Platelet-rich plasma versus platelet-poor plasma in the management of chronic diabetic foot ulcers: a comparative study

Non healing diabetic foot ulcers and the resulting potential amputations present significant costs to the health care system and reduce patient quality of life. The goal of diabetic foot ulcer treatment is to obtain wound closure as expeditiously as possible. The use of platelet-rich plasma (PRP) to enhance wound healing has increased dramatically over the last decade. However, controversies exist in the literature regarding the added benefit of this procedure. The aim of this study is to investigate the efficiency of platelet releasate on the healing of chronic diabetic ulcers in comparison with platelet-poor plasma (PPP). This study included 24 patients with chronic diabetic ulcers. They were systematically randomised into two groups: PRP group (n = 12) and PPP group (n = 12). The results showed that healing in PRP group was significantly faster (P < 0·005). PRP enhances healing of chronic diabetic foot ulcers.     

Platelet-rich plasma for muscle injuries: A systematic review of the basic science literature

BACKGROUND Platelet-rich plasma(PRP) is an increasingly used biologic adjunct for muscle injuries, as it is thought to expedite healing. Despite its widespread use, little is known regarding the mechanisms by which PRP produces its efficacious effects in some patients.AIM To clarify the effects of PRP on muscular pathologies at the cellular and tissue levels by evaluating the basic science literature.METHODS A systematic review of PubMed/MEDLINE and EMBASE databases was performed using the Preferred Reporting Items for Systematic Reviews and MetaAnalyses(PRISMA) guidelines and checklist. Level III in vivo and in vitro studies examining PRP effects on muscles, myocytes and/or myoblasts were eligible for inclusion. Extracted data included PRP preparation methods and study results.RESULTS Twenty-three studies were included(15 in vivo, 6 in vitro, 2 in vitro/in vivo). Only one reported a complete PRP cytology(platelets, and red and white blood cell counts). Five in vitro studies reported increased cellular proliferation, four reported increased gene expression, and three reported increased cellular differentiation. Five in vivo studies reported increased gene expression, three reported superior muscle regeneration, and seven reported improved histological quality of muscular tissue.CONCLUSION The basic science literature on the use of PRP in muscle pathology demonstrates that PRP treatment confers several potentially beneficial effects on healing in comparison to controls. Future research is needed to determine optimal cytology,dosing, timing, and delivery methods of PRP for muscle pathologies.     

Surgery for unilateral and bilateral patellar tendinopathy: a seven year comparative study

Purpose

Open surgery for patellar tendinopathy allows patients with unilateral and bilateral tendinopathy to return to high levels of physical activity.

Materials

Two groups of 23 athletes each underwent open surgical exploration for management of patellar tendinopathy. One group suffered from unilateral patellar tendinopathy (unilateral group), and the other group had bilateral (bilateral group) patellar tendinopathy. Maximum voluntary isometric contraction and anthropometric measures were assessed pre-operatively and at an average follow-up of seven years. The Victorian Institute of Sport Assessment (VISA)-P scoring system was also administered; functional outcomes were classified from excellent to poor according to a modification of Kelly’s criteria.

Results

At the final follow-up, in both groups, VISA-P scores were significantly improved compared with preoperative values, with no intergroup differences. Clinical results were excellent or good in 21 patients in the unilateral and 19 in the bilateral group. Twenty of 23 patients in the unilateral group and 17 of 23 in the bilateral group were still active in sports (p = 0.2). In the unilateral group, at the last follow-up, thigh volume and strength were significantly improved compared with baseline, with significant difference between operated and nonoperated limbs. In the bilateral group, there were no significant differences in thigh volume and strength between the dominant and nondominant limbs both before and after the index procedure.

Conclusions

This procedure is not technically demanding and provides a high rate of good and excellent outcomes in the long term.     

Platelet-rich plasma: New clinical application: A pilot study for treatment of jumper's knee

This study describes a simple, low-cost, minimally invasive way to apply PRP growth factors to chronic patellar tendinosis; 20 male athletes with a mean history of 20.7 months of pain received treatment, and outcomes were prospectively evaluated at 6 months follow-up. No severe adverse events were observed, and statistically significant improvements in all scores were recorded. The results suggest that this method may be safely used for the treatment of jumper's knee, by aiding the regeneration of tissue which otherwise has low healing potential.     

