons among time points, as determined by Friedman-ANOVA test, and between L-PRP and HA treatments, as determined by the Mann-Whitney U test, are not significant. w = week, m = month</p

Leukocyte-Rich Platelet-Rich Plasma Injections Do Not Up-Modulate Intra-Articular Pro-Inflammatory Cytokines in the Osteoarthritic Knee

<div><p>Introduction</p><p>The presence of leukocytes in platelet concentrates is deemed to cause deleterious effects when injected intra articularly. The aim of this study is to analyse both local and systemic effects induced by leukocyte-rich Platelet-rich Plasma (PRP) injections through a proteomic characterization of serial synovial fluid and blood samples obtained from subjects treated for knee OA. Secondary aim was to compare the effects on knee homeostasis and systemic response with those obtained with visco-supplementation.</p><p>Methods</p><p>Thirty-six OA patients treated either by autologous L-PRP or HA intra-articular knee injections, administered in series of three at one-week intervals, were analyzed. Just before the injection, 1 ml of synovial fluid was collected through the same needle way. In the same time, a peripheral blood sample was obtained and plasma separated. A further peripheral blood sample was collected at 2, 6, and 12 months. L-PRP, plasma and synovial fluid were tested by multiplex bead-based sandwich immunoassay by means of the Bio-Plex suspension array system (Bio-Rad Laboratories) for the presence of pro- and anti-inflammatory cytokines (IL-1beta, IL-6, IL-8, IL-17 and IL-4, IL-10, IL-13) and growth factors (FGF-b, HGF, PDGF-AB/BB).</p><p>Results</p><p>In general, pro-inflammatory cytokine levels were similar at basal condition and after treatment whereas anti-inflammatory ones were nearly undetectable. L-PRP administration did not modulate significant changes of cytokine concentrations either in synovial fluid or plasma, whatever the time points analyzed. No different trend was observed between L-PRP and HA administration in terms of pro- and anti-inflammatory cytokines, as well as growth factors.</p><p>Conclusions</p><p>In contrast with the evidence reported by “in vitro” studies, where a cellular pro-inflammatory response appears to be induced by the presence of leukocytes, these results suggest that the presence leukocyte-rich PRP doesn’t induce a relevant in vivo up regulation of pro-inflammatory mediators.</p></div

Cytokines concentrations in L-PRP.

<p>Cytokines concentrations in L-PRP.</p

Baseline plasma and synovial fluid cytokines concentrations.

<p>Baseline plasma and synovial fluid cytokines concentrations.</p

Plasma and synovial fluid concentration of IL-8 and IL-17 in patients treated with L-PRP or HA.

<p>Data are expressed as medians and interquartile ranges; comparisons among time points, as determined by Friedman-ANOVA test, and between L-PRP and HA treatments, as determined by the Mann-Whitney U test, are not significant, excluded the comparison between IL-8 concentration in the synovial fluids at w2, p<0.05. w = week, m = month</p

Synovial fluid concentration of FGF-b, HGF and PDGF-AB/BB in patients treated with L-PRP or HA.

<p> Data are expressed as medians and interquartile ranges; comparisons among time points, as determined by Friedman-ANOVA test, and between L-PRP and HA treatments, as determined by the Mann-Whitney U test, are not significant. w = week</p

Characteristics of patients included in the two treatment groups.

<p>Characteristics of patients included in the two treatment groups.</p

Growth Factors levels in L-PRP.

<p>Growth Factors levels in L-PRP.</p

sj-pdf-1-car-10.1177_19476035231224951 – Supplemental material for Knee Cartilage Injuries in Football Players: Clinical Outcomes and Return to Sport After Surgical Treatment: A Systematic Review of the Literature

Supplemental material, sj-pdf-1-car-10.1177_19476035231224951 for Knee Cartilage Injuries in Football Players: Clinical Outcomes and Return to Sport After Surgical Treatment: A Systematic Review of the Literature by Luca Andriolo, Theodorakys Marín Fermín, Giulia Marcella Maryse Chiari Gaggia, Andreas Serner, Elizaveta Kon, Emmanuel Papakostas, Andrew Massey, Peter Verdonk and Giuseppe Filardo in CARTILAGE</p