关节镜下微骨折术+自体富血小板血浆治疗膝关节软骨退变的临床疗效研究  

Clinical study of arthroscopic injection of platelet rich plasma into subchondral bone in the treatment of knee cartilage degeneration

作　　者：项卫卫[1] 伦韦丹[2] 何华宾[1] 刘训志[1] 何澄[1] XIANG Wei-wei;LUN Wei-dan;HE Hua-bin;LIU Xun-zhi;HE Cheng(Department of Orthopedics,The First Affiliated Hospital of Gannan Medical University;Department of Hematology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院骨科,江西赣州341000 [2]赣南医学院第一附属医院血液病研究室,江西赣州341000

出　　处：《赣南医学院学报》2022年第10期1040-1042,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科技计划项目(GZ2021ZSF030)。

摘　　要：目的:探讨关节镜下富血小板血浆软骨下骨注射治疗膝关节软骨退变的临床疗效。方法:Kellgren-Lawrence分级Ⅱ~Ⅲ级膝骨关节炎住院患者40例,随机分为A、B两组,各20例。A组关节镜下软骨退变处打微孔处理,不注射自体富血小板血浆。B组关节镜下软骨退变处打微孔处理后富血小板血浆微孔内注射。患者在治疗前和完成全部注射后的第3个月应用视觉疼痛模拟评分(VAS)比较两组患者治疗前后的疼痛程度,应用国际膝关节文献委员会评分(IKDCS)、膝关节评分(LKS)比较两组患者治疗前后关节恢复情况。结果:A、B组治疗后VAS评分低于治疗前,IKDCS和LKS评分高于治疗前,差异有统计学意义(P<0.05),患者的症状比治疗前有改善。治疗前A、B组间VAS、IKDCS和LKS评分比较,差异无统计学意义(P>0.05),治疗后B组VAS评分低于A组,IKDCS和LKS评分高于A组,差异均有统计学意义(P<0.05)。结论:关节镜下富血小板血浆软骨下骨注射治疗膝关节骨关节炎,能有效修复软骨细胞,改善关节功能。Objective:To explore the clinical study of arthroscopic injection of platelet rich plasma into subchondral bone in the treatment of knee cartilage degeneration.Methods :A total of 40 cases of Kellgren Lawrence grade Ⅱ-Ⅲ knee osteoarthritis were randomly divided into two groups:20 cases in group A and 20 cases in group B. In group A,micropores were made at the cartilage degeneration under arthroscopy without PRP injection. In group B,platelet rich plasma was injected into micropores after micropores were made at the cartilage degeneration under arthroscopy. The patients applied visual pain simulation score before treatment and the third month after completion of all injections VAS of the pain degree of the two groups before and after treatment was compared,and the International Knee Literature Committee score IKDCs and knee score were used,LKS of the joint recovery of the two groups before and after treatment was compared.Results:After treatment,the VAS scores ofthe two groups werelower than those before treatment,the IKDCS and LKS scores were higher than those before treatment,the patients’ symptoms were improved compared with those before treament,with statistical significance(P<0. 05). The scores of VAS,IKDCS and LKS of the two groups before treatment were with no statistical significance(P>0. 05). The scores of VAS,IKDCs and LKS in group B were significantly improved and better than that of group A after treatment(P<0. 05).Conclusion:Arthroscopic platelet rich plasma subchondral bone injection in the treatment of KOA can effectively relieve knee pain and improve joint function.

关 键 词：膝骨关节炎 富血小板血浆 关节镜 软骨下骨 

分 类 号：R684.3[医药卫生—骨科学]