Kaniki Nicole, Willits Kevin, Mohtadi Nicholas G H, Fung Vincent, Bryant Dianne
Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Faculty of Health Sciences, School of Kinesiology, Western University, London, Ontario, Canada; Fowler Kennedy Sports Medicine Clinic, London, Ontario, Canada.
Arthroscopy. 2014 Sep;30(9):1139-45. doi: 10.1016/j.arthro.2014.04.086. Epub 2014 Jul 3.
The aim of this study was to evaluate the effectiveness of platelet-rich plasma (PRP) in the nonoperative treatment of acute Achilles tendon rupture.
This was a comparative study that included a prospective cohort and a historical control group. The control group was formed from a randomized trial in which one arm of the trial underwent nonoperative treatment, including accelerated functional rehabilitation after acute Achilles tendon rupture identical to that performed in the prospective treatment group. Patients in the prospective group were recruited consecutively and were administered 2 injections of PRP during the first 2 weeks after the injury. The primary outcome was isokinetic plantar flexion strength at 1 and 2 years after injury. Secondary outcomes included range of motion (ROM), calf circumference, and Leppilahti score. The ankle-hindfoot scale (American Orthopedic Functional Ankle Scale [AOFAS]) was administered to patients who received the PRP injection in the prospective group but was not measured for the historical group.
A total of 73 patients participated in the prospective PRP study group and were compared with a retrospective control group of 72 patients from a previous randomized controlled trial (RCT). The mean difference between groups in isokinetic plantar flexion strength (injured/uninjured) at 1 year after injury was -4.3% (95% confidence interval [CI], -15.9 to 7.3; P = .5) and 2.4% (95% CI, -8.6 to 13.5; P = .7) at 30°/s and 60°/s, respectively. Results at 2 years after injury were -3.1% (95% CI, -13.5 to 7.2; P = .6) and 4.8% (95% CI, -3.5 to 13.1; P = .3) at 30°/s and 60°/s, respectively. All secondary outcomes were also not statistically different.
The results of this study suggest that there is no measurable clinical benefit to the addition of PRP to the treatment regimen for nonoperatively treated acute Achilles tendon rupture.
Level III, retrospective comparative study.
本研究旨在评估富血小板血浆（PRP）在急性跟腱断裂非手术治疗中的有效性。
这是一项对比研究，包括一个前瞻性队列和一个历史对照组。对照组来自一项随机试验，该试验的一个分支接受非手术治疗，包括急性跟腱断裂后与前瞻性治疗组相同的加速功能康复。前瞻性组的患者连续招募，并在受伤后的前2周内接受2次PRP注射。主要结局是受伤后1年和2年时的等速跖屈力量。次要结局包括活动范围（ROM）、小腿周长和莱皮拉hti评分。前瞻性组中接受PRP注射的患者接受了踝-后足量表（美国矫形外科功能性踝关节量表[AOFAS]）评估，但历史组未进行该量表测量。
共有73例患者参与前瞻性PRP研究组，并与来自先前随机对照试验（RCT）的72例患者的回顾性对照组进行比较。受伤后1年时，两组在30°/秒和60°/秒的等速跖屈力量（受伤侧/未受伤侧）的平均差异分别为-4.3%（95%置信区间[CI]，-15.9至7.3；P = 0.5）和2.4%（95%CI，-8.6至13.5；P = 0.7）。受伤后2年时，在30°/秒和60°/秒时的结果分别为-3.1%（95%CI，-13.5至7.2；P = 0.6）和4.8%（95%CI，-3.5至13.1；P = 0.3）。所有次要结局在统计学上也无差异。
本研究结果表明，在非手术治疗急性跟腱断裂的治疗方案中添加PRP没有可测量的临床益处。
III级，回顾性对比研究。
