关节镜手术联合富血小板血浆治疗半月板损伤临床疗效

The clinical efficacy of arthroscopic surgery combined with platelet-rich plasma in meniscus injury patients

目的评价富血小板血浆（PRP）应用于膝关节半月板损伤行关节镜缝合修复术后患者的临床效果。方法选择2013年5月至2014年5月半月板损伤患者28例,采用随机对照方法将患者分为两组：PRP组14例,为关节镜联合应用PRP组;关节镜组14例,为单纯关节镜治疗组。随访时间3-12个月,观察两组患者治疗后Lysholm评分、膝关节损伤和骨关节炎结果评分（KOOS）及临床疗效。结果随访发现两组患者术后分别有1例患者在术后1年接受半月板切除术,其余患者关节症状均好转;与治疗前比较,两组患者治疗后Lysholm评分显著提高（P〈0.01）,治疗后两组患者间比较差异无统计学意义（P〉0.05）;两组患者治疗后KOOS评分指标中,疼痛和体育运动评分比较差异有统计学意义（P〈0.05）,其余指标比较差异无统计学意义（P〉0.05）。结论关节镜下行半月板损伤修复手术有创伤小、恢复快及并发症少等优点。联合应用PRP治疗,其临床疗效改善并不明显,进一步探讨PRP在半月板损伤修复中的临床作用,未来需要更多前瞻性研究。

Objective To evaluate the clinical efficacy of platelet-rich plasma（PRP）combined arthroscopic suture repair in the treatment of knee joint meniscus injury.Methods Totally 28 patients suffered from meniscus injury of knee joint during May2013 to May 2014 were randomly divided into 2groups：PRP group（n=14）,arthroscopy suture repair combined with PRP;Arthroscopy group（n=14）,arthroscopic suture repair was the only treatment.Followed up for 3to 12 months,lysholm knee score scale（LKSS）,knee injury and osteoarthritis score（KOOS）and complication were recorded.Results One year follow-up showed that one patient of each groups were found to required knee joint meniscectomy,the rest of the joints in patients with symptoms were improved.The Lysholm score in two groups was significantly improved after treatment（P〈0.01）,but there was no significant difference between the two groups after treatment（P〉0.05）.The pian and sport score of KOSS had significantly differences in two groups（P〈0.05）,and other indicators had no statistically significant difference（P〉0.05）.Conclusion Arthroscopic meniscus injury repair has the advantages of less invasive,faster recovery and fewer complications.Clinical efficacy improvement was not significant combined with PRP treatment.We need more RCTs and cases to investigate the clinical efficacy in future.