Efektivitas Terapi Adjuvan Injeksi Platelet-Rich Plasma pada Osteoarthritis Sendi Lutut yang mendapatkan NSAIDs

Ika Rahmawati Sutejo✉, Dimas Zabirrurohman Putra, Cholis Abrori
DOI: https://doi.org/10.25077/mka.v46.i1.p37-44.2023

Abstract

Osteoartritis (OA) memengaruhi 303 juta orang di dunia dan menjadi salah satu masalah kesehatan yang harus diwaspadai. Terapi penyembuhan OA secara total belum ada. Platelet-rich plasma (PRP) saat ini menjadi target peneliti untuk penanganan pasien OA. Tujuan: Mengetahui efektivitas terapi adjuvan injeksi PRP pada pasien OA sendi lutut yang mendapatkan NSAIDs. Metode: Studi observasional dengan pendekatan cohort retrospektif dilakukan pada pasien osteoartritis sendi lutut di Rumah Sakit Jember Klinik dan Rumah Sakit Daerah Balung. Jumlah sampel yang didapatkan sebanyak 16 pasien. Penelitian ini membandingkan terapi non-steroidal anti-inflammatory drugs (NSAID) tunggal dan NSAID dengan adjuvan PRP. Evaluasi terapi dengan menilai perubahan derajat keparahan gambaran klinis menggunakan kuesioner Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC). Uji Fisher’s exact digunakan untuk membandingkan efektivitas terapi. Hasil: terdapat perubahan derajat keparahan gambaran klinis dari 16 sampel pasien. Sebanyak 11 pasien mengalami penurunan derajat keparahan gambaran klinis, dengan rincian 8 pasien (72,7%) dari kelompok terapi NSAIDs dengan adjuvan PRP dan 3 pasien (27,3%) dari kelompok pasien OA yang mendapatkan NSAIDs tanpa adjuvan PRP. Simpulan: Terapi adjuvan injeksi PRP pada pasien OA yang mendapatkan NSAIDs lebih efektif memperbaiki derajat keparahan gambaran klinis penyakit dibandingkan dengan pasien OA yang mendapatkan NSAIDs tanpa adjuvan injeksi PRP.

Keywords

Clinical Science; Degenerative disease

Full Text:

PDF

References

Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Am Coll Rheumatol. 2020;72(2):149–62.

Ahmad IW, Rahmawati LD, Wardhana TH. Demographic Profile, Clinical and Analysis of Osteoarthritis Patients in Surabaya. Biomol Heal Sci J. 2018;1(01):1–39.

Primorac D, Molnar V, Jeleˇc ERŽ, ˇCukelj F, Matiši´c V, Vrdoljak T, et al. Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes (Basel). 2020;11(8):854–89.

Soeroso J, Isbagio H, Kalim H, Broto R, Pramudiyo R. Oteoartritis.Dalam: Sudoyo AW, Setiyohadi B, Alwi I, Simadibrata M, Setiati S, et al. Buku Ajar Ilmu Penyakit Dalam. Edisi ke-5. Jakarta: Pusat Penerbitan Ilmu Penyakit Dalam;2009

Zheng L, Zhang Z, Sheng P, Mobasheri A. The role of metabolism in chondrocyte dysfunction and the progression of osteoarthritis. Ageing Res Rev. 2021;66:1–18.

López DB, Quirós MM, Ángel M, Villacañas F. Clinical and radiographic comparison of a single LP‑PRP injection, a single hyaluronic acid injection and daily NSAID administration with a 52‑week follow‑up: a randomized controlled trial. J Orthop Traumatol. 2019;1–9.

Le ADK, Enweze L, Debaun MR, Dragoo JL. Current Clinical Recommendations for Use of Platelet-Rich Plasma. Musculoskelet Med. 2018;11:624–34.

Battaglia M, Guaraldi F, Vannini F, Rossi G, Timoncini A, Buda R, et al. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics. 2013;36(12):1501–8.

Copsey B, Thompson JY, Vadher K, Ali U, Dutton SJ, Fitzpatrick R, et al. Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials. Qual Life Res. 2019;28(2):335–43.

Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: Influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659–64.

Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745–59.

Hussain SM, Cicuttini FM, Alyousef B, Wang Y. Female hormonal factors and osteoarthritis of the knee, hip and hand: a narrative review. Climacteric. 2018;21(2):132–9.

Greene MA, Richard F. Loeser. Aging-related Inflammation in Osteoarthritis Meredith. Physiol Behav. 2017;176(3):139–48.

Lim JU, Lee JH, Kim JS, Hwang Y Il, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J COPD. 2017;12:2465–75.

Reyes C, Leyland KM, Peat G, Cooper C, Arden NK, Prieto-Alhambra D. Association Between Overweight and Obesity and Risk of Clinically Diagnosed Knee, Hip, and Hand Osteoarthritis: A Population-Based Cohort Study. Arthritis Rheumatol. 2016;68(8):1869–75.

Hong M, Cheng C, Sun X, Yan Y, Zhang Q, Wang W, et al. Efficacy and Safety of Intra-Articular Platelet-Rich Plasma in Osteoarthritis Knee: A Systematic Review and Meta-Analysis. Biomed Res Int. 2021;11(5):1587–97.

Migliorini F, Driessen A, Quack V, Sippel N, Cooper B, Mansy Y El, et al. Comparison between intra-articular infiltrations of placebo, steroids, hyaluronic and PRP for knee osteoarthritis: a Bayesian network meta-analysis. Arch Orthop Trauma Surg. 2021;141(9):1473–90.

Bennell KL, Hunter DJ, Paterson KL. Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis. Curr Rheumatol Rep. 2017;19(5):1–10.

Southworth TM, Naveen NB, Tauro TM, Leong NL, Cole BJ. The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis. J Knee Surg. 2019;32(1):37–45.

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. 2020;15(1).



Bookmark and Share
-->