Angthong Chayanin, Khadsongkram Anuwat, Angthong Wirana
Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, Thammasat University Faculty of Medicine, Klong Nueng, Klong Luang, Pathum Thani, Thailand.
J Foot Ankle Surg. 2013 Jul-Aug;52(4):475-80. doi: 10.1053/j.jfas.2013.04.005. Epub 2013 May 4.
The present study aimed to determine the outcomes and quality of life after platelet-rich plasma therapy in patients with chronic recalcitrant diseases of the hindfoot and ankle and to identify the crucial clinical variables. The records of 12 adult patients with diseases of the hindfoot and ankle were included in the present study. These patients had been treated with platelet-rich plasma from September 2010 to April 2011 after 3 to 6 months or more of conservative treatment had been unsuccessful. They had attended the follow-up visits, were consecutively enrolled, and retrospectively studied. A total of 3 mL of autologous platelet-rich plasma was injected under fluoroscopic or ultrasound guidance into the affected areas. All patients had been evaluated using visual analog scale foot and ankle scoring before treatment and at set intervals after treatment. According to their scores at the final follow-up visit (mean 16 months), the patients were allocated to the satisfactory (score ≥ 80; n = 8) and unsatisfactory (score < 80; n = 4) groups. The health-related quality of life was assessed using the Medical Outcomes Study short-form, 36-item survey at the final follow-up visit, because the study was retrospective, and the information was not available before treatment. The mean visual analog score at the final follow-up visit (79.71 ± 17.81) was significantly greater than the mean pretreatment score (57.89 ± 20.77; p = .002). Four patients (33%) had unsatisfactory results. The mean short-form, 36-item score for the satisfactory group (85.23 ± 11.30) was significantly greater than that (57.33 ± 12.91) of the unsatisfactory group (p = .003). No definitive factors influencing the outcome of this treatment were found. The substantial number of patients with an unsatisfactory outcome indicates that platelet-rich plasma injection might be an option but might not be a mainstay of nonoperative treatment of problematic conditions of the hindfoot and ankle. The actual benefit of this treatment, including the factors influencing its outcome, are still inconclusive.
本研究旨在确定富血小板血浆治疗后足和踝关节慢性顽固性疾病患者的治疗结果及生活质量，并确定关键的临床变量。本研究纳入了12例患有后足和踝关节疾病的成年患者的记录。这些患者在经过3至6个月或更长时间的保守治疗失败后，于2010年9月至2011年4月接受了富血小板血浆治疗。他们接受了随访，连续入组并进行回顾性研究。在透视或超声引导下，将总共3 mL自体富血小板血浆注入受影响区域。所有患者在治疗前以及治疗后按设定时间间隔使用视觉模拟量表进行足和踝关节评分。根据他们在最后一次随访（平均16个月）时的评分，将患者分为满意组（评分≥80；n = 8）和不满意组（评分<80；n = 4）。由于本研究是回顾性的，且治疗前无法获得相关信息，因此在最后一次随访时使用医学结局研究简表36项调查问卷评估健康相关生活质量。最后一次随访时的平均视觉模拟评分为（79.71±17.81），显著高于治疗前的平均评分（57.89±20.77；p = 0.002）。4例患者（33%）结果不满意。满意组的平均简表36项评分为（85.23±11.30），显著高于不满意组（57.33±12.91；p = 0.003）。未发现影响该治疗结果的明确因素。相当数量的患者结果不满意表明，富血小板血浆注射可能是一种选择，但可能不是后足和踝关节问题性疾病非手术治疗的主要方法。该治疗的实际益处，包括影响其结果的因素，仍无定论。
