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富血小板血浆注射治疗慢性外侧踝关节不稳:病例系列

Platelet-Rich Plasma Injections in Chronic Lateral Ankle Instability: A Case Series.

作者信息

Medina-Porqueres Ivan, Martin-Garcia Pablo, Sanz-De-Diego Sofia, Reyes-Eldblom Marcelo, Moya-Torrecilla Francisco, Mondragon-Cortes Rafael, Rosado-Velazquez Daniel, Gomez-Caceres Abel

机构信息

Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain.

Medical Services, Malaga Football Club, 29011 Malaga, Spain.

出版信息

Biomedicines. 2024 Apr 26;12(5):963. doi: 10.3390/biomedicines12050963.

Abstract

The platelet-rich plasma (PRP) approach may be an effective treatment for joint and cartilage pathologies. However, the rationale for its effectiveness on joint instability is limited. This study aimed to assess the safety and effectiveness of PRP injections in patients with chronic lateral ankle instability (CLAI). This retrospective study was performed at a single-center outpatient clinic between January 2015 and February 2023 and included pre-intervention assessment and short-term follow-up. Patients were excluded if they had received previous surgical treatment or had constitutional hyperlaxity, systemic diseases, or grade II or III osteoarthritis. The clinical and functional evaluation consisted of the Karlsson score, the Cumberland Ankle Instability Tool (CAIT), Good's grading system, the patient's subjective satisfaction level, and the time required to return to exercise. The entire PRP therapy regime consisted of three PRP administrations at 7-day intervals and follow-up appointments. PRP was administered both intraarticularly and into talofibular ligaments. A total of 47 consecutive patients with CLAI were included, 11 were female (23.4%), with a mean age at intervention of 31.19 ± 9.74 years. A statistically significant improvement was found in the CAIT and Karlsson scores at 3 months (27.74 ± 1.68 and 96.45 ± 4.28, respectively) relative to the pre-intervention status (10.26 ± 4.33 and 42.26 ± 14.9, respectively, < 0.000). The mean follow-up of patients with CLAI was 17.94 ± 3.25 weeks. This study represents successful short-term functional and clinical outcomes in patients with CLAI after PRP treatment, with no adverse effects. It demonstrates the feasibility of a randomized controlled trial to further assess this therapy.

摘要

富含血小板血浆(PRP)疗法可能是治疗关节和软骨病变的有效方法。然而,其对关节不稳定有效性的理论依据有限。本研究旨在评估PRP注射治疗慢性外侧踝关节不稳定(CLAI)患者的安全性和有效性。这项回顾性研究于2015年1月至2023年2月在单中心门诊进行,包括干预前评估和短期随访。如果患者曾接受过手术治疗、有先天性关节过度松弛、全身性疾病或II级或III级骨关节炎,则被排除在外。临床和功能评估包括卡尔森评分、坎伯兰踝关节不稳定工具(CAIT)、古德分级系统、患者主观满意度水平以及恢复运动所需的时间。整个PRP治疗方案包括每隔7天进行三次PRP注射以及随访预约。PRP通过关节内注射和注入距腓韧带。总共纳入了47例连续的CLAI患者,其中11例为女性(23.4%),干预时的平均年龄为31.19±9.74岁。与干预前状态相比,3个月时CAIT和卡尔森评分有统计学意义的改善(分别为27.74±1.68和96.45±4.28)(干预前分别为10.26±4.33和42.26±14.9,<0.000)。CLAI患者的平均随访时间为17.94±3.25周。本研究表明PRP治疗后CLAI患者取得了成功的短期功能和临床结果,且无不良反应。它证明了进行随机对照试验以进一步评估这种疗法的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaa4/11118008/f09a43b8fd6c/biomedicines-12-00963-g001.jpg

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