富血小板血浆与皮质类固醇治疗肩袖肌腱病疗效对比的Meta分析

目的：探讨富含血小板血浆（platelet-rich plasma,PRP）注射与皮质类固醇（corticosteroids,CS）注射治疗肩袖肌腱病在肩关节功能恢复、疼痛缓解和关节活动度方面的临床疗效。方法：计算机检索Cochrane Library,EMBASE,PebMed,中国知网（CNKI）,万方数据库中PRP注射与CS注射肩袖肌腱病的随机对照试验（randomized controlled trial,RCT）文献,检索时间为建库至2022年4月20日。由2名研究者根据纳入和排除标准,进行文献筛选、数据提取及质量评价,并采用Review Manager 5.4.1软件对提取的数据进行统计学分析。比较注射后短期（3~6周）、中期（8~12周）、长期（≥ 24周）的视觉模拟评分（visual analogue scale,VAS）,美国肩肘医师协会（American Shoulder and Elbow Surgeons,ASES）评分,西安大略肩袖疾病评分指数（Western Ontario Rotator Cuff Index,WORC）,以及肩关节活动度（range of motion,ROM）。结果：共纳入7篇RCT文献,共379例患者,其中PRP组188例,CS组191例。Meta分析结果显示：两组在短期和中期随访内VAS、ASES及WORC比较,差异无统计学意义（P>0.05）。长期随访ASES评分[MD=7.1,95% CI （2.06,12.14）,P=0.006]和VAS[MD=-1.55,95% CI （-2.65,-0.55）,P=0.002]比较,差异有统计学意义。两组ROM比较,差异无统计学意义（P>0.05）。结论：对于肩袖肌腱病的患者,PRP与CS在疼痛缓解及功能恢复方面的短期和中期随访疗效相似。然而,长期随访发现,PRP较CS在功能恢复和疼痛缓解方面体现出优势。肩关节活动度在整个随访期间无明显差异。     

Evidence for the use of PRP in chronic midsubstance Achilles tendinopathy: A systematic review with meta-analysis

BackgroundPlatelet-rich plasma (PRP) injections have been proposed as an additional therapy in the treatment of chronic midsubstance Achilles tendinopathy (AT). The use of PRP injections as pharmacological treatment added to a conservative approach has gained growing interest, but the efficacy remains highly debated. The varying methodological quality of the available studies may contribute to these contradictory results. The aim of this systematic review with meta-analysis was to establish the existing evidence of PRP injections for chronic midsubstance AT on the functional outcome, with a risk of bias assessment of each included study.MethodsAccording to the PRISMA guidelines systematic searches were performed in Embase, the Cochrane library and Pubmed on June 12, 2020 for relevant literature. Only clinical trials comparing PRP injections with placebo, additional to an eccentric training program, in midsubstance AT were included. The primary outcome was Victorian Institute of Sport Assessment - Achilles (VISA-A) score at 3, 6 and 12 months post-injection. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (Rob 2). As secondary outcome we assessed reported changes in tendon structure after PRP injections.ResultsA total of 367 studies were identified with the initial database search. Finally, four randomized controlled trials (RCTs) met inclusion criteria for systematic review and meta-analysis with data of 170 patients available for pooling. Results showed no difference in clinical outcome between the PRP and placebo group at different points in time using the VISA-A score as outcome parameter (3 months 0.23 (CI -0.45, 0.91); 6 months 0.83 (CI -0.26, 1.92); 12 months 0.83 (CI -0.77, 2.44)). The bias analysis showed a low or intermediate risk of bias profile for all studies which supports the good methodological quality of each included article. Finally, it is unclear whether PRP injections cause an improvement in tendon structure. However, no direct relationship between tendon structure and clinical presentation of AT could be found.ConclusionPRP has no clear additional value in management of chronic midsubstance Achilles tendinopathy and therefore should not be used as a first-line treatment option.     

