Dai Wen-Li, Zhang Hua, Lin Ze-Ming, Shi Zhan-Jun, Wang Jian
Department of Orthopedic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road, Guangzhou, 510515, China.
Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China.
BMC Musculoskelet Disord. 2019 Mar 18;20(1):113. doi: 10.1186/s12891-019-2500-9.
To evaluate the clinical results of arthroscopic repair with or without platelet-rich plasma (PRP) for tears of the discoid lateral meniscus (DLM).
Twenty-nine patients with DLM tears within a stable knee were arthroscopically treated with meniscal suture repair. Of those, 14 were augmented with platelet-rich plasma (PRP), and 15 were performed without PRP augmentation. Patients were evaluated at baseline (the day before surgery) and then 12 and 24 months after the last injection. Evaluation included the Lysholm score, and Ikeuchi grade, Visual analogue score (VAS) for pain and failure rate. Failure was defined by patients developing symptoms of joint line pain, locking, swelling or requiring repeat arthroscopy.
There was no difference in the failure rate in the PRP group (1 of 14) compared with the non-PRP group (2 of 15) (P = 0.58). Statistically significant improvement in Lysholm score, Ikeuchi grade and VAS for pain was documented at the last follow-up compared with baseline in both PRP and non-PRP group. No significantly difference was found between the PRP group and non-PRP group on Lysholm score, Ikeuchi grade and VAS for pain at the last follow-up. In the univariate analysis of each variable, younger age (P = 0.036) and longer follow-up duration (P = 0.043) were statistically associated with a better function improvement. Whereas in multivariate analysis, only younger age (P = 0.004) was significantly associated with a better function improvement.
With regard to clinical evaluations in arthroscopic repair for DLM tears, PRP group had similar effect in pain relief and functional improvement to non-PRP group at mid-term follow-up. Future larger prospective studies with a longer follow-up are needed to determine whether PRP should be used with DLM repair.
评估关节镜下修复伴或不伴富血小板血浆（PRP）治疗盘状外侧半月板（DLM）撕裂的临床效果。
对29例膝关节稳定的DLM撕裂患者进行关节镜下半月板缝合修复治疗。其中14例使用富血小板血浆（PRP）增强修复，15例未使用PRP增强修复。在基线期（手术前一天）以及最后一次注射后12个月和24个月对患者进行评估。评估内容包括Lysholm评分、池内分级、疼痛视觉模拟评分（VAS）和失败率。失败的定义为患者出现关节线疼痛、绞锁、肿胀症状或需要再次进行关节镜检查。
PRP组（14例中的1例）与非PRP组（15例中的2例）的失败率无差异（P = 0.58）。与基线相比，PRP组和非PRP组在最后一次随访时Lysholm评分、池内分级和疼痛VAS均有统计学意义的显著改善。在最后一次随访时，PRP组和非PRP组在Lysholm评分、池内分级和疼痛VAS方面无显著差异。在对每个变量的单因素分析中，年龄较小（P = 0.036）和随访时间较长（P = 0.043）与功能改善较好有统计学关联。而在多因素分析中，只有年龄较小（P = 0.004）与功能改善较好有显著关联。
对于DLM撕裂关节镜修复的临床评估，中期随访时PRP组在缓解疼痛和功能改善方面与非PRP组效果相似。需要未来进行更大规模、更长随访时间的前瞻性研究来确定PRP是否应用于DLM修复。
