关节镜联合富血小板血浆治疗踝创伤关节炎的疗效

目的应用关节镜技术联合富血小板血浆(PRP)治疗踝关节创伤性关节炎的临床疗效评价。 方法对2016年4月至2018年4月在威海市立医院关节与运动医学科采用踝关节镜手术联合PRP治疗创伤性踝关节炎病例15例作为实验组，同期单纯采用踝关节镜手术治疗病例14例作为对照组。实验组在关节镜手术1周后开始注射高浓度PRP 2 ml，1次/周，连续3次。治疗前后以视觉模拟评分(VAS)和美国足踝外科协会踝－后足评分(AOFAS)评价临床效果。评估结果VAS评分采用秩和检验分析和AOFAS评分采用重复测量方差分析，组间和组内比较采用独立样本和配对t检验。 结果29例患者随访时间平均(12.9±1.0)个月。治疗前两组间VAS(Z＝0.089)、AOFAS评分(F＝0.781)差异无统计学意义(均为P>0.05)。治疗后1、3、6、12个月的VAS(Z＝2.120，P＝0.034)和AOFAS评分(F＝24.454、31.283、89.479、73.875，均为P <0.001)比较，实验组均优于对照组。 结论关节镜手术联合PRP治疗踝关节创伤性关节炎较单纯应用踝关节镜手术治疗可能具有更好的治疗效果。

Therapeutic efficacy of arthroscopic surgery combined with platelet-rich plasma for ankle traumatic arthritis

ObjectiveTo evaluate the clinical efficacy of arthroscopy combined with platelet-rich plasma (PRP) in the treatment of ankle joint traumatic arthritis. MethodsFrom April 2016 to April 2018, 15 cases of traumatic ankle arthritis treated by ankle arthroscopic surgery combined with PRP in the department of joint and sports medicine of Weihai Municipal Hospital were taken as the experimental group, and 14 cases treated by ankle arthroscopic surgery alone in the same period were taken as the control group. PRP treatment started once a week after arthroscopic surgery. High concentration PRP (2ml) was injected three times per week. The clinical effects were evaluated by visual analogue scale (VAS) and American orthopedic foot and ankle society (AOFAS) before and after treatment. The VAS score was analyzed by rank sum test, the AOFAS score analyzed by repeated measurement ANOVA. Independent sample t test and paired t test were used for the comparisons between the groups and within the groups. ResultsAll 29 patients were followed up for an average of (12.9±1.0) months. There was no statistically significant difference in VAS(Z=0.089) or AOFAS scores(F=0.781) between the two groups before the treatment (both P>0.05). In one, three, six, 12 months after the treatment, VAS (Z=2.120, P=0.034)and AOFAS scores of the experimental group were better than the control group (F=24.454, 31.283, 89.479, 73.875, all P <0.001). ConclusionArthroscopic surgery combined with PRP for the treatment of traumatic arthritis of the ankle might shows better results than ankle arthroscopic surgery alone.