富血小板血浆与体外冲击波治疗慢性跟腱止点腱病的疗效比较

目的:比较富血小板血浆(platelet rich plasma,PRP)与体外冲击波治疗慢性跟腱止点腱病的临床疗效。方法:2019年2月至2021年8月,根据病例选择最终纳入42例跟腱止点腱病患者,分为PRP组(20例28足)与冲击波组(22例29足)。PRP组男12例,女8例;年龄47.00(28.00,50.75)岁;病程7.00(6.00,7.00)个月;予患侧跟腱止点区域进行富血小板血浆注射治疗。冲击波组男16例,女6例;年龄42.00(35.75,47.25)岁;病程7.00(6.00,8.00)个月;予患侧跟腱止点区及小腿三头肌区域进行冲击波治疗。分别于治疗前及治疗后1、3、6个月采用疼痛视觉模拟评分(visual analogue scale,VAS)及维多利亚体育研究中心跟腱问卷表(Victorian Institute of Sport Assessment-Achilles,VISAA)评分进行疗效评价,并对所有患者进行满意度调查。结果:两组治疗1、3、6个月后VAS及VISA-A评分均较治疗前改善(P<0.05);PRP组治疗6个月后VAS及VISA-A评...     

Intraarticular injections (corticosteroid,hyaluronic acid,platelet rich plasma) for the knee osteoarthritis

Osteoarthritis (OA) is a complex “whole joint” disease pursued by inflammatory mediators, rather than purely a process of “wear and tear”. Besides cartilage degradation, synovitis, subchondral bone remodeling, degeneration of ligaments and menisci, and hypertrophy of the joint capsule take parts in the pathogenesis. Pain is the hallmark symptom of OA, but the extent to which structural pathology in OA contributes to the pain experience is still not well known. For the knee OA, intraarticular (IA) injection (corticosteroids, viscosupplements, blood-derived products) is preferred as the last nonoperative modality, if the other conservative treatment modalities are ineffective. IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA. IA hyaluronic acid (HA) injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk. But for HA injections, the cost-effectiveness is an important concern that patients must be informed about the efficacy of these preparations. Although more high-quality evidence is needed, recent studies indicate that IA platelet rich plasma injections are promising for relieving pain, improving knee function and quality of life, especially in younger patients, and in mild OA cases. The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction. But, there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.     

Acute traumatic rupture of the patellar tendon in pediatric population: Case series and review of the literature

BackgroundIntact knee extensor mechanism is required for the normal function of the lower extremity. Patellar tendon rupture is a relatively rare injury with peak age incidence around 40 years and usually occurs midsubstance. The occurrence of pure patellar tendon rupture without bony avulsion is an extremely rare injury in the pediatric population with few cases reported in the literature with limited information regarding frequency, complications, and outcomes in children. However, due to increased participation in sports and high-energy recreational activities during childhood, the frequency of such injuries has progressively increased.ObjectiveTo evaluate the frequency of pediatric patellar tendon rupture injuries and describe the radiological findings, treatment modalities, and outcome of such injuries.MethodsDemographic and clinical data on a series of patients who sustained patellar tendon rupture were reviewed. These data included age at time of injury, sex, laterality, mechanism of injury, associated injuries, complications, presence or absence of Osgood-Schlatter disease, diagnostic imaging such as plain radiographs and magnetic resonance images (MRI), surgical technique, method of fixation, period of postoperative immobilization, total duration of physiotherapy, time to return to sports activities and follow-up duration. Insall-Salvati ratio was calculated on the preoperative lateral x-ray. The functional outcome was evaluated with regard to final knee active range of motion (AROM), manual quadriceps muscle testing, and presence or the absence of terminal extension lag. Clinical outcome rating using knee society score (KSS) was performed and functional outcome was further classified according to the calculated score.ResultsFive male patients with patellar tendon rupture (7%) were identified among 71 pediatric patients who sustained acute traumatic injury of the knee extensor mechanism. The mean age at the time of injury was 13.6 years (range: 12–15 years). The injury occurred in relation to sports activities in 4 patients. Osteogenesis imperfecta and Osgood-Schlatter disease were identified in 2 patients. High riding patella is the hallmark diagnostic sign detected in plain x-ray with preoperative Insall-Salvati ratio ranged from 1.7 to 2.5. Three patients had pure soft tissue avulsion distally from the proximal tibia, 1 patient had pure soft tissue avulsion proximally from the inferior patellar pole, and 1 patient with midsubstance tendinous disruption. No associated intra-articular lesions were identified. Suture bridge double row technique, transpatellar suturing, and transosseous suturing through the proximal tibia were used for patellar tendon reinsertion. After a mean follow-up period of 18. 4 weeks (range: 10–30 weeks), patients achieved AROM ranging from 0 to 120° to 0–137° without terminal extension lag. The mean time to return to sports activity was 22 weeks (range: 13–30 weeks). Quadriceps muscle strength was 5/5 at the final follow-up visit in all patients; however, relative muscle atrophy was noted in comparison to the other side in one patient. The mean KSS was 91.8 points (range: 79–100 points) with excellent outcome in 4 patients and good outcome in 1 patient.ConclusionPatellar tendon rupture is rare in the pediatric population and represents 7% of pediatric patients who sustained acute traumatic injury of the knee extensor mechanism. Ruptures may occur midsubstance, or from proximal or distal insertions. High riding patella is the hallmark diagnostic sign for such injury. Although rare, it is considered a serious injury that necessitates early diagnosis and surgical intervention. Functional range of motion was obtained in all patients with different modalities of treatment.     

