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富血小板血浆注射辅助外侧半月板同种异体移植:至少两年的随访研究

Lateral meniscus allograft transplantation with platelet-rich plasma injections: A minimum two-year follow-up study.

作者信息

Zhang Hua, Chen Shiyang, Qiu Man, Zhou Aiguo, Yan Wenlong, Zhang Jian

机构信息

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Endoscopics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Knee. 2018 Aug;25(4):568-576. doi: 10.1016/j.knee.2018.03.005. Epub 2018 Apr 24.

Abstract

BACKGROUND

The aim of this study was to report the short-term clinical and imaging outcomes of lateral meniscus allograft transplantations (LMAT) combined with intra-articular platelet-rich plasma (PRP) injection.

METHODS

Thirty-three patients who had undergone LMAT combined with intra-articular PRP injection were evaluated. The Lysholm, International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index, Tegner activity level scale and visual analog scale for pain scores were used to evaluate the outcomes. Magnetic resonance imaging scans were performed postoperatively to assess graft position and chondral degeneration/damage.

RESULTS

A total of 31 of the original 33 patients were evaluated over a mean follow-up period of 37.0months. Patients demonstrated statistically significant improvements in all scoring data from the pre-operative to two-year follow-up period. The mean postoperative extrusion was 1.59±1.20mm (range 0-3.9mm). There were no significant differences in the distribution of the grade of chondral damage between the pre-operative and two-year follow-up periods. Three patients (9.7%) showed no improvements or had lower evaluation scores. One patient underwent matrix-induced autologous chondrocyte implantation at one year after LMAT.

CONCLUSION

Lateral meniscus allograft transplantation combined with intra-articular PRP injection resulted in statistically significant improvements in all functions and pain scores, and clinical improvements in Tegner, IKDC, and Lysholm values during short-term follow-up. A further case-control study with a larger sample size and longer follow-up is required to obtain an overall assessment of the benefits of PRP on MAT patients. Level of evidence IV.

摘要

背景

本研究旨在报告外侧半月板同种异体移植(LMAT)联合关节内注射富血小板血浆(PRP)的短期临床和影像学结果。

方法

对33例行LMAT联合关节内PRP注射的患者进行评估。采用Lysholm评分、国际膝关节文献委员会(IKDC)评分、西安大略和麦克马斯特大学骨关节炎指数、Tegner活动水平量表和视觉模拟疼痛评分来评估结果。术后进行磁共振成像扫描以评估移植物位置和软骨退变/损伤情况。

结果

在平均37.0个月的随访期内,对最初33例患者中的31例进行了评估。患者从术前到两年随访期的所有评分数据均有统计学意义的改善。术后平均挤出量为1.59±1.20mm(范围0 - 3.9mm)。术前和两年随访期之间软骨损伤分级分布无显著差异。3例患者(9.7%)无改善或评估得分较低。1例患者在LMAT术后1年接受了基质诱导自体软骨细胞植入术。

结论

外侧半月板同种异体移植联合关节内PRP注射在短期随访期间使所有功能和疼痛评分有统计学意义的改善,Tegner、IKDC和Lysholm值有临床改善。需要进一步进行更大样本量和更长随访期的病例对照研究,以全面评估PRP对MAT患者的益处。证据等级IV。

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