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富白细胞富血小板血浆在关节镜下肩袖修复中的临床疗效:一项随机对照试验的荟萃分析

Leukocyte-Rich Platelet-Rich Plasma's Clinical Effectiveness in Arthroscopic Rotator Cuff Repair: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Tang Peiyuan, Huang Meihui, Xiao Wenfeng, Wen Ting, Volotovsky Pavel, Gerasimenko Mikhail, Chu Shiyao, Liu Shuguang, Zhang Kai, Li Yusheng

机构信息

Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Bioengineering (Basel). 2025 Jun 5;12(6):617. doi: 10.3390/bioengineering12060617.

Abstract

: Arthroscopic rotator cuff repair faces high retear risks in multi-tendon injuries due to insufficient biological healing; leukocyte-rich PRP may enhance tendon-bone integration through inflammatory modulation and growth factor release. : Four databases including PubMed, Embase, Cochrane Library, and Web of Science were searched until March 2025. Literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. GRADE was used to grade the strength of the evidence and the results. : The main finding of this study was that leukocyte-rich platelet-rich plasma combined with arthroscopic surgery for rotator cuff injuries can improve the Constant Score (MD = 1.13, 95% CI: 0.19, 2.07, = 0.02, I = 47%), American Shoulder and Elbow Surgeons score (MD = 6.02, 95% CI: 4.67, 7.36, < 0.01, I = 0%), and University of California, Los Angeles score (MD = 1.20, 95% CI: 0.34, 2.06, < 0.01, I = 0%) of patients with rotator cuff tear after treatment, and reduce the postoperative Visual Analog Scale score (MD = -0.62, 95% CI: -1.16, -0.08, = 0.02, I = 83%) of patients. However, there were no statistical differences regarding the Simple Shoulder Test (MD = 0.08, 95% CI: -0.23, 0.39, = 0.61, I = 5%). : Based on current evidence, the use of LR-PRP in arthroscopic rotator cuff repair could lessen postoperative pain and improve postoperative functional scores in individuals with rotator cuff injuries.

摘要

由于生物愈合不足,关节镜下肩袖修复在多肌腱损伤中面临较高的再撕裂风险;富含白细胞的富血小板血浆(LR-PRP)可能通过炎症调节和生长因子释放来增强肌腱-骨整合。检索了包括PubMed、Embase、Cochrane图书馆和Web of Science在内的四个数据库,直至2025年3月。根据纳入和排除标准进行文献筛选、质量评估和数据提取。采用GRADE对证据强度和结果进行分级。本研究的主要发现是,富含白细胞的富血小板血浆联合关节镜手术治疗肩袖损伤可提高患者治疗后的Constant评分(MD = 1.13,95%CI:0.19,2.07,P = 0.02,I² = 47%)、美国肩肘外科医师学会评分(MD = 6.02,95%CI:4.67,7.36,P < 0.01,I² = 0%)和加州大学洛杉矶分校评分(MD = 1.20, 95%CI: 0.34, 2.06, P < 0.01, I² = 0%),并降低患者术后视觉模拟量表评分(MD = -0.62,95%CI:-1.16,-0.08,P = 0.02,I² = 83%)。然而,简单肩部试验方面无统计学差异(MD = 0.08,95%CI:-0.23,0.39,P = 0.61,I² = 5%)。基于目前的证据,在关节镜下肩袖修复中使用LR-PRP可减轻肩袖损伤患者的术后疼痛并改善术后功能评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a177/12189123/1f3610d212cc/bioengineering-12-00617-g001.jpg

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