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全膝关节置换术联合富血小板血浆疗法在膝创伤性关节炎中的应用价值。

Application Value of Total Knee Arthroplasty plus Platelet-Rich Plasma Therapy in Traumatic Arthritis of the Knee.

机构信息

Department of Orthopedics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000 Fujian, China.

Department of Orthopedics, Ningbo Beilun People's Hospital, Ningbo, 315800, Zhejiang, China.

出版信息

Comput Math Methods Med. 2022 Sep 26;2022:5483101. doi: 10.1155/2022/5483101. eCollection 2022.

Abstract

PURPOSE

This work is aimed at determining the application value of platelet-rich plasma (PRP) therapy plus total knee arthroplasty (TKA) in traumatic arthritis (TA) of the knee.

METHODS

A retrospective study was conducted on 78 cases of TA of the knee admitted between March 2021 and January 2022 to the Quanzhou First Hospital Affiliated to Fujian Medical University. Based on different treatment methods, 38 cases treated with TKA were assigned to the control group, and 40 cases intervened by PRP+TKA were included in the observation group. The operation time (OT), drainage volume (DV), total blood loss (TBL), incision inflammatory reaction rate, and grade A healing rate were recorded. Besides, preoperative and postoperative knee joint Hospital for Special Surgery (HSS) scores, knee joint pain assessed by visual analogue scale (VAS), knee joint range of motion (ROM), and bone metabolism parameters (osteocalcin (OST), total N-terminal propeptide of type I procollagen (tPINP), and -isomerized C-terminal telopeptides (-CTX)) were recorded.

RESULTS

The observation group showed reduced postoperative DV and TBL than the control group ( < 0.05). The two cohorts differed insignificantly in OT, incision inflammatory response rate, and grade A healing rate ( > 0.05). The observation group also had better improvement in the HSS score, pain VAS score, and knee ROM ( < 0.05). And higher postoperative OST and tPINP levels while lower -CTX were determined in the observation group ( < 0.05).

CONCLUSIONS

PRP+TKA can validly improve the levels of bone metabolism markers in patients with TA of the knee and promote their knee functional recovery, with favorable safety.

摘要

目的

本研究旨在探讨富血小板血浆(PRP)疗法联合全膝关节置换术(TKA)在膝创伤性关节炎(TA)中的应用价值。

方法

回顾性分析 2021 年 3 月至 2022 年 1 月福建医科大学附属泉州第一医院收治的 78 例膝 TA 患者,根据治疗方法的不同分为 TKA 组(38 例)和 PRP+TKA 组(40 例)。记录两组手术时间(OT)、引流量(DV)、总失血量(TBL)、切口炎症反应发生率及甲级愈合率,术前、术后膝关节美国特种外科医院(HSS)评分、视觉模拟评分法(VAS)评估的膝关节疼痛程度、膝关节活动度(ROM)及骨代谢指标[骨钙素(OST)、I 型前胶原氨基端肽(tPINP)、β-胶原特殊序列(β-CTX)]。

结果

观察组术后 DV 和 TBL 均低于对照组( < 0.05),OT、切口炎症反应发生率、甲级愈合率两组比较差异无统计学意义( > 0.05)。观察组 HSS 评分、VAS 评分、膝关节 ROM 改善均优于对照组( < 0.05),术后 OST、tPINP 水平高于对照组,-CTX 水平低于对照组( < 0.05)。

结论

PRP+TKA 能有效改善膝 TA 患者骨代谢标志物水平,促进膝关节功能恢复,且安全性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70ba/9529441/b421942ec2f2/CMMM2022-5483101.001.jpg

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