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富血小板血浆术中注射治疗软骨膝关节损伤可改善患者预后。一项前瞻性随机试验。

Leucocyte-poor-platelet-rich plasma intra-operative injection in chondral knee injuries improve patients outcomes. A prospective randomized trial.

机构信息

Unort.E Hospital de Ortopedia, Av. Higienópolis no 2600, Londrina, PR, 86050-000, Brazil.

Departamento de Cirurgia, Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.

出版信息

Int Orthop. 2021 Feb;45(2):463-471. doi: 10.1007/s00264-020-04830-4. Epub 2020 Sep 29.

Abstract

PURPOSE

Evaluate the effects of intra-operative leucocyte-poor-platelet-rich plasma (PRP) (type P3-Bβ with endogenous activation) injection in International Cartilage Repair Society (ICRS) grade III knee chondral injuries treated by chondroplasties, to increase and ameliorate the repair tissue.

METHODS

Patients were divided into two groups. Group A (control) consisted of 31 patients and Group B (PRP) 33 patients, totaling 64 patients analyzed. Patients also could had associated injuries (meniscal and/or ACL) being equally divided between both groups to avoid bias. PRP was injected at the end of surgery in group B. The patient outcomes were assessed using subjective International Knee Documentation Committee (IKDC) form, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Tegner activity forms, prior to the surgery and three, six, 12, and 24 months after surgery (medium-term follow up).

RESULTS

IKDC and KOOS scores showed increase at each evaluation time points after surgery in both groups, but the treated Group (B) showed a higher increase with statistically significant difference. The Tegner activity scores were higher for the treated group only at six and 12 months.

CONCLUSION

Based on the subjective IKDC, KOOS, and Tegner scores, those patients affected by ICRS grade III chondral injuries undergoing arthroscopic chondroplasty who were also treated with PRP showed better and faster outcomes than the control group. Independently from the associated injury (meniscal or ACL). This difference could be measured for up to two years.

摘要

目的

评估术中富含白细胞的血小板血浆(PRP)(内源性激活的 P3-Bβ 型)注射在接受软骨成形术治疗的国际软骨修复学会(ICRS)III 级膝关节软骨损伤中的作用,以增加和改善修复组织。

方法

患者分为两组。A 组(对照组)包括 31 例患者,B 组(PRP 组)包括 33 例患者,共 64 例患者进行分析。两组患者还可能存在半月板和/或 ACL 等相关损伤,以避免偏倚。B 组在手术结束时注射 PRP。患者在手术前和手术后 3、6、12 和 24 个月(中期随访)使用主观国际膝关节文献委员会(IKDC)表格、膝关节损伤和骨关节炎结果评分(KOOS)和 Tegner 活动量表进行评估。

结果

两组患者在术后每个评估时间点的 IKDC 和 KOOS 评分均有所增加,但治疗组(B 组)的增加更为显著,具有统计学意义。仅在 6 个月和 12 个月时,治疗组的 Tegner 活动评分更高。

结论

基于主观 IKDC、KOOS 和 Tegner 评分,接受关节镜软骨成形术治疗的 ICRS 分级 III 型软骨损伤患者,在接受 PRP 治疗后,与对照组相比,其结果更好且恢复更快。与半月板或 ACL 等相关损伤无关。这种差异可在两年内测量到。

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