Platelet rich plasma and plasma rich in growth factors for split-thickness skin graft donor site treatment in the burn patient setting: A randomized clinical trial

IntroductionManagement of donor site morbidity in the setting of split thickness skin graft (STSG) is of crucial importance with no superior wound dressing described to date and the growing need of decreasing epithelializing time. The purpose of the study was to compare the standard of care using a hydrocolloid dressing to platelet rich plasma (PRP) and plasma rich in growth factors (PRGF) in order to determine its therapeutic potential in this setting.MethodsA randomized clinical trial was conducted in which each patient served as its own control. PRGF was obtained by means of freeze-thaw out of the PRP from the subject of the study. Patients from the study had three donor sites and each donor site received either to PRP, PRGF or the standard of care, hydrocolloid. The main variable was time to epithelialization, and secondary variables subject to study were pain, quality of the scar, complications and cost.Results20 patients were recruited with a total number of 60 donor sites to study. On the 8th post-operative day 55% and 45% of the sites treated with PRP and PRGF, respectively, complete epithelialization was observed as compared to 20% of the sites treated with hydrocolloid, statistical significance was achieved between the latter two (p = 0.036). The areas treated with PRP and PRGF received inferior values on the visual analog scale on post-op day 5 and 8 compared to hydrocolloid. Values on wound healing metrics were lower in the PRP when compared to hydrocolloid. No adverse effects were recorded.ConclusionDonor site of STSG treated with PRP in the setting of the burn patient decreased time to epithelialization. In our study a better pain control and in scar quality was observed in both, the PRP and PRGF group.     

The effectiveness of intralesional injection of platelet‐rich plasma in accelerating the healing of chronic ulcers: an experimental and clinical study

The purpose of this prospective experimental and clinical study is to evaluate the effectiveness of the intralesional injection of platelet‐rich plasma (PRP), in the management of non‐healing chronic wounds. Skin defects were created in the ears of 20 white New Zealand rabbits. In the study group, autologous PRP was injected intralesionally. The control group was treated conservatively. Nineteen out of 20 cases of the study group healed within a mean time of 24·9 days. In the control group, seven defects healed within a mean period of 26·7 days, seven ulcers did not heal at day 28 and in six cases a full thickness ear defect was recorded. For a 3‐year period, 26 patients with chronic ulcers underwent surgical debridement and intralesional injection of PRP. A histological study was performed before and 7 days after PRP injection. Ten patients healed within a mean period of 7 weeks. In 16 cases, PRP prepared the wound bed for the final and simpler reconstructive procedure. Intralesional injection is a newly described method for application of PRP and represents an effective therapeutic option when dealing with non‐healing wounds.     

The effects of dexamethasone on human patellar tendon stem cells: Implications for dexamethasone treatment of tendon injury

Injection of Dexamethasone (Dex) is commonly used in clinics to treat tendon injury such as tendinopathy because of its anti‐inflammatory capabilities. However, serious adverse effects have been reported as a result of Dex treatment, such as impaired tendon healing and tendon rupture. Using both in vitro and in vivo approaches, this study was to determine the effects of Dex treatment on the proliferation and differentiation of human tendon stem cells (hTSCs), which can directly impact tendon healing. We found that Dex treatment stimulated cell proliferation at lower concentrations (<1,000 nM), whereas a high concentration (1,000 nM) decreased cell proliferation. Moreover, at all concentrations used (5, 10, 100, and 1,000 nM), Dex treatment induced non‐tenocyte differentiation of hTSCs, as evidenced by a change in cell shape, a nearly complete suppression of collagen type I expression, and an upregulation of non‐tenocyte related genes (PPARγ and Sox‐9), which was especially evident when higher concentrations (>10 nM) of Dex were used. Implantation of Dex‐treated hTSCs for a short time (3 weeks) resulted in the extensive formation of fatty tissues, cartilage‐like tissues, and bony tissues. These findings suggest that Dex treatment in clinics may cause a paradoxical effect on the injured tendons it is supposed to treat: by inducing non‐tenocyte differentiation of hTSCs, Dex treatment depletes the stem cell pool and leads to the formation of non‐tendinous tissues (e.g., fatty and cartilage‐like tissues), which make tendon susceptible to rupture. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:105–110, 2012     

