富含血小板血浆对前交叉韧带重建后腱骨愈合的影响

摘要

Objective:To investigate the effect of platelet-rich plasma (PRP) on tendon-bone healing in anterior cruciate ligament (ACL) reconstruction.Methods:50 cases of patients with ACL injury treated in our hospital from January 2015 to June 2016 were recruited and randomly divided into group A and group B,with 25 cases in each group.All patients were treated with ACL reconstruction.PRP (group A) or saline (group B) was used to soak autologous hamstring tendons and injected in articular cavity.Knee joint function was evaluated by Lysholm Scoring Scale and International Knee Documentation Committee (IKDC) evaluation form.After operation,the reduction degree of tibial tunnel was compared between the two groups.Results:There were significant differences in Lysholm score and IKDC scores before and after surgery in both groups (P ＜0.05).The percentage of excellent in Lysholm scores and IKDC scores in group A were similar to those in group B at 1 year post-operation (P ＞0.05).After 3 and 6 months operation,the reduction of tibial tunnel in group A was more evident than that in group B (P ＜0.05).Conclusion:ACL reconstruction assisted by arthroscope was effective in ACL injury,but PRP was not the essential factor influencing the postoperative knee joint function.The application of PRP could promote tendon-bone healing after ACL reconstruction.%目的:探讨富含血小板血浆(PRP)对前交叉韧带(ACL)重建后腱骨愈合的影响.方法:选取2015年1月至2016年6月广西医科大学第八附属医院收治的ACL损伤患者50例,按随机数字表法将患者分为A组和B组,每组25例.两组患者均行ACL重建术,A组采用PRP处理自体腘绳肌腱及关节腔注射,B组采用等量生理盐水处理自体腘绳肌腱及关节腔注射.于术前、术后采用Lysholm评分、国际膝关节文献委员会(IKDC)评分对两组的膝关节功能进行评分,比较两组术后胫骨隧道缩小程度.结果:两组患者手术前、后的Lysholm评分比较,差异均有统计学意义(均P＜0.05).两组患者术后1年的Lysholm评分及IKDC评分优良率比较差异均无统计学意义(均P＞0.05).A组术后3个月、6个月胫骨骨隧道缩小的程度较B组明显,差异有统计学意义(P＜0.05).结论:关节镜下自体腘绳肌腱重建ACL的临床效果良好,但PRP不是影响ACL重建术后膝关节功能恢复的决定因素;PRP可促进ACL重建后腱骨愈合.