Peerbooms Joost C, de Wolf Gideon S, Colaris Joost W, Bruijn Daniël J, Verhaar Jan A N
Department of Orthopaedic Surgery, HAGA Hospital, The Hague, the Netherlands.
Acta Orthop. 2009 Oct;80(5):557-62. doi: 10.3109/17453670903350081.
Activated platelets release a cocktail of growth factors, some of which are thought to stimulate repair. We investigated whether the use of autologous platelet gel (PG) in total knee arthroplasty (TKA) would improve wound healing and knee function, and reduce blood loss and the use of analgesics.
102 patients undergoing TKA were randomly assigned to a PG group (n = 50) or to a control (C) group (n = 52). The primary analysis was based on 73 participants (PG: 32; C: 41) with comparison of postoperative wound scores, VAS, WOMAC, knee function, use of analgesics, and the pre- and postoperative hemoglobin values after a follow-up of 3 months. 29 participants were excluded due to insufficient data.
The characteristics of the protocol-compliant patients were similar to those of the patients who were excluded. Analysis was per protocol and focused on the remaining 73 patients. At baseline and after 3 months of follow-up, there were no statistically significant differences between both groups regarding age, height, weight, sex, side of operation, platelet count, hemoglobin values, severity of complaints (WOMAC), and level of pain.
In our patients undergoing TKA, application of PG to the wound site did not promote wound healing. Also, we found that PG had no effect on pain, knee function, or hemoglobin values.
活化血小板会释放多种生长因子,其中一些被认为可刺激修复。我们研究了在全膝关节置换术(TKA)中使用自体血小板凝胶(PG)是否会改善伤口愈合和膝关节功能,并减少失血及镇痛药的使用。
102例行TKA的患者被随机分为PG组(n = 50)或对照组(C组,n = 52)。主要分析基于73名参与者(PG组:32名;C组:41名),比较术后3个月随访时的伤口评分、视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、膝关节功能、镇痛药使用情况以及术前和术后血红蛋白值。29名参与者因数据不足被排除。
符合方案的患者特征与被排除患者的特征相似。分析按方案进行,重点关注其余73名患者。在基线和随访3个月后,两组在年龄、身高、体重、性别、手术侧、血小板计数、血红蛋白值、主诉严重程度(WOMAC)和疼痛程度方面均无统计学显著差异。
在我们行TKA的患者中,在伤口部位应用PG并未促进伤口愈合。此外,我们发现PG对疼痛、膝关节功能或血红蛋白值没有影响。