富血小板血浆对前交叉韧带重建术后骨隧道扩大化的影响

发布时间：2018-10-11 11:15

【摘要】：目的:探讨PRP对前交叉韧带重建后骨隧道扩大化的影响。方法:随机选取31例自体移植物重建前交叉韧带患者,随机分成实验组(16例)以及对照组(15例)。实验组术中及术后第2、3、4、5、6、7周返院,制作PRP约10ml后打入膝关节囊内,对照组在相同的时间用生理盐水代替。所有患者分别进行随访,随访内容为包括:体格检查:膝关节活动度(ROM)、Lachman试验;膝关节功能评分:术前及末次随访采用Lysholm评分表评价膝关节功能;影像学方面:所有患者在末次随访时行膝关节三维CT检查。骨隧道口测量:通过三维CT,检查骨隧道2个位置点(胫骨内口、股骨内口)。结果:PRP组CT:股骨骨道内口扩大程度2.062±0.814mm,发生率25%(4/16);胫骨骨道内口扩大程度1.969±0.884mm,发生率均为25%(4/16)。对照组CT:股骨骨道内口扩大程度2.433±1.193mm,发生率为33.33%(5/15);胫骨骨道内口扩大程度2.167±1.080mm,发生率均为33.33%(5/15)。PRP组与对照组骨隧道口扩大值比较结果(F=4.064,t=-1.133,P=0.0480.05)有统计学意义。膝关节活动度(ROM):术后随访未发现关节屈伸活动障碍者,PRP组以及对照组患侧关节活动度两者间差异无统计学意义(t=-1.844,P=0.069)。PRP组患者术前Lys holm评分为(41.937±3.991)分,术后为(95.875±2.363)分,两者差异有统计学意义(t=-46.516,P=0.0030.05);术前IKDC评分为(55.14±3.12)分,术后(85.91±3.17)分,两者差异有统计学意义(t=-24.07,P0.001)。对照组患者术前Lysholm评分为(43.60±3.776)分,术后为(95.333±2.500)分,两者差异有统计学意义(t=-44.258,P=0.0440.05);术前IKDC评分为(51.232±7.98)分,术后(83.76±4.37)分,两者差异有统计学意义(t=-27.38,P0.001)。PRP组与空白组术前术后Lysholm评分比较,P0.05,差异没有统计学意义,两组术前及术后IKDC评分比较,P0.05,差异没有统计学意义。结论:在交叉韧带重建中使用PRP可以促进腱骨愈合,减小骨隧道扩大化的程度。
[Abstract]:Objective: to investigate the effect of PRP on the expansion of bone tunnel after anterior cruciate ligament reconstruction. Methods: Thirty-one patients with anterior cruciate ligament reconstruction were randomly divided into experimental group (n = 16) and control group (n = 15). The patients in the experimental group returned to hospital 7 weeks after the operation and the second trimester, and the PRP was made about 10ml into the capsule of the knee joint. The control group was replaced by normal saline at the same time. All the patients were followed up, including: physical examination: knee motion (ROM), Lachman test; knee function score: Lysholm scale was used to evaluate knee function before and after the last follow-up. Imaging: three-dimensional CT examination of knee joint was performed in all patients at the last follow-up. Measurement of bone tunnel orifice: 2 position points of bone tunnel (tibia and femur) were examined by three dimensional CT,. Results: in the PRP group, the degree of expansion of the femoral meatus was 2.062 卤0.814 mm, the incidence rate was 25% (4 / 16), and the degree of expansion of the tibial bone canal was 1.969 卤0.884mm, the incidence rate was 25% (4 / 16). In the control group, the degree of enlargement of the femoral meatus was 2.433 卤1.193mm, the incidence rate was 33.33% (5 / 15), and the degree of the expansion of the tibial canal was 2.167 卤1.080mm, the incidence rate was 33.33% (F _ (4.064) ~ 1.133P0.0480.05) in the 5 / 15). PRP group compared with the control group (F _ (4.064) ~ 1.133P0.0480.05). There was no significant difference in the range of motion of the knee joint between the PRP group and the control group after (ROM):. The preoperative Lys holm score was (41.937 卤3.991) in the PRP group and (95.875 卤2.363) in the control group (P < 0.05). The IKDC score was (55.14 卤3.12) before operation and (85.91 卤3.17) after operation. The Lysholm score was (43.60 卤3.776) before operation and (95.333 卤2.500) after operation in the control group, the difference was statistically significant (t _ (44.258) P _ (0.044), the preoperative IKDC score was (51.232 卤7.98), the postoperative IKDC was (83.76 卤4.37). There was no significant difference between the two groups in Lysholm score before and after operation (P 0.05). There was no significant difference in IKDC score before and after operation between the two groups (P 0.05). Conclusion: the use of PRP in cruciate ligament reconstruction can promote tendon bone healing and reduce the extent of bone tunnel enlargement.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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