Valoración clínica y mediante técnicas de imagen de la evolución de pacientes con gonartrosis tratados mediante ácido hialurónico y plasma rico en plaquetas
Bibliographic record
Abstract
Introducción: La artrosis de rodilla es una enfermedad muy frecuente con una alta prevalencia en la población adulta. Provoca en los pacientes afectados dolor y limitación de su capacidad funcional. Algunas modalidades terapéuticas como el tratamiento con antiinflamatorios no esteroideos (AINES), la infiltración de plasma rico en plaquetas o la de ácido hialurónico pueden producir un alivio del dolor y una mejora de la capacidad funcional. \nObjetivos: Evaluar el beneficio proporcionado por el plasma rico en plaquetas (PRP) en comparación con el ácido hialurónico y el tratamiento con antiinflamatorios no esteroideos tanto desde un punto clínico como estructural mediante evaluación con resonancia magnética nuclear. \nMaterial y métodos: Un total de 124 pacientes fueron incluidos y distribuidos aleatoriamente en el estudio, de acuerdo a los criterios diagnósticos de artrosis de rodilla de la Sociedad Española de Reumatología, concluyendo el presente estudio un número de 98 pacientes (33 prosiguieron tratamiento con AINES, 32 recibieron una única infiltración de ácido hialurónico, 33 recibieron una única infiltración de PRP). Los pacientes fueron evaluados prospectivamente al inicio, a las 26 y a las 52 semanas usando la escala Western Ontario McMaster Universities osteoarthritis index (WOMAC) y la escala visual analógica (EVA). Se realizaron radiografías simples y estudio mediante resonancia magnética al inicio y a las 52 semanas. \nResultados: A las 52 semanas de seguimiento, en el grupo tratado con PRP mejoró de forma estadísticamente significativa tanto el dolor como la función articular (p<0.005).. Los pacientes tratados con ácido hialurónico o con AINES también experimentaron una disminución del dolor pero de menor intensidad al grupo tratado con PRP, mientras que los parámetros de función articular empeoraron. No se obtuvieron diferencias estadísticamente significativas entre los tres grupos de tratamiento en relación a la evolución de los datos obtenidos tanto en la radiografía como en la resonancia magnética nuclear. \nConclusiones: El tratamiento con infiltraciones de plasma rico en plaquetas en los pacientes afectados de artrosis de rodilla proporciona una mejoría clínica superior al tratamiento con ácido hialurónico o AINES. Una única infiltración de PRP es efectiva en producir dicha mejoría clínica. Introduction: Knee osteoarthritis (OA) is a common disease with a high prevalence in the adult population. It causes pain and decreased functional capacity. Different methods such as the prescription of nonsteroidal anti-inflammatory drugs (NSAID) or intra-articular injections (hyaluronic acid or platelet-rich plasma (PRP)) could alleviate the pain and improve the functional capacity in these patients. \nPurpose: To evaluate the benefit provided by platelet-rich plasma injections in comparison with hyaluronic acid injections and NSAIDs treatment in patients with knee joint degeneration. This present study investigated that benefit in terms of clinical and structural improvement, measured by magnetic resonance. \nMaterial and methods: A total of 124 patients were enrolled and randomized in the present study according to the Spanish Rheumatology Society knee osteoarthritis diagnosis criteria, 98 of whom completed the study (33 patientes received NSAIDs treatment, 32 a single hyaluronic acid injection and 33 received a single platelet-rich plasma injection). Patients were prospectively evaluated at baseline, at 26 and at 52 weeks using the Western Ontario McMaster Universities osteoarthritis index (WOMAC) and the visual analog scale (VAS). Radiography and magnetic resonance were carried out at baseline and 52 weeks. \nResults: At the 52-weeks follow-up, pain and functional capacity improved in the PRP group. WOMAC pain and VAS improved in the hyaluronic acid and NSAIDs groups. However, better results were obteined in the PRP group compared to the hyaluronic acid and NSAIDs groups (p<0.005). Functional capacity got worse at the 52-weeks follow-up in the hyaluronic acid and NSAIDs groups. There was no statistically significant difference among the three groups in terms of structural damage, measured by radiography and magnetic resonance. \nConclusions: Platelet-rich plasma injections provide a superior clinical improvement with respect to hyaluronic acid injections or NSAIDs treatment in knee osteoarthritis patients. A single PRP injection is effective.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".