自体富血小板血浆对前交叉韧带重建术后腱骨愈合的影响

Effect of autologous platelet rich plasma on tendon-bone healing after anterior cruciate ligament reconstruction

目的探讨自体富血小板血浆(PRP)对前交叉韧带(ACL)重建术后腱骨愈合的影响。方法将94例ACL损伤患者分为PRP组(n=42)和对照组(n=52),2组均行ACL重建术,PRP组在肌腱移植前用PRP浸泡,并于术后第1、3、5周关节腔内注射PRP,对照组无特殊处理。比较术前及术后3、6、12个月国际膝关节文献委员会膝关节评估表(IKDC)评分、Lysholm评分以及疼痛视觉模拟评分法(VAS)评分,比较2组手术当天和术后3、12个月股骨骨道直径差异,比较2组术后愈合情况。结果术后3、6、12个月时,2组IKDC评分、Lysholm评分较术前升高,VAS评分较术前降低,差异有统计学意义(P<0.05);术后3、6个月时,2组患者IKDC评分、Lysholm评分、VAS评分相比,差异有统计学意义(P<0.05)。对照组手术当天、术后3个月、术后12个月股骨骨道直径两两比较,差异有统计学意义(P<0.05);对照组术后3、12个月股骨骨道直径大于PRP组,差异有统计学意义(P<0.05)。术后12个月,PRP组股骨隧道移植物愈合情况优于对照组,差异有统计学意义(P<0.05)。结论自体PRP应用于ACL重建术能提高腱骨愈合的速度,缩短ACL重建术后恢复时间,提高腱骨愈合质量。

Objective To investigate the effect of autologous platelet rich plasma(PRP)on tendon-bone healing after anterior cruciate ligament(ACL)reconstruction.Methods Totally 94 patients with ACL injury were divided into PRP group(n=42)and control group(n=52).ACL reconstruction was performed in both groups.In the PRP group,the tendon was soaked in PRP before transplantation,and PRP was injected into the articular cavity at 1,3 and 5 weeks after operation.There was no special treatment in the control group.The International Knee Documentation Committee knee joint evaluation form(IKDC)score,Lysholm score and Visual Analogue Scale(VAS)score were compared before operation and 3,6 and 12 months after operation.The differences of femoral canal diameter on the day of operation,3 and 12 months after operation were compared between the two groups,and the healing situation after operation was compared as well.Results At 3,6 and 12 months after operation,the IKDC score and Lysholm score in both groups were significantly higher than those before operation,while the VAS score was significantly lower than that before operation(P<0.05).At 3 and 6 months after operation,there were significant differences in IKDC score,Lysholm score and VAS score between the two groups(P<0.05).In the control group,there were significant differences in the diameters of femoral canal on the day of operation,3 months and 12 months after operation(P<0.05).The diameter of femoral canal in the control group was significantly larger than that in the PRP group at 3 and 12 months after operation(P<0.05).At 12 months after operation,the healing of femoral tunnel graft in the PRP group was better than that in the control group(P<0.05).Conclusion Application of autologous PRP in ACL reconstruction can accelerate the speed of tendon-bone healing,shorten the recovery time after ACL reconstruction,and improve the quality of tendon-bone healing.