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。

Clinical efficacy of acupotomy combined with platelet rich plasma in the treatment of early lateral patellar compression syndrome

Objective　To investigate the clinical efficacy of acupotomy, platelet-rich plasma (PRP) and acupotomy combined with PRP in the treatment of early lateral patellar compression syndrome.　Methods　From October 2017 to June 2020, 60 patients with lateral patellar hypertension in our hospital were retrospectively analyzed. According to the treatment methods, they were divided into three groups: needle-knife group, platelet-rich plasma group and needle-knife combined with platelet-rich serum group. In the acupotomy group, 20 cases were treated with acupotomy to release lateral patellar retinaculum. The PRP group (20 cases) was treated by injecting PRP into knee joint. Twenty patients in the acupotomy combined with platelet-rich plasma group were treated with acupotomy releasing lateral patellar retinaculum combined with intra-articular injection of platelet-rich plasma. The scores of VAS and Kujala were recorded and compared among the three groups before treatment and at the last follow-up of more than one year after operation. The knee joint axial radiography was used to compare the patellar lateral angle and patellar lateral displacement at the above time points.　Results　No serious complications such as infection occurred in all patients. There was no statistical significance in VA and Kujala score before treatment in three groups (P>0.05). At the last follow-up, the scores of the three groups were significantly improved compared with those before treatment (P<0.05), and the scores of the acupotomy combined with PRP group were significantly higher than those of the other two groups (P<0.05). Imaging, three groups of patients before treatment, patella lateral angle and patella lateral displacement were not statistically significant, but at the last follow-up, the needle knife group and needle knife combined with PRP group were significantly improved than before surgery, the difference was statistically significant (P<0.05), there was no statistical difference between the two groups (P>0.05).　Conclusion　The clinical effect of acupotomy combined with platelet rich plasma in the treatment of early llateral patellar compression syndrome is satisfactory, and can improve the patellar roll to a certain extent.