Patellar Tendon Healing With Platelet-Rich Plasma A Prospective Randomized Controlled Trial
Patellar Tendon Healing With Platelet-Rich Plasma A Prospective Randomized Controlled Trial
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DOI：
10.1177/0363546512441344
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发表时间：
2012-06-01
影响因子：
4.8
通讯作者：
Hernandez, Arnaldo Jose
中科院分区：
文献类型：
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作者：
de Almeida, Adriano Marques;Demange, Marco Kawamura;Hernandez, Arnaldo Jose
背景：髌骨肌腱中央三分之一切除后愈合能力有限。富血小板血浆（PRP）可促进髌腱愈合。假设：在髌腱移植重建前交叉韧带（ACL） 6个月后，将PRP添加到髌腱收获部位可以改善供区愈合并改善临床结果。研究设计：随机对照试验；证据等级：1。方法：27例患者在ACL重建过程中，随机分为在髌腱收获部位接受PRP （n = 12）和不接受PRP （n = 15）两组。主要终点是6个月后髌腱愈合（间隙区）的磁共振成像（MRI）评估。次要结果是问卷调查和髌腱移植重建前交叉韧带的等速测试，比较两组的差异。结果：PRP组髌骨腱间隙面积明显减小(4.9 +/- 5.3 mm(2)；95%可信区间[CI]， 1.1-8.8)比对照组(9.4 +/- 4.4 mm(2)；95% ci, 6.6-12.2；P = .046)。术后即刻PRP组疼痛视觉模拟量表评分（3.8 +/- 1.0;95% CI, 3.18-4.49）低于对照组（5.1 +/- 1.4;95% CI, 4.24-5.90; P = 0.02）。6个月后，两组的问卷调查和等速测试结果均无差异。结论：我们发现PRP在6个月后的MRI上对髌骨肌腱收获部位愈合有积极的影响，并且在术后立即减轻了疼痛。6个月时，两组间问卷调查和等速测试结果无显著差异。
Background: The patellar tendon has limited ability to heal after harvesting its central third. Platelet-rich plasma (PRP) could improve patellar tendon healing.Hypothesis: Adding PRP to the patellar tendon harvest site would improve donor site healing and improve clinical outcome at 6 months after anterior cruciate ligament (ACL) reconstruction with a patellar tendon graft.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: Twenty-seven patients were randomly divided to receive (n = 12) or not receive (n = 15) PRP in the patellar tendon harvest site during ACL reconstruction. The primary outcome was magnetic resonance imaging (MRI) assessment of patellar tendon healing (gap area) after 6 months. Secondary outcomes were questionnaires and isokinetic testing of ACL reconstruction with a patellar tendon graft comparing both groups.Results: Patellar tendon gap area was significantly smaller in the PRP group (4.9 +/- 5.3 mm(2); 95% confidence interval [CI], 1.1-8.8) than in the control group (9.4 +/- 4.4 mm(2); 95% CI, 6.6-12.2; P = .046). Visual analog scale score for pain was lower in the PRP group immediately postoperatively (3.8 +/- 1.0; 95% CI, 3.18-4.49) than in the control group (5.1 +/- 1.4; 95% CI, 4.24-5.90; P = .02). There were no differences after 6 months in questionnaire and isokinetic testing results comparing both groups.Conclusion: We showed that PRP had a positive effect on patellar tendon harvest site healing on MRI after 6 months and also reduced pain in the immediate postoperative period. Questionnaire and isokinetic testing results were not different between the groups at 6 months.