The role of corticosteroid injections in treating plantar fasciitis: A systematic review and meta-analysis

BackgroundPlantar fasciitis is a recurrent cause of heel pain and is often treated by corticosteroid infections (CSI). The current study reviewed and analysed the role of CSI with platelet rich plasma (PRP), and CSI with extracorporeal shock wave therapy (EWST) for plantar fasciitis treatment.MethodsPubMed, Medline, Web of Science, Embase, Cochrane, and Google Scholar databases were searched for relevant studies. Preferred Reporting in Systematic Review & Meta-Analysis (PRISMA) guidelines were used to search relevant studies published from infinity to April 2021. The risk of bias was performed using Cochrane Collaboration’s tool. GRADE assessment was used for quality of evidence. Data analysis was performed with the use of R software and P < 0.05 was considered statistically significant. CSI was compared with PRP and EWST.ResultsEighteen studies comprising 1180 patients were included in this meta-analysis. When compared to PRP, CSI with lignocaine/lidocaine had significantly higher mean difference on visual analogue scale (VAS) pain scores at 3 months (0.62 [0.13; 1.12], P = 0.01) and 6 months (MD = 1.49 [0.22; 2.76], P = 0.02). At 6 months, VAS scores were higher in the CSI group than the ESWT group (MD = 0.8 [0.38; 1.22], P = 0.1). At 6 months, a significant reduction in the American Orthopaedic Foot and Ankle Score (AOFAS) was observed in the CSI group compared to PRP (MD = − 11.53 [− 16.62; − 6.43], P < 0.0001).ConclusionPatients suffering from plantar fasciitis, PRP achieved better VAS scores compared to CSI at 3 and 6-month follow-up. In addition, ESWT had better VAS score outcomes at 6 months compared to CSI. Regarding AOFAS score, PRP was more efficacious than CSI at 6 months of follow-up. Only through the development of high-quality, large-scale longitudinal studies, will the findings and conclusions of this meta-analysis be strengthened and influence our clinical practice in the treatment of plantar fasciitis.Level of clinical evidenceII.     

Plantar fasciitis: A randomized comparative study of platelet rich plasma and low dose radiation in sportspersons

BackgroundPlantar Fasciitis makes up about 15% of patients requiring professional care due to foot symptoms. The treatment methods are numerous with none proving to be clearly superior to others. We aimed to compare two common treatment methods in search of the best treatment.MethodAll consecutive sportspersons presenting to our OPD with clinical diagnosis of plantar fasciitis underwent treatment consisting of stretching exercises, activity modification, and NSAID’s for 6 months. First 40 patients who did not respond to the treatment were divided randomly into two groups of 20 patients each, Group A (Platelet rich plasma − PRP) and Group B (low dose radiation − LDR). At the time of final follow-up (6 months) the mean improvement in the pain score (Visual-Analogue-Scale), American Orthopaedic Foot and Ankle Score (AOFAS) and Plantar fascia thickness on ultrasound were compared.ResultSignificant improvement in all 3 parameters was noted at the time of final follow up within both groups. When compared to each other, the difference in outcome of both these Groups on the given 3 parameters came out to be insignificant (p > 0.05).ConclusionPRP is as good as LDR in patients with chronic recalcitrant plantar fasciitis not responding to physical therapy.     

