富血小板血浆或透明质酸关节内注射对 TPLO 治疗十字韧带断裂犬后肢功能恢复的影响:一项随机对照试验。

Effect of intra-articular platelet-rich plasma or hyaluronic acid on limb function recovery in dogs with TPLO for cranial cruciate ligament rupture: a randomised controlled trial.

机构信息

Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany.

出版信息

J Small Anim Pract. 2024 Apr;65(4):223-233. doi: 10.1111/jsap.13704. Epub 2024 Feb 10.

Abstract

OBJECTIVES

This study aimed to investigate the recovery of limb function following a single intra-articular injection of platelet-rich plasma or hyaluronic acid in dogs with cranial cruciate ligament rupture treated with tibial plateau levelling osteotomy compared to dogs receiving no injection intraoperatively.

MATERIALS AND METHODS

Sixty-two dogs with cranial cruciate ligament rupture, body weights of 20 to 40 kg, and no other orthopaedic conditions were enrolled in this prospective, randomised, double-blind, controlled study at the small animal clinic at LMU Munich. All dogs underwent tibial plateau levelling osteotomy. Based on random allocation, they received either a single intra-articular injection of platelet-rich plasma, hyaluronic acid or no injection intraoperatively. Gait analysis, clinical examinations, radiography of the stifle joint for osteoarthritis progression and two validated owner questionnaires were compared among groups at three timepoints postoperatively (6 weeks, 3 and 6 months). Limb function was primarily assessed by measuring the ground reaction forces.

RESULTS

At all times postoperatively, no differences were observed among groups regarding clinical examinations, osteoarthritis score values, ground reaction forces or owner questionnaires. All dogs showed significant improvement in limb function clinically, in all ground reaction forces and in the validated questionnaires. Osteoarthritis progressed minimally during rechecks in all dogs regardless of the additional injection or not.

CLINICAL SIGNIFICANCE

All dogs treated with tibial plateau levelling osteotomy for cranial cruciate ligament rupture showed improvements in limb function. No additive effect on faster recovery was demonstrated with the additional intra-articular injection of platelet-rich plasma or hyaluronic acid. Addition of platelet-rich plasma/hyaluronic acid injections during tibial plateau levelling osteotomy is unnecessary considering the lack of benefit observed up to 6 months postoperatively.

摘要

目的

本研究旨在比较接受胫骨平台平整术(TPLO)治疗的十字韧带断裂犬单次关节内注射富血小板血浆(PRP)或透明质酸后与未接受术中关节内注射的犬相比,四肢功能的恢复情况。

材料和方法

在慕尼黑大学小动物诊所进行了这项前瞻性、随机、双盲、对照研究,共纳入 62 只体重为 20 至 40 公斤、无其他骨科疾病的十字韧带断裂犬。所有犬均接受 TPLO 手术。根据随机分配,它们接受单次关节内注射 PRP、透明质酸或术中不注射。在术后 6 周、3 个月和 6 个月时,通过步态分析、临床检查、膝关节 X 线摄影评估骨关节炎进展以及两种经过验证的主人调查问卷对各组进行比较。肢体功能主要通过测量地面反力来评估。

结果

术后所有时间点,各组之间的临床检查、骨关节炎评分值、地面反力或主人调查问卷均无差异。所有犬的临床、所有地面反力和经过验证的问卷均显示出明显的肢体功能改善。所有犬在复查时关节炎均有轻微进展,但无论是否额外注射,关节炎均未加重。

临床意义

所有接受 TPLO 治疗十字韧带断裂的犬的肢体功能均有改善。额外关节内注射 PRP 或透明质酸并未显示出更快恢复的附加效果。考虑到术后 6 个月内未观察到益处,在 TPLO 中添加 PRP/透明质酸注射是不必要的。

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