Foot & Ankle International - June 2017 - 602
602
Foot & Ankle International 38(6)
Table 7. Secondary Clinical Outcomes for the Early Stage and Late Stage Groups.
OA grade (n)
Mean ± SD (95% CI)
JSSF
Group, P = .04; time, P < .001 in repeated measures ANOVA
Early-stage (7)
Baseline
56.9 ± 8.8 (53.1-66.1)
4 weeks
72.3 ± 7.6 (66.7-77.9)
12 weeks
76.9 ± 6.9 (71.7-82.0)
24weeks
66.2 ± 19.7 (51.7-80.9)
Late-stage (13)
Baseline
48.5 ± 14.0 (40.9-56.2)
4 weeks
69.8 ± 10.4 (64.1-75.4)
12 weeks
65.1 ± 12.3 (58.4-71.8)
24 weeks
65.0 ± 15.0 (56.9-73.1)
SAFE-Q Pain and pain related
Group, P < .001; time, P = .03 in repeated measures ANOVA
Early-stage (7)
Baseline
56.9 ± 14.4 (46.2-67.5)
4 weeks
70.0 ± 13.2 (60.3-79.8)
12 weeks
75.3 ± 11.6 (66.7-83.9)
24 weeks
66.2 ± 18.8 (48.2-76.2)
Late-stage (13)
Baseline
41.2 ± 14.3 (40.9-56.2)
4 weeks
51.4 ± 14.8 (64.1-75.4)
12 weeks
54.3 ± 14.2 (46.6-62.0)
24 weeks
52.8 ± 18.4 (42.8-62.8)
P value
Baseline vs 4 weeks:
Baseline vs 12 weeks:
Baseline vs 24 weeks:
.009a
.09
.009
.11
Baseline vs 4 weeks:
Baseline vs 12 weeks:
Baseline vs 24 weeks:
.005a
.005
.04
.07
.16a
.22a
Abbreviations: JSSF scale, Japanese Society for Surgery of the Foot ankle/hindfoot scale; SAFE-Q, Self-Administered Foot Evaluation Questionnaire.
a
Kruskul-Wallis test. Other P values are for the post-hoc tests.
the last injection, and the effect was diminished at 24
weeks. This trend is consistent with previous reports that
showed that the effect of an intra-articular injection of
PRP on knee and hip cartilage degeneration and OA
peaked at 2 to 3 months after the treatment and then gradually decreased.15,22,23 In addition, the results of this study
might change depending on the number of injections,
treatment dose and intervals, patient selection and education, and postprocedural rehabilitation, which are essential
to maximize the therapeutic effect of PRP.42
We used the ultrasonography-guided technique for
intra-articular injections to minimize the risk of extra-articular injections because the purpose of this study was to
assess the efficacy of PRP. However, injections without
ultrasonography guidance may be more common in clinical practice because of the cost and time with the use of
ultrasonography.43 In these cases, the risk of extra-articular
injections may be higher, resulting in a diminished treatment effect.39
Our study has several limitations. First, the number of
patients was small, and no control group was included. The
main purpose of this study was to confirm the safety of intraarticular injections of PRP in patients with primary varus
ankle OA.29 Thus, we conducted a single-arm study with a
small number of patients that the institutional review board
of our institute permitted. The results of this study could provide important information for which the number of patients
can be estimated for future studies to confirm the efficacy of
PRP. Second, we evaluated the patients for 6 months. We
determined the period on the basis of previous reports.23,26
However, considering that the efficacy lasted for at least 6
months in this study, a longer follow-up may be required for
future studies. Third, the frequency and number of injections, the volume and concentration of PRP, and the activation method were determined based on previous reports.12,22,26
However, the results might change if different treatment protocols are used. For example, the number and dose of hyaluronic acid injections for ankle OA have an impact on the
clinical outcome,41 and the same may be true for PRP injections. In addition, the concentration of platelets in PRP is
largely dependent on the extraction method (Table 1).24
Although the mean concentration, 5.1 times higher than that
in whole blood, was comparable to that in previous studies,
which ranged from 2- to 6-fold,15 future research should
focus on the optimal platelet concentration to obtain maximal efficacy. Fourth, the patients in this study had various
Table of Contents for the Digital Edition of Foot & Ankle International - June 2017
Contents
Foot & Ankle International - June 2017 - Intro
Foot & Ankle International - June 2017 - Cover1
