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富血小板纤维蛋白基质在肩袖修复中的应用:一项前瞻性、单盲、随机研究,随访 2 年。

Platelet-rich plasma in fibrin matrix to augment rotator cuff repair: a prospective, single-blinded, randomized study with 2-year follow-up.

机构信息

TRIA Orthopaedic Center, Bloomington, MN, USA.

TRIA Orthopaedic Center, Bloomington, MN, USA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.

出版信息

J Shoulder Elbow Surg. 2018 Sep;27(9):1553-1563. doi: 10.1016/j.jse.2018.05.003. Epub 2018 Jul 9.

Abstract

BACKGROUND

Application of autologous platelet-rich plasma in fibrin matrix (PRPFM) improves tendon healing in patients undergoing arthroscopic rotator cuff repair. We performed a prospective, randomized, single-blinded study of 76 patients, with an α level of 5% and power of 80%.

MATERIALS AND METHODS

Seventy-six patients were divided into 2 randomized groups. The treatment group underwent arthroscopic rotator cuff repair with PRPFM. The control group did not receive the PRPFM treatment. Patients were evaluated preoperatively and at 6 months and 24 months postoperatively with validated clinical outcome scores, and dynamometer examination. A magnetic resonance imaging scan was performed at 6 months postoperatively.

RESULTS

The 2 randomized groups were homogeneous. Western Ontario Rotator Cuff (WORC) scores were not statistically different at any time interval. The WORC scores changed from 1257 to 139 in the control group and from 1106 to 99 in the PRPFM group over the 24-month study period. On the Simple Shoulder Test, improvement over the study period was noted from 45% to 96% in the control group and from 49% to 96% in the PRPFM group. Strength of the supraspinatus at 24 months by dynamometer testing was 99.8% in the control group and 96.3% in the PRPFM group. Infraspinatus strength was 104% in the control group and 103% in the PRPFM group. The secondary outcome of retear occurred at a rate of 19% for the double-row technique and 7.4% for the PRPFM technique at 6 months. All our results were statistically insignificant.

CONCLUSIONS

Our results showed no benefit from PRPFM used for rotator cuff repair according to the WORC Index, Simple Shoulder Test, and shoulder strength index.

摘要

背景

在关节镜肩袖修复术中应用富血小板纤维蛋白(PRPFM)可改善患者的肌腱愈合。我们进行了一项前瞻性、随机、单盲研究,共纳入 76 例患者,α 值为 5%,效能为 80%。

材料和方法

76 例患者被分为 2 个随机组。治疗组接受 PRPFM 关节镜肩袖修复术。对照组未接受 PRPFM 治疗。患者在术前、术后 6 个月和 24 个月接受了验证的临床结果评分和测力计检查。术后 6 个月进行磁共振成像扫描。

结果

2 个随机组是同质的。在任何时间间隔,Western Ontario Rotator Cuff(WORC)评分均无统计学差异。对照组 WORC 评分从 1257 分降至术后 24 个月的 139 分,PRPFM 组从 1106 分降至 99 分。在简易肩测试中,对照组研究期间的改善从 45%升至 96%,PRPFM 组从 49%升至 96%。测力计测试显示,术后 24 个月时,对照组的冈上肌力量为 99.8%,PRPFM 组为 96.3%。对照组的冈下肌力量为 104%,PRPFM 组为 103%。双排技术的次要转归为 6 个月时再撕裂率为 19%,PRPFM 技术为 7.4%。我们的所有结果均无统计学意义。

结论

根据 WORC 指数、简易肩测试和肩部力量指数,我们的结果显示 PRPFM 用于肩袖修复术并无获益。

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