RU2654607C1 - Method of restoring pararticular tissue by inserting a platelet autologous plasma - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology, orthopedics, reconstructive medicine, neurology and reconstructive surgery. Management of platelet autoplasm is carried out once in 7 days, on the course of 4 procedures. To do this, the patient is taken venous blood in a volume of 18 ml, a vacuum system of blood sampling, through a 21G catheter. Then blood is then centrifuged at an acceleration of 1,000 g for 5 minutes. After centrifugation, a platelet autologous plasma is taken from the tube by a syringe. 1 procedure involves injection of platelet autoplasma with a syringe with a 27G needle × 13 mm, in the muscle points, where pain is sublimated, these points are determined in each patient individually, by palpation, with 0.5–1.0 ml of platelet autologous plasma at each such point. 2 procedure is carried out 7 days after the first, according to the same protocol. 3 procedure includes intra-articular insertion of platelet autologous plasma, which is performed by a syringe with a 23G needle × 38 mm, 0.8 ml per incision symmetrically on both sides of the joint, in total 2 injections. 4 procedure involves the introduction of platelet autologous plasma in the thickness of muscles, leading limbs, coupled with the joint in motion, platelet autologous plasma is injected through a 5.0 ml syringe with a 23G needle × 38 mm, 0.2–0.3 ml per injection, all over the muscle, with an interval of 3 cm between injections.

EFFECT: method allows to increase the volume of active movements in the joint, to remove the pain syndrome due to the growth factors and biologically active substances contained in the platelet autologous plasma, and to improve microcirculation.

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Description

The invention relates to medicine, in particular to traumatology, orthopedics, reconstructive medicine, neurology and reconstructive surgery, and can be used to restore the soft tissue component of the paraarticular zones of large and small joints.

The group of patients with inflammatory processes in the periarticular soft tissues is numerous in the practice of general practitioners, neuropathologists, and restorative medicine doctors. The treatment of these diseases remains relevant due to the lack of effective therapy, respectively, the functional ability of the patient may significantly decrease, up to disability.

With injuries of paraarticular tissues, foci of necrosis, hemorrhage occur, chemically active substances (histamine, serotonin, bradykinin) are released, which play a large role in the development of the pathological process. In recent years, there has been growing interest in the action of prostaglandins, which are also released during soft tissue damage. They increase vascular permeability, contribute to increased pain and increased edema. In addition, prostaglandins stimulate collagen biosynthesis, which leads to the development of scar tissue after such injuries.

Currently, the treatment of damage to para-aorticular tissues can be both surgical and conservative. However, even after surgical treatment, up to 30% of patients report persisting pain.

Among conservative methods of treatment, methods are known that include local administration of drugs, as well as non-drug efferent therapy that affects the whole body. This includes various novocaine blockades, the introduction of vitamins and hydrocortisone, the introduction of hyaluronic acid.

Known methods have several disadvantages. All types of novocaine blockades give a short-term analgesic effect, also only locally and for a short time. They can temporarily improve microcirculation, reduce tissue swelling and inflammation. In addition, they do not have a prolonged effect.

Known methods of treatment are those in which preparations containing hyaluronic acid derivatives (noltrex, sinocrom, viscorneal ortho, ostenil, synvisc, suplazin, etc.) are introduced into the joint or periarticularly (1. Lila AM Modern pharmacotherapy of osteoarthritis. // New St. Petersburg medical doctors 2005. No. 1 (35) P. 38-44; 2. Lopatina DV, Lobanov SV Clinical experience of using derivatives of hyaluronic acid in the complex treatment of patients with deforming arthrosis of large joints. // Russian Medical Journal 2010 No. 11 (756) p. 12-16; 3).

With the introduction of hyaluronic acid preparations, the lubrication of the articular surfaces improves, the mechanical damage to the cartilage at the time of the functional load decreases. However, the currently existing drugs are exogenous substances, and polysaccharides of various molecular weights and origin, as well as different concentrations of sodium hyaluronate, are used for their production, and therefore there is always a risk of unwanted side effects, such as various allergic reactions, acute aseptic arthritis, acute synovitis, the development of acute gouty and pseudogouty arthritis. The clinically unproven effect of these drugs on the regenerative ability of the cartilage tissue of the joint, the short clinical effect, the high cost of drugs containing hyaluronic acid, as well as the relatively high frequency of side effects make it necessary to search for more effective and affordable methods.

