Učinki trombocitne plazme in hialuronske kisline na bolečino in kvaliteto življenja pri pacientih z okvaro hrustanca kolena : magistrsko delo

Kac, Janez (author), Vauhnik, Renata (mentor), Pilih, Klemen Aleš (comentor), Stražar, Klemen (reviewer)

Uvod: Bolečina je glavni simptom pri okvari hrustanca, ki vpliva na zmanjšanje funkcije in kvalitete življenja. Zdravljenje je usmerjeno v obvladovanje simptomov. Trombocitna plazma in hialuronska kislina se uporabljata kot način zdravljenja z namenom zmanjšanja bolečine in izboljšanja funkcije kolena. Namen: Ugotoviti učinke trombocitne plazme na zmanjšanje bolečine in izboljšanje kvalitete življenja pri pacientih z okvaro hrustanca kolena. Metode dela: Izvedena je bila klinična intervencija brez kontrolne skupine, ki je vključevala 54 preiskovancev z okvaro hrustanca kolena. Prejeli so eno injekcijo trombocitne plazme. Meritve smo izvedli pred aplikacijo in šest mesecev po njej. Za oceno bolečine v mirovanju in med gibanjem smo uporabili številsko analogno lestvico, Vprašalnik o težavah s kolenskim sklepom in Indeks artroze Univerz Zahodnega Ontaria in McMaster za oceno kvalitete življenja in funkcije ter lestvico Tegner za oceno telesne dejavnosti. Statistična analiza je bila opravljena s programom R. Za primerjavo rezultatov smo uporabili test t za odvisne vzorce. Z mešanimi linearnimi modeli smo iskali povezave med lastnostmi preiskovancev in spremembami stanja skozi čas. Rezultati: Pri vseh vprašalnikih je prišlo do statistično značilnih razlik med začetnim testiranjem in po šestih mesecih. P-vrednosti so bile manjše ali enake 0,025. Klinično pomembna razlika za oceno bolečine v mirovanju in gibanju po številski analogni lestvici ter kvalitete življenja po Vprašalniku o težavah s kolenskim sklepom je bila zajeta v 95-% interval zaupanja za razliko povprečij. V 95-% intervalu zaupanja za razliko povprečij pri oceni bolečine po Vprašalniku o težavah s kolenskim sklepom in stopnje telesne dejavnosti po Tegner-ju ni klinično pomembne razlike. Razprava in zaključek: Trombocitna plazma lahko vpliva na zmanjšanje bolečine in izboljšanje kvalitete življenja pri pacientih z okvarami hrustanca kolena. Iz analize podatkov sklepamo, da se stanje, ki je ocenjeno z Vprašalnikom o težavah s kolenskim sklepom in sicer z delom za bolečino in stopnja telesne dejavnosti po Tegner-ju po šestih mesecih ne izboljšata klinično pomembno. Pomembno je poudariti, da gre za spremljanje pacientov v obdobju šestih mesecev, kjer ugotovitev zaradi odsotnosti kontrolne skupine ne moremo posploševati. Potrebne so dodatne raziskave na večjih vzorcih ter poenotenje protokolov priprave in postopkov injiciranja trombocitne plazme.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, okvara hrustanca kolena, trombocitna plazma, bolečina, kvaliteta življenja
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Kac]
• Year: 2024
• Number of pages: 40 str., [11] str. pril.
• PID: 20.500.12556/RUL-167678
• UDC: 615.8
• COBISS.SI-ID: 228145923
• Publication date in RUL: 06.03.2025

Secondary language

• Language: English
• Title: Effects of platelet rich plasma and hialuronic acid on pain and quality of life in patients with knee cartilage damage : master thesis

Abstract

Introduction: Pain is the primary symptom associated with cartilage damage in the knee. It can lead to impaired function and lower quality of life. Symptomatic management is the primary focus of treatment. Platelet rich plasma and hialuronic acid can be used as methods to reduce pain and improve knee function. Purpose: The purpose of this study was to evaluate the effects of platelet rich plasma on the reduction of pain and improvement of quality of life in patients with knee cartilage damage. Methods: A clinical intervention without a control group was conducted in 54 participants with knee cartilage damage. They recieved one injection of platelet rich plasma. Measurements were made before and six months after the intervention. Numeric rating scale was used to asses pain at rest and in movement, the Knee Injury and Osteoarthritis Outcome Score, the Western Ontario and McMaster Universities Osteoarthritis Index for quality of life and knee function. Tegner Activity Scale was used to asses physical activity. Statistical analysis was made using program R. To compare results we used the paired t test. Mixed linear models were used to indentify associations between participants characteristics and changes over time. Results: Statistically significant differences were observed in all questionnaires between baseline and after six months. P-values were less than or equal to 0,025. Clinically meaningful differences in pain at rest and movement on Numeric Analog Scale and quality of life on Knee Injury and Osteoarthritis Outcome Score were included in the 95-% confidence interval for mean differences. Pain assessment on the Knee Injury and Osteoarthritis Outcome Score and activity level on Tegner Scale did not include clinically meaningful differences. Discussion and conclusion: Platelet rich plasma may contribute to pain reduction and improvement of quality of life in patients with knee cartilage damage. Analysis suggest that pain score on the Knee Injury and Osteoarthritis Outcome Score and physical activity on Tegner did not improve to a clinically significant degree after six months. It is essential to highlight that this was a six month observational study without control group, so findings cannot be generalized. Further studies with a larger sample sizes and standardized protocol of preparation and injection of the platelet rich plasma are needed.

• Keywords: master's theses, physiotherapy, cartilage damage, platelet rich plasma, pain, quality of life