富血小板血浆治疗肩袖损伤的研究进展

A review of platelet-rich plasma in the treatment of rotator cuff injury

肩袖损伤是肩关节常见损伤之一。其腱骨结合部位为骨、纤维软骨、肌腱多层结构移行的特殊组织,同时又是肩关节的应力集中点,因此一旦发生损伤常难以自愈。虽然可以通过手术治疗的方式对肩袖组织进行修补,但术后较高的再撕裂率仍是影响预后的一个重要因素。富血小板血浆(platelet-rich plasma,PRP)由自体全血浓缩得到,其血小板浓度高于全血基线水平且包含多种生长因子等血液成分,因此被广泛应用在骨科、皮肤科及口腔科等领域。近年来,PRP在肩袖损伤中的应用受到关注,可在调节炎症、血管生成、基质合成和组织重塑方面辅助肩袖损伤的愈合。但目前文献报道中PRP治疗肩袖损伤的疗效差异较大,其不同成分、给药方式及患者肩袖损伤类型等因素对疗效的影响不同。本文以PRP治疗肩袖损伤为核心,系统阐述不同研究间的差异,揭示不同成分、给药形式对PRP疗效的影响,为其在肩袖损伤治疗中的合理应用提供参考,同时为今后的研究提供理论基础。

Rotator cuff injury is one of the common injuries of the shoulder joint.The tendon-bone interface is the special organizational structure of the multi-layer structure of bone,fibrocartilage and tendon.Further,it has stress concentration point.Thus,rotator cuff injury is often difficult to heal spontaneously once injuries and it has a higher re-tear rate after surgical intervention.Platelet-rich plasma(PRP)is obtained by concentrating autologous whole blood.Its platelet concentration is higher than the baseline level of whole blood.It also contains various growth factors and other blood components.At present,it has been widely used in treating orthopedics,skin and oral disorders.In recent years,the application of PRP in rotator cuff injury has attracted attention.PRP can assist the treatment of rotator cuff injury in regulating inflammation,angiogenesis,matrix synthesis and tissue remodeling.The use of PRP after rotator cuff repair can improve the postoperative shoulder joint function score,relieve postoperative pain in the short term,and effectively reduce the rotator cuff re-tear rate.However,the efficacy of PRP in treating rotator cuff injuries is affected by many factors,such as the type of PRP,the severity of rotator cuff tear,and different using approaches.Currently,we focus on PRP in the treatment of rotator cuff injury,aiming to systematically explain the differences among different studies and reveal the differences in the efficacy of PRP with varied components and different forms of administration.Moreover,we want to provide a reference for the proper and rational use of PRP in the treatment of various rotator cuff injuries.Meanwhile,the present review could provide a basis for future researches in the application of PRP for rotator cuff injury.