富血小板血浆注射治疗萎缩性骨折不愈合

目的:探讨富血小板血浆(platelet-rich plasma,PRP)注射治疗萎缩性骨折不愈合的临床疗效。方法 :自2015年3月至2017年3月采用PRP注射治疗15例萎缩性骨折不愈合患者,其中男10例,女5例;年龄23～56(40.0±9.1)岁;不愈合时间6～14 (8.87±2.45)个月。抽取外周血60～100 ml,制备PRP,PRP血小板计数587～1 246(947.13±158.58)×10~9/L。透视定位下于骨折断端注射PRP 13～20 ml,分别于治疗后的第1、2周各注射1次,每月复查1次。观察术后患肢是否有短缩、成角、旋转畸形等并发症,并对其影像学检查进行评估。结果:所有患者获得随访,时间6～12(6.8±2.1)个月。治疗后患肢均无短缩、成角、旋转畸形等并发症发生。13例患者骨折愈合,愈合时间4～6(4.8±0.7)个月;2例患者12个月随访时完全无骨痂形成,其中1例治疗期间螺钉松动;其余病例均无并发症。结论:萎缩性骨折不愈合内固定术后骨折断端稳定是局部PRP注射的适应证。PRP治疗萎缩性骨折不愈合局麻穿刺下即可完成,操作安全、疗效可靠。     

Topical application of platelet-rich plasma for diabetic foot ulcers: a systematic review

AIM To determine if topical application of platelet-rich plasma(PRP) to diabetic foot ulcers(DFUs) results in superior healing rates. METHODS A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Level Ⅰ-Ⅳ investigations of topical PRP application in DFUs were sought in multiple databases including: MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials. The search terms used were "platelet rich plasma", "diabetes", "ulcers", and "wound". The Modified Coleman Methodology Score(MCMS) was used to analyze study methodological quality. Study heterogeneity and a mostly non-comparative nature of evidence precluded meta-analysis. Only the outcome measurements used by more than 50% of the studies were included in the data synthesis to increase power of the measurement over that of individual studies. A weighted mean of healing rate per week between PRP group vs controls were compared using two-sample z-tests using P-value of less than 0.05 for significance.RESULTS One thousand two hundred and seventeen articles were screened. Eleven articles(322 PRP subjects, 126 controls, PRP subject mean age 58.4 ± 7.2 years, control mean age 58.7 ± 5.9 years) were analyzed. Six articles were level Ⅱ evidence, four were level Ⅲ, and one article was level Ⅳ. The mean MCMS was 61.8 ± 7.3. Healing rate was significantly faster with PRP application compared to controls(0.68 ± 0.56 cm2/wk vs 0.39 ± 0.09 cm2/wk; P 0.001). Mean heal time to 90% of the original ulcer area was 7.8 ± 2.7 wk and 8.3 ± 3.7 wk for patients in the PRP group and control groups, respectively(P = 0.115). There were significantly lower adverse effects reported with PRP application compared to controls(7 wound infections, 1 contact dermatitis vs 14 wound infections, 1 maceration; P 0.001).CONCLUSION The topical application of PRP for DFUs results in statistically superior healing rates and lower complication rates compared to controls.     

针刀联合富血小板血浆治疗早期髌骨外侧高压征的疗效分析

目的:探讨针刀、富血小板血浆及针刀联合富血小板血浆治疗早期髌骨外侧高压征的临床疗效。方法:回顾性分析2017年10月—2020年6月我院收治的60例髌骨外侧高压征患者的临床资料,根据其治疗方式的不同,分为针刀组、富血小板血浆组及针刀联合富血小板血浆组,每组20例。其中针刀组患者采用针刀松解髌外侧支持带进行治疗;富血小板血浆组患者采用膝关节腔注射富血小板血浆进行治疗;针刀联合富血小板血浆组采用针刀松解髌外侧支持带联合关节腔注射富血小板血浆进行治疗。记录并比较三组患者治疗前及治疗后1年以上末次随访时VAS及Kujala评分,膝关节轴位X线影像学比较上述时间点髌骨倾斜角及髌骨外移度。结果:所有患者均无感染等严重并发症发生。三组患者治疗前VAS及Kujala评分无统计学意义(P>0.05),而末次随访时三组患者评分较治疗前明显改善,差异有统计学意义(P＜0.05),针刀联合PRP组较其他两组改善更明显,差异有统计学意义(P＜0.05)。影像学方面,三组患者治疗前髌骨倾斜角及髌骨外移度均无统计学意义,而末次随访时,针刀组及针刀联合PRP组患者较术前明显改善,差异有统计学意义(P＜0.05),两组间比较无统计学意义(P>0.05)。结论:针刀联合富血小板血浆治疗早期髌骨外侧高压征临床疗效满意,且可以在一定程度上纠正髌骨侧倾。