镜下微骨折联合富血小板血浆治疗距骨软骨损伤  

Arthroscopic microfracture combined with intraarticular injection of platelet rich plasma for osteochondral lesions of the talus

作　　者：徐明明 张焱[1] 刘云鹏 XU Ming-ming;ZHANG Yan;LIU Yun-peng(Department of Orthopaedics,The 904 Hospital,Joint Logistic Support Force of PLA,Wuxi 214044,China)

机构地区：[1]中国人民解放军联勤保障部第904医院,江苏无锡214044

出　　处：《中国矫形外科杂志》2021年第6期548-551,共4页Orthopedic Journal of China

摘　　要：[目的]介绍镜下微骨折联合富血小板血浆治疗距骨软骨损伤的手术技术和初步临床结果。[方法] 2016年3月~2018年12月,采用镜下微骨折联合富血小板血浆关节腔注射治疗距骨软骨损伤患者23例。行踝关节镜下清理术,显露损伤的软骨下骨,给予微骨折处理,于术毕时向踝关节腔注射PRP,间隔1周,分别再注射2次,共注射3次。[结果]所有患者均顺利完成手术,无严重手术并发症。随时间推移,患者VAS评分显著降低(P<0.005),而AOFAS评分显著增加(P<0.05)。术后12个月的核磁共振影像显示距骨软骨损伤信号较术前显著改善。[结论]镜下微骨折联合富血小板血浆治疗距骨软骨损伤操作简单,无严重医源性损伤和并发症,可以有效减轻疼痛和改善功能。[Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic microfracture combined with intraarticular injection of platelet rich plasma(PRP) for osteochondral lesions of the talus(OLT). [Methods] A total of 23 patients underwent this treatment for OLT from March 2016 to December 2018. Arthroscopic debridement was conducted to expose the subchondral bone of the lesion, followed by microfractures on the lesion. At the end of the operation, PRP was injected intraarticularly, which repeated for 2 times in an interval of 1 week, with 3 times of injection in total. [Results] All patients had operation conducted successfully without serious complications. The VAS score significantly decreased, whereas the AOFAS score significantly increased over time(P<0.05). In addition, MRI images at 12 months after operation showed that the signals of OLT significantly improved compared with those before operation.[Conclusion] Arthroscopic microfracture combined with PRP, a simple surgical intervention with minimized iatrogenic injury and complication, might considerably relieve pain and improves ankle function for OLT.

关 键 词：距骨软骨损伤 关节镜术 微骨折术 富血小板血浆 

分 类 号：R687.4[医药卫生—骨科学]