富血小板血浆增强对内镜辅助经皮跟腱修复的影响。
Effect of Platelet-Rich Plasma Augmentation on Endoscopy-Assisted Percutaneous Achilles Tendon Repair.
作者信息
Hung Chun-Yu, Lin Shih-Jie, Yeh Chia-Yi, Yeh Wen-Ling
机构信息
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Yunlin 638, Taiwan.
Department of Orthopedic Surgery, Jen-Ai Hospital, Taichung 412, Taiwan.
出版信息
J Clin Med. 2022 Sep 14;11(18):5389. doi: 10.3390/jcm11185389.
Background: Achilles tendon ruptures are one of the most common sports injuries. Recently, platelet-rich plasma (PRP) has been widely used in tendon-related disorders to enhance tendon healing. However, studies regarding PRP treatment in Achilles tendon rupture show inconsistent results. The purpose of this study was to evaluate the effectiveness of PRP in patients with acute Achilles tendon rupture treated with endoscopy-assisted percutaneous repair. Methods: A total of 62 patients with acute Achilles tendon rupture treated with surgical repair from January 2014 to December 2018 were enrolled in this study. Surgical repair in conjunction with PRP augmentation after surgery was classified as the PRP group. Surgical repair without PRP augmentation was classified as the non-PRP group. All patients were followed up at least 2 years post-operation. The outcomes were evaluated on the basis of rate of return to sports, time to return to play, Achilles Tendon Total Rupture Score (ATRS), calf circumference ratio, ankle range of motion (ROM) and complications following surgery. Results: At 2-year follow-up, the ATRS score was not significantly different between groups (p = 0.8), but the ATRS score in both groups improved with time. Rate of return to sports and time to return to play were not different between the two groups (p = 1.00). Moreover, calf circumference ratio and ankle ROM were evaluated at 6-month, 12-month, 18-month and 24-month follow-ups. At 6 months, the PRP group had better ankle ROM (p = 0.003) and a higher calf circumference ratio (p = 0.011); however, at the 24-month evaluation, there were no between-group differences regarding calf circumference ratio, ankle dorsiflexion and plantarflexion (p > 0.05). Conclusion: We show that PRP augmentation in Achilles tendon surgery did not yield superior functional and clinical outcomes. Therefore, clinicians should inform patients of the above information when undergoing Achilles tendon surgery and offer correct expectations to family and patients regrading PRP treatment.
背景
跟腱断裂是最常见的运动损伤之一。近年来，富血小板血浆（PRP）已广泛应用于肌腱相关疾病以促进肌腱愈合。然而，关于PRP治疗跟腱断裂的研究结果并不一致。本研究旨在评估PRP在接受内镜辅助经皮修复的急性跟腱断裂患者中的有效性。方法：本研究纳入了2014年1月至2018年12月期间接受手术修复的62例急性跟腱断裂患者。术后联合PRP增强的手术修复被归为PRP组。未进行PRP增强的手术修复被归为非PRP组。所有患者术后至少随访2年。根据恢复运动的比例、恢复运动的时间、跟腱总断裂评分（ATRS）、小腿围度比、踝关节活动范围（ROM）以及术后并发症来评估结果。结果：在2年随访时，两组间的ATRS评分无显著差异（p = 0.8），但两组的ATRS评分均随时间改善。两组间恢复运动的比例和恢复运动的时间无差异（p = 1.00）。此外，在6个月、12个月、18个月和24个月随访时评估小腿围度比和踝关节ROM。在6个月时，PRP组的踝关节ROM更好（p = 0.003）且小腿围度比更高（p = 0.011）；然而，在24个月评估时，两组间在小腿围度比、踝关节背屈和跖屈方面无差异（p > 0.05）。结论：我们发现跟腱手术中使用PRP增强并未产生更好的功能和临床结果。因此，临床医生在进行跟腱手术时应告知患者上述信息，并就PRP治疗向家属和患者提供正确的预期。
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