Foot & Ankle International - June 2017 - Cover2
Foot & Ankle International - June 2017 - i
Foot & Ankle International - June 2017 - ii
Foot & Ankle International - June 2017 - Contents
Foot & Ankle International - June 2017 - iv
Foot & Ankle International - June 2017 - v
Foot & Ankle International - June 2017 - vi
Foot & Ankle International - June 2017 - vii
Foot & Ankle International - June 2017 - viii
Foot & Ankle International - June 2017 - 1A
Foot & Ankle International - June 2017 - 1B
Foot & Ankle International - June 2017 - ix
Foot & Ankle International - June 2017 - x
Foot & Ankle International - June 2017 - xi
Foot & Ankle International - June 2017 - xii
Foot & Ankle International - June 2017 - 2A
Foot & Ankle International - June 2017 - 2B
Foot & Ankle International - June 2017 - xiii
Foot & Ankle International - June 2017 - xiv
Foot & Ankle International - June 2017 - xv
Foot & Ankle International - June 2017 - xvi
Foot & Ankle International - June 2017 - 3A
Foot & Ankle International - June 2017 - 3B
Foot & Ankle International - June 2017 - xvii
Foot & Ankle International - June 2017 - xviii
Foot & Ankle International - June 2017 - xix
Foot & Ankle International - June 2017 - xx
Foot & Ankle International - June 2017 - xxi
Foot & Ankle International - June 2017 - xxii
Foot & Ankle International - June 2017 - 589
Foot & Ankle International - June 2017 - 590
Foot & Ankle International - June 2017 - 591
Foot & Ankle International - June 2017 - 592
Foot & Ankle International - June 2017 - 593
Foot & Ankle International - June 2017 - 594
Foot & Ankle International - June 2017 - 595
Foot & Ankle International - June 2017 - 596
Foot & Ankle International - June 2017 - 597
Foot & Ankle International - June 2017 - 598
Foot & Ankle International - June 2017 - 599
Foot & Ankle International - June 2017 - 600
Foot & Ankle International - June 2017 - 601
Foot & Ankle International - June 2017 - 602
Foot & Ankle International - June 2017 - 603
Foot & Ankle International - June 2017 - 604
Foot & Ankle International - June 2017 - 605
Foot & Ankle International - June 2017 - 606
Foot & Ankle International - June 2017 - 607
Foot & Ankle International - June 2017 - 608
Foot & Ankle International - June 2017 - 609
Foot & Ankle International - June 2017 - 610
Foot & Ankle International - June 2017 - 611
Foot & Ankle International - June 2017 - 612
Foot & Ankle International - June 2017 - 613
Foot & Ankle International - June 2017 - 614
Foot & Ankle International - June 2017 - 615
Foot & Ankle International - June 2017 - 616
Foot & Ankle International - June 2017 - 617
Foot & Ankle International - June 2017 - 618
Foot & Ankle International - June 2017 - 619
Foot & Ankle International - June 2017 - 620
Foot & Ankle International - June 2017 - 621
Foot & Ankle International - June 2017 - 622
Foot & Ankle International - June 2017 - 623
Foot & Ankle International - June 2017 - 624
Foot & Ankle International - June 2017 - 625
Foot & Ankle International - June 2017 - 626
Foot & Ankle International - June 2017 - 627
Foot & Ankle International - June 2017 - 628
Foot & Ankle International - June 2017 - 629
Foot & Ankle International - June 2017 - 630
Foot & Ankle International - June 2017 - 631
Foot & Ankle International - June 2017 - 632
Foot & Ankle International - June 2017 - 633
Foot & Ankle International - June 2017 - 634
Foot & Ankle International - June 2017 - 635
Foot & Ankle International - June 2017 - 636
Foot & Ankle International - June 2017 - 637
Foot & Ankle International - June 2017 - 638
Foot & Ankle International - June 2017 - 639
Foot & Ankle International - June 2017 - 640
Foot & Ankle International - June 2017 - 641
Foot & Ankle International - June 2017 - 642
Foot & Ankle International - June 2017 - 643
Foot & Ankle International - June 2017 - 644
Foot & Ankle International - June 2017 - 645
Foot & Ankle International - June 2017 - 646
Foot & Ankle International - June 2017 - 647
Foot & Ankle International - June 2017 - 648
Foot & Ankle International - June 2017 - 649
Foot & Ankle International - June 2017 - 650