Closest to the claimed method is the introduction into the affected joint and paraarticular tissue obtained 1-2 hours before the procedure, the platelet-rich autoplasma containing from 725 to 3029 thousand / μl of platelets (normal - from 162 to 358 thousand / μl). Autoplasma is activated with a 0.25% solution of CaCl ₂ in a ratio of 3: 1, in an amount of 10-15 ml. The introduction of platelet-rich autoplasma is carried out 2 times per course of treatment with an interval of 5-7 days (patent No. 2455028, 2012). This method is characterized by high cost, a very long logistical stage.

The technical result of the claimed method is to increase the volume of active movements in the joint, relieve pain due to growth factors and biologically active substances contained in platelet autologous plasma. As well as improved microcirculation and increased tissue oxygenation.

The method is as follows. The introduction of platelet autoplasma is carried out 1 time in 7 days, for a course of 4 procedures.

Venous blood was taken from a patient in a volume of 18 ml, by a vacuum blood sampling system, through a 21G catheter. Then the blood is centrifuged with an acceleration of 1000g for 5 minutes. After centrifugation from a test tube with a syringe of 5.0 ml, 3.5-4.0 ml of platelet autologous plasma is taken.

1 procedure is aimed at relieving pain due to growth factors and biologically active substances contained in platelet autologous plasma. Also, due to improved microcirculation and increased oxygen tension in the tissues, relief of pain is observed.

Injection of platelet autoplasma is carried out with a syringe with a 27G × 13 mm needle, at the muscle points where the pain sublimates. These points are determined for each patient individually, by palpation. 0.5-1.0 ml of platelet autologous plasma is injected at each trigger point.

2 procedure is carried out 7 days after the first, according to the same protocol.

Procedure 3 - intra-articular injection of platelet autologous plasma is carried out by a syringe with a needle 23 G × 38 mm, 0.8 ml per injection into the joint cavity symmetrically from both sides, 2 points of injection into the joint cavity. This introduction is necessary for the regeneration of hyaline cartilage, the introduction of energy and building substrate to stimulate physiological regeneration.

4 procedure - the introduction of platelet autologous plasma into the thickness of the muscles that are associated with the joint in motion.

This introduction stimulates muscle activity, thereby triggering indirectly the physical activity of the joint. Autologous platelet plasma is injected with a syringe with a 23G × 38 mm needle, 0.2-0.3 ml per injection, throughout the muscle with an interval of 3 cm between injections, typically 8-10 injections.

At the end of the course, patients note relief of pain, an increase in the volume of active movements in the joint. This course is recommended to be repeated 1-2 times a year.

The practical applicability of the method and the features of its use are illustrated by the following example.

Example 1

Patient M., 54 years old. I went to a neurologist with complaints of pain in the knee joints, limitation of range of motion, swelling of the joints.

Diagnosis: Osteoarthritis of the knee.

The patient received venous blood in a volume of 18 ml, obtained after centrifugation of 6.5 ml of platelet autologous plasma. Autologous platelet plasma was taken into syringes of 5.0 ml and 2.5 ml.

The platelet autologous plasma was administered according to the protocol - introduction to the trigger points, intra-articular injection and to the lower leg muscles.

After a course of 4 procedures, the patient noted a marked decrease in pain, a decrease in joint swelling, an increase in the volume of active movements in the joint, and the possibility of physical activity without pain.

Claims (1)

The method of restoring paraarticular tissue by administering platelet autologous plasma involves collecting venous blood from a patient, centrifuging blood and administering platelet autologous plasma, characterized in that platelet autoplasma is administered once every 7 days, for a course of 4 procedures; for this, venous is taken from the patient blood in a volume of 18 ml, by a vacuum blood sampling system, through a 21G catheter, then the blood is centrifuged with an acceleration of 1000 g for 5 minutes, after centrifugation from a test tube with a syringe platelet autologous plasma is abiraded; 1 procedure involves injecting platelet autoplasma with a syringe with a 27G × 13 mm needle into the muscle points where the pain sublimates, these points are determined individually for each patient by palpation, with 0.5-1.0 ml of autologous platelet being injected into each such point plasma; 2 procedure is carried out 7 days after the first, according to the same protocol; 3 procedure involves intra-articular injection of platelet autologous plasma, which is carried out with a syringe with a needle 23G × 38 mm, 0.8 ml per injection symmetrically from both sides of the joint, a total of 2 injections; 4 procedure involves the introduction of platelet autologous plasma into the thickness of the muscles leading the limbs associated with the joint in motion, while platelet autologous plasma is injected through a 5.0 ml syringe, a 23G × 38 mm needle, 0.2-0.3 ml per injection , throughout the muscle, with an interval of 3 cm between injections.