↓↓English Below↓↓
皆さん、こんにちは！！
東京都千代田区、麹町駅と半蔵門駅の間にある整形外科クリニック、One Clinic 麹町（ワンクリニック麹町）院長の栗本です。
天候不順が続きますがいかがお過ごしでしょうか？
今回は、膝の変形性関節症に対するPFC-FD療法とリハビリテーションの組み合わせについて、2026年に発表された論文をもとに考えてみたいと思います。
膝の痛みは「軟骨が悪い」だけではない
変形性膝関節症は「軟骨がすり減って痛くなる病気」と思われがちですが、痛みや歩きにくさは軟骨の状態だけで決まりません。太ももの筋力低下、膝の動かしにくさ、歩き方の変化、膝に負担のかかる動作、痛みをかばうことによる活動量の低下も影響します。つまり、膝の中だけでなく、膝をどう使っているかまで見る必要があります。
PFC-FDが担当する部分とは？
PFC-FDは、患者さん自身の血液から作る血小板由来の製剤です。血小板に含まれる成長因子などを利用し、膝関節内の環境に働きかけることを目指します。
ただし、痛みや関節内の状態が改善しても、落ちた筋力や、長い間に身についた歩き方・身体の使い方まで自動的に元へ戻るわけではありません。
そこで重要になるのがリハビリテーションです。
リハビリが担当する「身体を使う部分」
リハビリの目的は、単に筋肉を鍛えることではありません。関節の動きや筋力を整え、歩き方や身体の使い方を見直すことも大切です。
痛みをかばって反対側の脚に体重をかけたり、膝の曲げ伸ばしを避けたりする癖は、痛みが軽くなっても自然には戻らないことがあります。
「痛みを改善すること」と「正しく動けるようになること」は別の課題です。PFC-FDなどの治療とリハビリを組み合わせる意味は、ここにあります。
実際に「PFC-FD＋リハビリ」を調べた研究
変形性膝関節症の患者17人に対し、PFC-FD注射を3回行い、その後に
（最初から強い運動をするのではなく、状態を確認しながら負荷を上げていく）段階的なリハビリを実施した結果が報告されました。
3か月後には約7割の患者さんで臨床的に改善
研究では、痛みだけでなく、日常生活、スポーツ・レクリエーション、生活の質（QOL）も評価されました。
その結果、1か月後には17人中9人（52.9％）、3か月後には12人（70.6％）が「臨床的に意味のある改善」の基準を満たしました。日常生活動作やスポーツ、QOLにも改善がみられています。
興味深いのは、痛みの改善と身体機能の改善に時間差があったことです。痛みやQOLは比較的早く改善した一方、日常生活やスポーツに関する機能の回復にはより時間がかかりました。
筋力や長年の動作の癖はすぐには戻らないため、治療後もリハビリを続けることが大切だと考えられます。
「PFC-FD＋リハビリ」が良いと証明されたわけではない？
今回の結果だけで「PFC-FDはリハビリと組み合わせた方が効果が高い」と断定はできません。
比較対象となるPFC-FD単独群やリハビリ単独群がなく、対象も17人と少ない後ろ向き観察研究だからです。
どの効果がPFC-FD、リハビリ、または両者の組み合わせによるものかは、この研究だけでは判断できません。
著者らも、今後は対照群を設けた大規模研究が必要だとしています。
現時点では、「PFC-FD＋リハビリには可能性がある」という表現が適切です。
結論
当院では、PFC-FD治療を、注射だけで完結させないようにしています。治療のゴールは注射そのものではなく、痛みを減らし、歩く、階段を上る、旅行や趣味を楽しむ、スポーツへ戻るといった、患者さんが望む生活を取り戻すことだからです。
そのためには、組織の状態だけでなく、筋力、関節の動き、歩行、身体の使い方まで確認する必要があります。
PFC-FDによるBiologyに、衝撃波治療を含むリハビリテーションを組み合わせ、最終的な機能回復を目指す考え方です。ただし、すべての患者さんにPFC-FDや衝撃波が必要なわけではありません。痛みの原因や膝の状態、筋力、動作を評価し、その方に必要な治療を選ぶことが重要です。
膝に限らず、変形性関節症では、痛みを和らげるだけでなく、その先の「できるだけ以前に近い状態で動けるようになること」まで考えることが大切です。
今回の研究は、PFC-FDとリハビリを組み合わせることで、痛みだけでなく身体機能やQOLも改善する可能性を示した初期的な報告です。
まだ検証は必要ですが、再生医療を過大評価せず、分かっていることと分かっていないことを整理して治療を選ぶことが大切です。
「どう動けるようにするか」まで考える
一人でも多くの方に明日が楽しみになって頂けるよう、クリニック一丸となって努力してまいります。お体のことで疑問や不安がありましたらいつでもお気軽にご相談ください。
天候不順が続いております。インフルエンザもいつもより早い時期から流行しているようです。
くれぐれもご自愛ください。
お気軽にお問い合わせくださいませ!(^^)!
Hello everyone.
