富血小板血浆对肩关节镜下肩袖修补术疗效的影响

EFFECTS OF PLATELET-RICH PLASMA ON THE OUTCOME OF ARTHROSCOPIC ROTATOR CUFF REPAIR

目的观察富血小板血浆(PRP)对肩关节镜下肩袖修补术术后效果的影响。方法选取2015年1月—2021年7月于本院关节外科就诊并接受肩关节镜下肩袖缝合术治疗的肩袖损伤病人78例,术中联合使用PRP治疗的40例病人为试验组,未使用PRP治疗的38例病人为对照组。比较两组手术前和术后1个月、3个月、1年的视觉模拟疼痛评分(VAS评分)、美国加州大学肩关节评分(UCLA评分)、肩关节Constant-Murley评分、前屈角度、外展角度、外旋角度的差别。结果试验组平均住院时间短于对照组(t=2.22,P<0.05),试验组术后1个月及3个月UCLA评分和Constant-Murley评分均大于对照组(F=11.99~74.15,P<0.05);试验组术后1个月的前屈、外展、外旋角度大于对照组(F=8.43~28.88,P<0.05);试验组病人术后3个月的前屈和外展角度大于对照组(F=28.03、33.60,P<0.05)。结论肩关节注射PRP在肩袖损伤修补术后短期效果明显,能够加快肩关节功能和活动度的恢复,但远期效果相比单纯肩关节镜下肩袖修补术并不显著。

Objective To investigate the effects of platelet-rich plasma(PRP)on the outcome of arthroscopic rotator cuff repair.Methods We included 78 patients who underwent an arthroscopic surgery to repair an injured rotator cuff at the department of joint surgery of our hospital from January 2015 to July 2021.Forty cases received PRP treatment(experimental group),while 38 cases did not(control group).The two groups were compared in terms of the visual analogue scale score,University of California at Los Angeles(UCLA)shoulder score,Constant-Murley shoulder score,range of flexion,range of abduction,and range of external rotation before operation and 1 month,3 month,and 1 year after operation.Results The mean length of hospital stay of the experimental group was significantly shorter than that of the control group(t=2.22,P<0.05).The UCLA scores and Constant-Murley scores at 1 month and 3 month after operation were significantly higher in the experimental group than in the control group(F=11.99-74.15,P<0.05).The experimental group showed significantly greater degrees of flexion,abduction,and external rotation at 1 month after operation(F=8.43-28.88,P<0.05)and significantly greater degrees of flexion and abduction at 3 month after operation(F=28.03,33.60,P<0.05)compared with the control group.Conclusion Injection of PRP into the shoulder joint can improve the short-term efficacy of arthroscopic rotator cuff repair to promote the recovery of shoulder joint’s function and range of motion,but no superior long-term effects were observed.