踝关节牵张术联合PRP关节注射治疗踝关节骨性关节炎

Ankle distraction combined with PRP joint injection in the treatment of ankle osteoarthritis

目的 评估踝关节牵张术联合PRP关节注射治疗踝关节骨性关节炎的疗效。方法 回顾性分析2017年1月-2019年2月收治的44例踝关节骨性关节炎患者临床资料,采用随机数字表法分为观察组23例,行踝关节牵张术联合PRP关节注射治疗;对照组21例,仅行踝关节牵张术治疗。采用SF-36生活质量(QOL)量表评估患者生活质量;采用美国矫形足踝协会踝后足(AOFAS)评分和踝骨关节炎量表(AOS)评分、关节活动范围(ROM)进行功能评价;对胫骨前表面(TAS)角、距骨倾斜(TT)角、胫骨内踝(TMM)角、距骨(TC)角、胫骨外表面(TLS)角和后脚对中(HFA)角进行评估。结果两组AOFAS评分、AOS疼痛和功能评分、SF-36评分均显著改善(P<0.05),观察组改善效果显著优于对照组,差异均有统计学意义(P<0.05);两组治疗后TAS、TT、TC、TLS和HFA角度均较术前显著改善(P<0.05),但治疗后组间比较TAS、TT、TC、TLS和HFA差异均无统计学意义(P>0.05)。结论 牵引关节成形术结合PRP关节注射可以恢复创伤后踝关节功能、缓解疼痛,是治疗终末期复杂性踝关节骨性关节炎值得推广的一种手术方式。

Objective To evaluate the effect of ankle distraction combined with PRP joint injection in the treatment of ankle osteoarthritis.Methods The clinical data of 44 patients with ankle osteoarthritis treated by ankle traction combined with PRP joint injection were analyzed.SF-36 quality of life(QOL)scale was used for patients'quality of life;The function was evaluated by the American Orthopaedic Foot and ankle Association(AOFAS)posterior ankle score and ankle osteoarthritis scale(AOS);The anterior tibial surface(TAS)angle,talus tilt(TT)angle,talus(TC)angle,tibial lateral surface(TLS)angle and posterior foot centering(HFA)angle were evaluated.Results The AOFAS score,AOS pain and function score and SF-36 score of two groups were significantly improved(P<0.05),and the angles of TAs,TT,TC,TLS and HFA were significantly improved(P<0.05).The improvement effect of the treatment group was significantly better than that of the control group(P<0.05).Conclusion Traction arthroplasty combined with PRP joint injection can restore the function of post-traumatic ankle arthritis and relieve pain.It is a surgical method worthy of popularization for end-stage complex ankle arthritis.