镜下股骨髋臼撞击症治疗是否使用富血小板血浆  

Arthroscopic correction of femoroacetabular impingement with or without intrarticular injecton of platelet-rich plasma

作　　者：张寒 张子安[2] 李涛[2] 景雷 翟喜成[1] 王英振[2] 陈冠宏[1] ZHANG Han;ZHANG Zi-an;LI Tao;JING Lei;ZHAI Xi-cheng;WANG Ying-zhen;CHEN Guan-hong(Department of Joint Surgery,Shanxian Central Hospital of Heze City,Heze 274300,Chian;Department of Joint Surgery,Affliated Hospital,Qingdao University,Qingdao 266000,Chinan)

机构地区：[1]山东省菏泽市单县中心医院关节外科,山东菏泽274300 [2]青岛大学附属医院关节外科,山东青岛266000

出　　处：《中国矫形外科杂志》2023年第9期797-802,共6页Orthopedic Journal of China

基　　金：山东省医药卫生科技发展计划项目(面上项目,编号:202104070500)。

摘　　要：[目的]评价髋关节镜下矫形联合应用富含血小板血浆(platelet-rich plasma,PRP)治疗股骨髋臼撞击综合征(femoroacetabular impingement,FAI)的早期临床效果。[方法]回顾性分析2021年1月-2022年1月本院镜下手术治疗FAI的32例患者的临床资料。根据医患沟通结果,17例采用髋关节镜手术联合关节内注射PRP(PRP组),15例采用单纯髋关节镜手术(非PRP组),比较两组围手术期、随访及影像结果。[结果]两组患者均顺利完成手术,术中无神经、血管损伤等严重并发症。两组手术时间、切口总长度、术中失血量、下地行走时间、切口愈合情况、住院时间的差异均无统计学意义(P>0.05)。所有患者均获得随访,随访时间平均(12.8±0.9)个月,两组完全负重活动时间的差异无统计学意义(P>0.05)。随术后时间推移,两组患者VAS评分显著减少(P<0.05),Harris评分、伸-屈ROM及内-外旋ROM评分显著增加(P<0.05)。术后1个月,PRP组在VAS评分[(3.1±1.5)vs(4.2±1.3),P<0.05]、Harris评分[(70.5±4.4)vs(64.2±2.8),P<0.05]、伸-屈ROM[(102.6±5.5)°vs(95.3±6.4)°,P<0.05]及内-外旋ROM[(38.3±4.2)°vs(35.2±2.8)°,P<0.05]均显著优于非PRP组(P<0.05);但是术后6个月及末次随访,两组上述指标的差异均无统计学意义(P>0.05)。影像方面,两组术后1个月及末次随访时,髋关节α角、LCEA、Offset值及均较术前显著改善(P<0.05),但T?nnis分级无显著变化(P>0.05)。相应时间点,两组上述影像指标的差异均无统计学意义(P>0.05)。[结论]髋关节镜联合PRP治疗FAI可减轻疼痛、改善髋关节功能并提高早期临床疗效。[Objective]To evaluate the early clinical outcomes of arthroscopic correction combined with intraarticular injection of platelet rich plasma(PRP)for femoroacetabular impingement(FAI).[Methods]A retrospective study was performed on 32 patients who underwent arthroscopic surgery for FAI in our hospital from January 2021 to January 2022.According to doctor-patient communication,17 patients received hip arthroscopy combined with intraarticular injection of PRP(PRP group),while the remaining 15 patients received hip arthroscopy only without PRP injection(non-PRP group).The perioperative period,follow-up and imaging data of the two groups were compared.[Results]All patients in both groups had operation performed successfully without neurovascular injury and other serious complications.There were no significant differences in operation time,total incision length,intraoperative blood loss,postoperative walking time,incision healing grade and hospital stay between the two groups(P<0.05).All patients were followed up for an average of(12.80.9)months,and there was no significant difference in the time to resume full weight-bearing activities between the two groups(P>0.05).The VAS score decreased significantly(P<0.05),whereas the Harris score,extension-flexion ROM and internal-external rotation ROM scores increased significantly in both groups over time postoperatively(P<0.05).The PRP group proved significantly superior to the non-PRP group in terms of VAS score[(3.1±1.5)us(4.2±1.3),P<0.05],Harris score[(70.5±4.4)us(64.2±2.8),P<0.05],extension-flexion R0M[(102.6±5.5)us(95.3±6.4)°,P<0.05]and internal-external rotation R0M[(38.3±4.2)°vs(35.2±2.8)°,P<0.05]1 month postoperatively,whereas which became not statistically significant between the two groups at 6 months after surgery and the last follow-up(P>0.05).Radiographically,theαangle,lateral center edge angle(LCEA)and femoral head-neck offset(FHNO)significantly improved(P<0.05),but Tonnis classification remained un-changed(P>0.05)in both groups at 1 month after surg

关 键 词：股骨髋臼撞击综合征 髋关节镜 矫形 富血小板血浆 

分 类 号：R681.57[医药卫生—骨科学]