RESUMEN
Osteoarthritis (OA) is the most common cause of disability in the United States. With an aging population, its incidence is only likely to rise. Articular cartilage has a poor capacity to heal. The advent of regenerative medicine has heralded a new approach to early treatment of degenerative conditions such as osteoarthritis by focusing on regenerating damaged tissue rather than focusing on replacement. Platelet-rich plasma (PRP) is one such treatment that has received much recent attention and has been used particularly for tendon healing. Recent studies have focused on assessing its use on degenerative conditions such as OA. In this article, we review the evidence for the pathologic basis for the use of PRP in OA and also the clinical outcomes pertaining to its use. Finally, we also consider reasons for the inconsistent clinical success pertaining to its use.
Asunto(s)
Osteoartritis/terapia , Plasma Rico en Plaquetas , Corticoesteroides/uso terapéutico , Animales , Humanos , Ácido Hialurónico/uso terapéutico , Inyecciones Intraarticulares , Osteoartritis/etiología , Osteoartritis/patología , Resultado del Tratamiento , Viscosuplementos/uso terapéuticoRESUMEN
OBJECTIVES: To report the incidence of symptomatic heterotopic ossification (HO) in a defined civilian amputee population, describe its characteristics, and compare these findings to published data in military amputees. DESIGN: Retrospective chart analysis from July 1998 to July 2009. SETTING: Ambulatory amputee clinic within a large university medical center. PARTICIPANTS: Adults with lower limb amputation (N=158). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Patients with symptomatic HO confirmed by radiographs. RESULTS: A total of 261 patients were evaluated; 158 met inclusion criteria, with 59% having traumatic etiology, 18% vascular etiology, 22% infection, and 1% tumor. Symptomatic HO was diagnosed in 36 (22.8%) patients, and 94% patients had mild HO on radiographic scoring. Rate of HO in amputations related to trauma was not increased compared with those of other etiologies. Surgical resection of the ectopic bone was required in 4 (11%) patients. CONCLUSIONS: HO is seen commonly after civilian lower limb amputation regardless of etiology. The prevalence was less than that observed in previous reports from military populations. This is the first report estimating the prevalence of HO in adult civilian amputees.