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解剖学前交叉韧带重建:富血小板血浆能加速肌腱愈合吗?

Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing?

作者信息

Silva Alcindo, Sampaio Ricardo

机构信息

Military Hospital D. Pedro V, Avenida da Boavista, 4050-113, Porto, Portugal.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2009 Jun;17(6):676-82. doi: 10.1007/s00167-009-0762-8. Epub 2009 Mar 14.

Abstract

Recently, the use of hamstring tendons in anterior cruciate ligament repair has been increasing. However, tendon-to-bone healing occurs slowly, which can be a problem to an early return to sport activities. The use of growth factors from platelets seems to improve tissue healing. We enrolled 40 patients in a prospective study that were submitted to an anatomic reconstruction of the anterior cruciate ligament. Patients were sequentially enrolled into four groups: group A without platelet-rich plasma (PRP); group B with PRP in femoral tunnels at the end of surgery; group C with PRP in femoral tunnels at the end of surgery and intra-articular at 2- and 4 weeks after surgery; group D with PRP activated with thrombin in the femoral tunnels. All patients underwent magnetic resonance imaging of the knee 3 months after surgery to evaluate the signal intensity of the fibrous interzone (FIZ) in the femoral tunnels. We did not find any difference among the groups when comparing the signal intensity of the FIZ on magnetic resonance imaging.

摘要

最近,腘绳肌腱在前交叉韧带修复中的应用一直在增加。然而,肌腱与骨的愈合过程缓慢,这可能成为早期恢复体育活动的一个问题。使用来自血小板的生长因子似乎可以改善组织愈合。我们纳入了40例患者进行一项前瞻性研究,这些患者均接受了前交叉韧带的解剖重建。患者被依次分为四组:A组不使用富血小板血浆(PRP);B组在手术结束时在股骨隧道内使用PRP;C组在手术结束时在股骨隧道内使用PRP,并在术后2周和4周在关节内使用;D组在股骨隧道内使用经凝血酶激活的PRP。所有患者在术后3个月接受膝关节磁共振成像,以评估股骨隧道内纤维中间区(FIZ)的信号强度。在比较磁共振成像上FIZ的信号强度时,我们未发现各组之间存在任何差异。

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