超声引导下PRP关节腔内精准注射辅助全内重建术在后交叉韧带损伤中的应用研究  

Study on application of ultrasound-guided intraarticular PRP precision injection assisted all-inside reconstruction for posterior cruciate ligament injury

作　　者：杨庆磊 喻红英 刘慧敏[3] 黄耀斌[1] 朱文刚[1] 张德[1] YANG Qing-lei;YU Hong-ying;LIU Hui-min(Department of Osteoarticular Medicine,Yuebei People's Hospital,Shaoguan 512000,China)

机构地区：[1]广东省韶关市粤北人民医院关节骨病科,512000 [2]广东省韶关市粤北人民医院药学部,512000 [3]广东省韶关市粤北人民医院超声影像科,512000

出　　处：《中国实用医药》2024年第10期25-29,共5页China Practical Medicine

基　　金：广东省韶关市卫生健康科研项目(项目编号:Y22038)。

摘　　要：目的 研究超声引导下富血小板血浆(PRP)关节腔内精准注射辅助全内重建术对后交叉韧带(PCL)损伤的临床治疗效果。方法 44例住院手术治疗的PCL损伤患者,按随机数字表法分为对照组与试验组,每组22例。试验组实施超声引导下PRP关节腔内精准注射辅助全内重建术治疗,对照组实施全内重建术治疗,两组术后均进行功能锻炼。分析两组患者手术及随访情况,比较两组患者术后6个月移植物磁共振成像(MRI)评分及手术前后双膝后向松弛度差异值、国际膝关节文献委员会膝关节评估表(IKDC)评分、踝-后足美国足踝外科医师协会(AOFAS)评分。结果 两组患者手术均顺利完成,手术切口均愈合良好,正常出院后遵医嘱进行康复训练,并定期复查,所有患者均随访超过1年,随访过程中未发现自体供腱区相关并发症,未发现胫骨凹陷。术前及术后3、6、12个月,试验组患者患侧膝关节IKDC评分分别为(51.6±3.7)、(78.3±4.1)、(87.5±2.6)、(92.2±2.1)分,对照组分别为(50.5±4.7)、(74.8±4.2)、(82.9±4.0)、(90.2±3.1)分。术后3、6、12个月,两组患者患侧膝关节IKDC评分均较术前显著改善,同时术后6、12个月较术后3个月显著改善,术后12个月较术后6个月显著改善,差异均有统计学意义(P<0.05)。试验组术后3、6、12个月患侧膝关节IKDC评分均显著优于对照组,差异均有统计学意义(P<0.05)。术前及术后3、6、12个月,试验组患者患侧踝-后足AOFAS评分分别为(98.7±1.0)、(98.4±0.8)、(98.5±0.9)、(98.6±0.8)分,对照组分别为(98.2±0.9)、(98.0±0.8)、(98.3±0.9)、(98.4±1.0)分。术后第3、6、12个月,两组患者患侧踝-后足AOFAS评分与术前比较均无显著性差异(P>0.05);两组患者术前及术后3、6、12个月患侧踝-后足AOFAS评分组间比较无统计学差异(P>0.05)。术后6个月复查膝关节MRI提示两组患者的重建韧带均走行良好,腱骨愈合情况满意。试验组术后6个Objective To study the clinical effect of ultrasound-guided intraarticular platelet rich plasma(PRP)precision injection assisted all-inside reconstruction for posterior cruciate ligament(PCL)injury.Methods 44 patients with PCL injuries who were hospitalized for surgical treatment were divided into a control group and an experimental group according to the random number table method,with 22 cases in each group.The experimental group underwent ultrasound-guided intraarticular PRP precision injection assisted all-inside reconstruction,while the control group underwent all-inside reconstruction surgery.Both groups underwent functional exercise after surgery.The surgery and follow-up conditions of the two groups were analyzed,and the magnetic resonance imaging(MRI)scores of the grafts at 6 months postoperatively and the difference of the posterior laxity of both knees preoperatively and postoperatively,the International Knee Documentation Committee Knee Evaluation(IKDC)scores,and the American Orthopedic Foot and Ankle Society(AOFAS)ankle hindfoot score were compared between the two groups.Results All patients in the two groups successfully completed the operation,and the surgical incisions healed well.After normal discharge,rehabilitation training was carried out according to the doctor's advice,and regular review was conducted.All patients were followed up for more than 1 year,and no complications related to the autodonor tendon area were found during the follow-up.Preoperatively and at 3,6,and 12 months postoperatively,the IKDC scores of the affected knee joints of the patients in the experimental group were(51.6±3.7),(78.3±4.1),(87.5±2.6),and(92.2±2.1)points,and those of the control group were(50.5±4.7),(74.8±4.2),(82.9±4.0),and(90.2±3.1)points.At 3,6,and 12 months postoperatively,the IKDC scores of the affected knee joints of patients in both groups were significantly improved compared with those preoperatively;while the improvement at 6 and 12 months postoperatively were more significant compared with tha

关 键 词：超声引导 富血小板血浆 全内重建术 后交叉韧带 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]