Foot & Ankle International - June 2017 - 651
Foot & Ankle International - June 2017 - 652
Foot & Ankle International - June 2017 - 653
Foot & Ankle International - June 2017 - 654
Foot & Ankle International - June 2017 - 655
Foot & Ankle International - June 2017 - 656
Foot & Ankle International - June 2017 - 657
Foot & Ankle International - June 2017 - 658
Foot & Ankle International - June 2017 - 659
Foot & Ankle International - June 2017 - 660
Foot & Ankle International - June 2017 - 661
Foot & Ankle International - June 2017 - 662
Foot & Ankle International - June 2017 - 663
Foot & Ankle International - June 2017 - 664
Foot & Ankle International - June 2017 - 665
Foot & Ankle International - June 2017 - 666
Foot & Ankle International - June 2017 - 667
Foot & Ankle International - June 2017 - 668
Foot & Ankle International - June 2017 - 669
Foot & Ankle International - June 2017 - 670
Foot & Ankle International - June 2017 - 671
Foot & Ankle International - June 2017 - 672
Foot & Ankle International - June 2017 - 673
Foot & Ankle International - June 2017 - 674
Foot & Ankle International - June 2017 - 675
Foot & Ankle International - June 2017 - 676
Foot & Ankle International - June 2017 - 677
Foot & Ankle International - June 2017 - 678
Foot & Ankle International - June 2017 - 679
Foot & Ankle International - June 2017 - 680
Foot & Ankle International - June 2017 - 681
Foot & Ankle International - June 2017 - 682
Foot & Ankle International - June 2017 - 683
Foot & Ankle International - June 2017 - 684
Foot & Ankle International - June 2017 - 685
Foot & Ankle International - June 2017 - 686
Foot & Ankle International - June 2017 - 687
Foot & Ankle International - June 2017 - 688
Foot & Ankle International - June 2017 - 689
Foot & Ankle International - June 2017 - 690
Foot & Ankle International - June 2017 - 691
Foot & Ankle International - June 2017 - 692
Foot & Ankle International - June 2017 - 693
Foot & Ankle International - June 2017 - 694
Foot & Ankle International - June 2017 - 695
Foot & Ankle International - June 2017 - 696
Foot & Ankle International - June 2017 - 697
Foot & Ankle International - June 2017 - 698
Foot & Ankle International - June 2017 - 699
Foot & Ankle International - June 2017 - 700
Foot & Ankle International - June 2017 - 701
Foot & Ankle International - June 2017 - 702
Foot & Ankle International - June 2017 - CT1
Foot & Ankle International - June 2017 - CT2
Foot & Ankle International - June 2017 - 4A
Foot & Ankle International - June 2017 - 4B
Foot & Ankle International - June 2017 - Cover3
Foot & Ankle International - June 2017 - Cover4
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2020
https://www.nxtbook.com/nxtbooks/sage/psychologicalscience_demo
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2020
https://www.nxtbook.com/nxtbooks/sage/fai_202009
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_august2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2019
https://www.nxtbook.com/nxtbooks/sage/fai_201909
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_july2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2019
https://www.nxtbook.com/nxtbooks/sage/canadianpharmacistsjournal_05062019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2019
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201903
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2018
https://www.nxtbook.com/nxtbooks/sage/tec_20180810
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2018
https://www.nxtbook.com/nxtbooks/sage/fai_201807
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2018
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201803
https://www.nxtbook.com/nxtbooks/sage/slas_discovery_201712
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_november2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_september2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2017
https://www.nxtbook.com/nxtbooks/sage/fai_supplement_201709
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_may2017
https://www.nxtbook.com/nxtbooks/sage/fai_201706
https://www.nxtbook.com/nxtbooks/sage/fai_201607
https://www.nxtbookmedia.com