Ji Qingming, Yang Yuhui, Chen Hao, Geng Weizheng, Dong Hang, Yu Qingwei
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun Jilin, 130033, P.R.China.
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun Jilin, 130033,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Apr 15;31(4):410-416. doi: 10.7507/1002-1892.201611056.
To investigate the clinical outcomes of autologous platelet rich plasma (PRP) for anterior cruciate ligament (ACL) reconstruction.
Between August 2014 and August 2016, 42 patients with ACL ruptures who underwent arthroscopic ACL reconstruction were randomly divided into 2 groups: 21 patients received graft soaked with PRP (trial group) and 21 patients received routine graft in ACL reconstruction (control group). Because 6 patients failed to be followed up, 17 patients of trial group and 19 of control group were enrolled in the study. There was no significant difference in gender, age, body mass index, side, injury reason, disease duration, Kellgren-Lawrence grade, and preoperative visual analogue scale (VAS), Lysholm score, and International Knee Documentation Committee (IKDC) activity scores between 2 groups ( >0.05). VAS score, Lysholm score, and IKDC activity scores were used to evaluate pain and function at 3 and 12 months postoperatively. Further, second arthroscopy and MRI examination were performed at 12 months postoperatively.
The patients in both groups were followed up 3 to 12 months with an average of 9.83 months. The VAS score, Lysholm score, and IKDC activity scores were significantly improved at 3 and 12 months after operation in 2 groups ( <0.05), and the scores of trial group were significantly better than those of control group at 3 months ( <0.05), but no significant difference was found between 2 groups at 12 months ( >0.05). No complications of effusion, infection, and allergy were observed in 2 groups during follow-up. MRI showed good position of ACL grafts and good signal quality of the graft in the majority of the cases. However, mixed hyperintense and presence of synovial fluid at the femoral bone-tendon graft interface were found in 3 patients of trial group and 4 patients of control group, indicating poor remodeling ligamentation. MRI score was 3.53±1.13 in trial group and was 3.21±0.92 in control group, showing no significant difference ( =0.936, =0.356). The second arthroscopy examination showed ligament remodeling score was higher in trial group than control group ( =3.248, =0.014), but no significant difference was found in synovial coverage score and the incidence of cartilage repair ( =2.190, =0.064; =0.090, =0.764).
PRP application in allograft ACL reconstruction can improve knee function and relieve pain after operation, which may also accelerate graft remodeling.
探讨自体富血小板血浆（PRP）在前交叉韧带（ACL）重建中的临床疗效。
2014年8月至2016年8月，42例接受关节镜下ACL重建的ACL断裂患者被随机分为2组：21例患者接受浸泡PRP的移植物（试验组），21例患者在ACL重建中接受常规移植物（对照组）。因6例患者失访，试验组纳入17例患者，对照组纳入19例患者。两组在性别、年龄、体重指数、患侧、损伤原因、病程、Kellgren-Lawrence分级以及术前视觉模拟评分（VAS）、Lysholm评分和国际膝关节文献委员会（IKDC）活动评分方面差异均无统计学意义（>0.05）。采用VAS评分、Lysholm评分和IKDC活动评分评估术后3个月和12个月时的疼痛和功能。此外，术后12个月进行二次关节镜检查和MRI检查。
两组患者随访3至12个月，平均9.83个月。两组患者术后3个月和12个月时VAS评分、Lysholm评分和IKDC活动评分均显著改善（<0.05），试验组3个月时评分显著优于对照组（<0.05），但两组在12个月时差异无统计学意义（>0.05）。随访期间两组均未观察到积液、感染和过敏等并发症。MRI显示大多数病例中ACL移植物位置良好，移植物信号质量良好。然而，试验组3例患者和对照组4例患者在股骨-肌腱移植物界面处发现混合高信号和滑膜液存在，提示韧带重塑不良。试验组MRI评分为3.53±1.13，对照组为3.2~±0.92，差异无统计学意义（=0.936，=0.356）。二次关节镜检查显示试验组韧带重塑评分高于对照组（=3.248，=0.014），但滑膜覆盖评分和软骨修复发生率差异无统计学意义（=2.190，=0.064；=0.090，=0.764）。
PRP应用于同种异体ACL重建可改善膝关节功能并减轻术后疼痛，还可能加速移植物重塑。
