Department of Orthopedic Surgery, Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Chengdu, China.
Department of Orthopedic Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
Orthop Surg. 2022 Jan;14(1):88-95. doi: 10.1111/os.13175. Epub 2021 Dec 6.
To investigate the effect of platelet-rich plasma on tendon-bone healing after anterior cruciate ligament reconstruction.
This retrospective study included 85 patients (range, 18-50 years; mean age, 33.95 ± 10.53 years; male/female, 49/36) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between August 2017 and June 2019 at our institute. The participants in the study group (n = 42) were injected with platelet-rich plasma at both ends of the tendon graft, while those in the control group (n = 43) received an injection of normal saline. Magnetic resonance imaging signal/noise quotient values of the femoral and tibial ends, knee Lysholm scores, and International Knee Documentation Committee scores were compared at 3, 6, and 12 months postoperatively.
The signal/noise quotient values of the femoral and tibial ends in both groups were higher at 6 months than at 3 and 12 months postoperatively. The signal/noise quotient values of the tibial end were significantly lower in the platelet-rich plasma group than in the normal saline group at all follow-up time points (P < 0.05). The signal/noise quotient values of the tibial and femoral ends in both groups were significantly different at 3, 6, and 12 months postoperatively (P < 0.05). Additionally, the signal/noise quotient values of the tibia were significantly lower than those of the femur in both groups (P < 0.05). The Lysholm and International Knee Documentation Committee scores were significantly better in the platelet-rich plasma group than in the normal saline group only at 3 months postoperatively. No complications, such as knee joint infection or vascular and nerve injuries, occurred in any of the 85 patients. The knee flexion of all patients were more than 90°, and the straight degree was 0°. No joint stiffness was observed in all patients.
Platelet-rich plasma can promote tendon-bone healing in grafts and can improve early postoperative knee joint function.
探讨富血小板血浆对前交叉韧带重建后腱骨愈合的影响。
本回顾性研究纳入了 2017 年 8 月至 2019 年 6 月在我院接受自体腘绳肌腱前交叉韧带重建的 85 例患者(年龄 18-50 岁,平均年龄 33.95±10.53 岁;男/女,49/36)。研究组(n=42)在肌腱移植物的两端注射富血小板血浆,对照组(n=43)注射生理盐水。比较两组患者术后 3、6、12 个月时股骨和胫骨端的磁共振成像信号/噪声比值、膝关节 Lysholm 评分和国际膝关节文献委员会评分。
两组患者术后 6 个月时股骨和胫骨端的信号/噪声比值均高于术后 3 个月和 12 个月。在所有随访时间点,研究组的胫骨端信号/噪声比值均明显低于对照组(P<0.05)。两组患者术后 3、6、12 个月时股骨和胫骨端的信号/噪声比值均有显著差异(P<0.05)。此外,两组胫骨端的信号/噪声比值均明显低于股骨端(P<0.05)。术后 3 个月,研究组的 Lysholm 和国际膝关节文献委员会评分明显优于对照组。85 例患者均未发生膝关节感染、血管和神经损伤等并发症。所有患者的膝关节屈曲度均大于 90°,伸直度为 0°。所有患者均未出现关节僵硬。
富血小板血浆可促进移植物中的腱骨愈合,并可改善术后早期膝关节功能。