摘要
目的探究膝关节镜下内侧副韧带(medial collateral ligament,MCL)松解技术联合富血小板血浆(platelet rich plasma,PRP)注射治疗膝关节退行性撕裂半月板损伤的效果及对膝关节本体感觉、损伤愈合情况的影响。方法选取南京医科大学第四附属医院2020年7月至2023年10月收治的膝关节退行性撕裂半月板损伤患者83例,采用随机信封法分为单一组(行膝关节镜下MCL松解技术,n=41)和联用组(在单一组的基础上联用PRP注射,n=42)。随访6个月,比较两组的LKSS评分优良率、西安大略与麦克马斯特大学骨关节炎评分(WOMAC)、膝关节本体感觉、损伤愈合情况和并发症情况。结果患者均随访6个月以上。术后6个月,联用组LKSS评分优良率(92.86%)高于单一组(75.61%),差异具有统计学意义(P<0.05)。术后6个月,两组患者膝关节WOMAC评分中的疼痛程度、强直程度和肢体机能评分明显降低,且联用组均低于单一组(P<0.05);术后3、6个月,两组患者15°、45°、75°的膝关节本体感觉测量差值均逐渐降低(P<0.05),且联用组均低于单一组(P<0.05);联用组患者半月板内部信号、半月板形态、半月板流血信号和关节腔积液评分均低于单一组(P<0.05)。联用组并发症发生率为4.76%,低于单一组的19.51%,两组比较差异有统计学意义(P<0.05)。结论膝关节镜下MCL松解技术联合PRP注射治疗膝关节退行性撕裂半月板损伤效果显著,LKSS评分优良率高,可以有效改善患者的膝关节功能和膝关节本体感觉,促进损伤的愈合,同时还可以降低并发症发生率,安全性高。
Objective To explore the effect of medial collateral ligament(MCL)relaxation technique under knee arthroscopy combined with platelet-rich plasma(PRP)injection in the treatment of meniscal injury of degenerative tear of the knee joint and its influence on knee proprioception and injury healing status.Methods A total of 83 patients with meniscal injury of degenerative tear of the knee joint at the Fourth Affiliated Hospital of Nanjing Medical University were selected from July 2020 to October 2023,and were divided into single group(MCL relaxation technique under knee arthroscopy,n=41)and combined group(PRP injection on the basis of single group,n=42)by random envelope method.After 6 months of follow-up,the LKSS,knee function[Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)],knee proprioception,injury healing status and complications were compared between groups.Results All patients were followed up for more than 6 months.The LKSS excellent and good rate at 6 months after surgery was 92.86%in the combined group and 75.61%in the single group(P<0.05).After treatment,the scores of pain level,stiffness level,and limb function of knee WOMAC were significantly decreased in both groups,and the scores in the combined group were lower than those in the single group(P<0.05).At 3 and 6 months after surgery,the difference values of knee proprioception at 15°,45°,and 75°were gradually decreased in both groups(P<0.05),and the above indicators were lower in the combined group(P<0.05).The scores of meniscal internal signal,meniscal morphology,meniscal bleeding signal,and articular effusion were lower in the combined group compared with the single group(P<0.05).The incidence of complications in the combined group was 4.76%,which was lower than 19.51%in single group(P<0.05).Conclusion MCL relaxation technique under knee arthroscopy combined with PRP injection has a significant effect in the treatment of meniscal injury of degenerative tear of the knee joint,with high excellent and good rate.It can effectively improve knee function and knee proprioception,promote injury healing,and reduce the incidence of complications with high safety.
作者
窦亚栋
李小云
姜诚诚
焦李
杨书丰
Dou Yadong;Li Xiaoyun;Jiang Chengcheng;Jiao Li;Yang Shufeng(Department of Orthopedics,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu,210000,China)
出处
《生物骨科材料与临床研究》
2025年第3期30-35,共6页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
膝关节镜
内侧副韧带
富血小板血浆
退行性撕裂半月板损伤
膝关节本体感觉
损伤愈合
Knee arthroscopy
Medial collateral ligament
Platelet-rich plasma
Degenerative tear with meniscal injury
Knee proprioception
Injury healing