I’m Dr. Hisatsugu Kurimoto, Director of One Clinic Kojimachi, an orthopedic clinic located between Kojimachi Station and Hanzomon Station in Chiyoda-ku, Tokyo.
In this article, I would like to discuss the combination of PFC-FD therapy and rehabilitation for knee osteoarthritis, based on a study published in 2026.
Knee Pain Is Not Simply a Problem of “Damaged Cartilage”
Knee osteoarthritis is often thought of as a disease in which “the cartilage wears down and causes pain.” However, pain and difficulty walking are not determined solely by the condition of the cartilage.
Factors such as weakness of the thigh muscles, restricted knee movement, changes in walking patterns, movements that place excessive stress on the knee, and reduced activity caused by avoiding pain can all contribute to symptoms.
In other words, it is important to look not only at what is happening inside the knee, but also at how the knee is being used.
The “Biological” Component Addressed by PFC-FD
PFC-FD is a platelet-derived product prepared from the patient’s own blood. It utilizes growth factors and other substances derived from platelets, with the aim of influencing the biological environment within the knee joint.
However, even if pain or the condition inside the joint improves, this does not automatically restore muscle strength or correct walking patterns and movement habits that have developed over a long period of time.
This is where rehabilitation becomes important.
The “Movement” Component Addressed by Rehabilitation
The purpose of rehabilitation is not simply to strengthen muscles.
It is also important to improve joint mobility and muscle function, while reassessing walking patterns and the way the body is being used.
For example, some people develop habits such as putting more weight on the opposite leg to protect the painful knee or avoiding bending and straightening the knee. These movement patterns do not always return to normal naturally, even after the pain has improved.
Improving pain and restoring the ability to move properly are two different challenges. This is one of the reasons why combining treatments such as PFC-FD with rehabilitation may be meaningful.
A Study Investigating “PFC-FD + Rehabilitation”
A study reported the outcomes of 17 patients with knee osteoarthritis who received three PFC-FD injections followed by a staged rehabilitation program.
Rather than starting with intense exercise immediately, the rehabilitation program gradually increased the level of physical activity while monitoring the patient’s condition.
Approximately 70% of Patients Showed Clinically Meaningful Improvement After Three Months
The study evaluated not only pain, but also daily activities, sports and recreational activities, and quality of life (QOL).
The results showed that 9 of the 17 patients (52.9%) met the criteria for clinically meaningful improvement at one month, while 12 patients (70.6%) met the criteria at three months.
Improvements were also observed in daily activities, sports and recreation, and QOL.
One particularly interesting finding was that improvements in pain and improvements in physical function did not occur at exactly the same pace.
Pain and QOL improved relatively early, whereas recovery of functions related to daily activities and sports took longer.
Muscle strength and movement patterns that have developed over many years do not change immediately. This suggests that continuing rehabilitation after treatment may be important.
Does This Prove That “PFC-FD + Rehabilitation” Is Better?
The results of this study alone do not allow us to conclude that PFC-FD is more effective when combined with rehabilitation.
There was no comparison group receiving PFC-FD alone or rehabilitation alone, and the study involved only 17 patients. In addition, it was a retrospective observational study.
Therefore, this study cannot determine how much of the observed improvement was attributable to PFC-FD, rehabilitation, or the combination of the two.
The authors also noted that larger studies with appropriate control groups are needed in the future.
At this stage, it is more appropriate to say that the combination of PFC-FD and rehabilitation shows potential, rather than claiming that its superiority has been established.
Conclusion
At One Clinic Kojimachi, we do not consider PFC-FD treatment to be complete simply because an injection has been administered.
The goal of treatment is not the injection itself. It is to reduce pain and help patients regain the activities and lifestyle they want—whether that means walking comfortably, climbing stairs, traveling, enjoying their hobbies, or returning to sports.
To achieve this, it is important to evaluate not only the condition of the tissues, but also muscle strength, joint mobility, walking patterns, and overall movement.
Our approach combines the biological component of PFC-FD with rehabilitation, including physical treatments such as shockwave therapy, with the ultimate goal of improving physical function.
However, not every patient requires PFC-FD or shockwave therapy.
The most important thing is to evaluate the cause of the pain, the condition of the knee, muscle strength, and movement patterns, and then select the treatments that are appropriate for each individual patient.
This approach is not limited to the knee. In osteoarthritis, it is important not only to reduce pain, but also to consider the next step: helping patients regain the ability to move as close as possible to their previous level of function.
The study discussed in this article is an early report suggesting that combining PFC-FD with rehabilitation may improve not only pain but also physical function and quality of life.
Further research is still needed. Rather than overestimating regenerative medicine, we believe it is important to distinguish between what is currently known and what remains uncertain when making treatment decisions.
Thinking Beyond Pain: “How Can We Help You Move Better?”
At One Clinic Kojimachi, our entire team is committed to helping as many people as possible look forward to tomorrow.
If you have any questions or concerns about your health or musculoskeletal condition, please feel free to contact us at any time.
The weather has remained unsettled recently, and influenza also appears to be spreading earlier than usual this year.
Please take good care of yourself.
