富血小板血浆在髌骨外侧高压症治疗中的应用  

Platelet-rich Plasma as a Treatment for Lateral Patellar Compression Syndrome

作　　者：张强 岳宪虎 李瑞 黄象艳 ZHANG Qiang;YUE Xianhu;LI Rui(Department of Orthopaedics,the 960th Hospital of the PLA Joint Logistice Support Force,Jinan,Shandong 250031)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院骨科,250031 [2]中国人民解放军联勤保障部队第九六〇医院输血医学科,250031

出　　处：《临床输血与检验》2023年第3期348-353,共6页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：山东省济南市临床医学科技创新计划(No.202225073)资助。

摘　　要：目的研究单采自体富血小板血浆(platelet-rich plasma,PRP)联合外侧支持带松解(lateral retinacular release,LRR)治疗髌骨外侧高压症(lateral patellar compression syndrome,LPCS)的临床疗效。方法回顾性分析2018年8月—2021年4月在我院骨科治疗的符合纳入标准的髌骨外侧高压症患者15例(22膝),分为试验组和对照组。试验组行关节镜下LRR术,术后予以单采自体PRP关节腔注射(单膝注射剂量5 mL,7天注射1次,3次为一个疗程);对照组仅行关节镜下LRR术。采用视觉模拟评分法(VAS)、髌股关节Kujala评分法对不同治疗方法的治疗效果进行比较。通过MRI影像学进一步评估试验组的治疗效果。结果随访时间12~13(12.4±0.5)月。手术前后VAS评分结果:试验组分别为5.64±0.54,1.46±0.28;对照组分别为5.46±0.37,2.55±0.28。试验组Kujala评分从手术前的61.09±4.40增加到手术后的90.73±1.94;对照组Kujala评分从手术前的66.82±3.84增加到手术后的82.82±2.53。两组患者术后膝关节疼痛症状及髌股关节功能评分均较术前显著改善(P<0.0001),而且试验组VAS评分和Kujala评分优于对照组(P<0.05)。MRI随访显示,试验组治疗后髌骨及股骨外髁骨髓水肿的容积减小。结论单采自体PRP关节腔注射联合LRR是治疗LPCS的有效手段。Objective To explore the clinical efficacy of autologous apheresis platelet-rich plasma(PRP)combined with lateral retinacular release(LRR)for the treatment of lateral patellar compression syndrome(LPCS).Methods A total of 15 patients(22 knees)with LPCS who met the inclusion criteria from August 2018 to April 2021 were retrospectively analyzed.They were divided into the experimental group and the control group.The experimental group underwent arthroscopic LRR surgery,followed by intra-articular injection of autologous PRP(5 mL injection per knee,once every 7 days,3 times as a course).The control group only underwent arthroscopic LRR surgery.Visual analog scale(VAS)and Kujala score were used to compare the therapeutic effects.The therapeutic effect of the experimental group was further evaluated by MRI imaging.Results The follow-up time was 12~13(12.4±0.5)months.VAS score before and after operation was 5.64±0.54 and 1.46±0.28 in the experimental group,respectively,5.46±0.37 and 2.55±0.28 in the control group.Kujala score increased from 61.09±4.40 to 90.73±1.94 in the experimental group.Kujala score increased from 66.82±3.84 to 82.82±2.53 in the control group.Postoperative knee pain symptoms and patellofemoral joint function scores of both groups were significantly improved compared with those before surgery(P<0.0001),and VAS score and Kujala score in the experimental group were better than those in the control group(P<0.05).MRI follow-up showed that the volume of bone marrow edema of the patella and external condyle in the experimental group reduced after treatment.Conclusion Intra-articular injection of autologous apheresis PRP combined with LRR is an effective method for the treatment of LPCS.

关 键 词：髌骨外侧高压症 外侧支持带松解 血细胞分离单采 富血小板血浆 

分 类 号：R874.5[医药卫生—运动医学]