[1]秦德强,蒋 翔,谭沙沙,等.PRP联合微创关节镜下自体韧带重建治疗内翻型伴多韧带损伤K-L Ⅲ级KOA老年患者效果观察[J].医学信息,2026,39(01):90-94.[doi:10.3969/j.issn.1006-1959.2026.01.015]
　QIN Deqiang,JIANG Xiang,TAN Shasha,et al.Observation on the Effect of PRP Combined with Minimally Invasive Arthroscopic Autologous Ligament Reconstruction in Treating Elderly KOA Patients of K-L Ⅲ Grade with Inversion Typeand Multiple Ligament Injury[J].Journal of Medical Information,2026,39(01):90-94.[doi:10.3969/j.issn.1006-1959.2026.01.015]
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PRP联合微创关节镜下自体韧带重建治疗内翻型伴多韧带损伤K-L Ⅲ级KOA老年患者效果观察()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年01期
页码:
90-94
栏目:
临床证据信息
出版日期:
2026-01-01

文章信息/Info

Title:
Observation on the Effect of PRP Combined with Minimally Invasive Arthroscopic Autologous Ligament Reconstruction in Treating Elderly KOA Patients of K-L Ⅲ Grade with Inversion Typeand Multiple Ligament Injury
文章编号:
1006-1959（2026）01-0090-05
作者:
秦德强; 蒋 翔; 谭沙沙; 蔡志荣; 徐洪锴; 杨 鹏
玉溪市中山医院骨科，云南 玉溪 652599
Author(s):
QIN Deqiang;  JIANG Xiang;  TAN Shasha;  CAI Zhirong;  XU Hongkai;  YANG Peng
Orthopaedics Department of Yuxi Zhongshan Hospital, Yuxi 652599, Yunnan, China
关键词:
微创关节镜技术; 富血小板血浆; 膝骨关节炎; 多韧带损伤; 老年患者; 阳性病例对照研究
Keywords:
Minimally invasive arthroscopic technique;  Platelet rich plasma;  Knee osteoarthritis;  Multiple Ligament injury;  Elderly patients;  Positive case-control study
分类号:
R687.4
DOI:
10.3969/j.issn.1006-1959.2026.01.015
文献标志码:
A
摘要:
目的 评估富血小板血浆（PRP）联合微创关节镜下自体韧带重建技术治疗内翻型K-L Ⅲ级膝骨关节炎（KOA）伴多韧带损伤老年患者的实际临床效果及安全性。方法 回顾性选取2022年3月-2023年3月我院收治的内翻型K-L分级Ⅲ级膝骨关节炎伴多韧带损伤老年患者93例。依据计算机随机数表法分为试验组（n=46）及对照组（n=47）。对照组给予微创关节镜下自体韧带重建后关节腔内注射玻璃酸钠5 ml，试验组给予微创关节镜下自体韧带重建术后关节腔内注射自体PRP 5 ml。两组间隔8 d再次注射1次，4次为1个周期。两组持续治疗1周期，共28 d。比较两组膝关节生活功能评价（WOMAC量表）、疼痛缓解程度（VAS评分）、术后恢复程度（住院总时长、EQ-5D）、血清炎性因子（CRP、c-Jun、MMP9水平）及安全性（不良反应发生率）。结果 治疗后，试验组WOMAC量表评分低于对照组，差异有统计学意义（P＜0.05）。试验组VAS评分低于对照组，差异有统计学意义（P＜0.05）。试验组住院总时长短于对照组，EQ-5D评分高于对照组，差异有统计学意义（P＜0.05）。试验组CRP、c-Jun、MMP9水平低于对照组，差异有统计学意义（P＜0.05）。试验组与对照组不良反应发生率未见统计学差异（P＞0.05）。结论 微创关节镜下自体韧带重建术联合富血小板血浆可改善内翻型K-L分级Ⅲ级膝骨关节炎伴多韧带损伤老年患者功能，减轻关节疼痛，缩短术后恢复病程，降低关节腔炎性因子浓度，安全性良好。
Abstract:
Objective To evaluate the clinical efficacy and safety of platelet-rich plasma (PRP) combined with minimally invasive arthroscopic autologous ligament reconstruction in treating elderly knee osteoarthritis (KOA) patients of K-L Ⅲ Grade with inversion type and multiple ligament injury. Methods From March 2022 to March 2023, 93 elderly knee osteoarthritis patients of K-L Ⅲ Grade with inversion type and multiple ligament injury admitted to our hospital were retrospectively selected. According to the computer random number table method, they were divided into experimental group (n=46) and control group (n=47). The control group was given intra-articular injection of sodium hyaluronate 5 ml after minimally invasive arthroscopic autologous ligament reconstruction, and the experimental group was given intra-articular injection of autologous PRP 5 ml after minimally invasive arthroscopic autologous ligament reconstruction. The two groups were injected once again at an interval of 8 days, 4 times as a cycle. The two groups were treated for 1 cycle, a total of 28 d. The knee joint life function evaluation (WOMAC scale), pain relief degree (VAS score), postoperative recovery degree (total hospitalization time, EQ-5D), serum inflammatory factors (CRP, c-Jun, MMP9) and safety (incidence of adverse reactions) were compared between the two groups. Results After treatment, the WOMAC scale score of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The VAS score of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The total hospitalization time in the experimental group was shorter than that in the control group, and the EQ-5 D score was higher than that in the control group, the differences were statistically significant (P<0.05). The levels of CRP, c-Jun and MMP9 in the experimental group were lower than those in the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the experimental group and the control group (P>0.05). Conclusion Minimally invasive arthroscopic autologous ligament reconstruction combined with platelet-rich plasma can improve the function of elderly knee osteoarthritis patients of K-L Ⅲ Grade with inversion type and multiple ligament injury, reduce the joint pain, shorten the course of postoperative recovery, and reduce the concentration of inflammatory factors in the joint cavity, with good safety.

参考文献/References:

[1]Sharma L.Osteoarthritis of the Knee [J].N Engl J Med,2021,384(1):51-59.[2]胡银华,薛龙.中国中老年人症状性膝骨关节炎的发病率及危险因素[J].中华关节外科杂志(电子版),2023,17(4):470-478.[3]Giorgino R,Albano D,Fusco S,et al.Knee Osteoarthritis: Epidemiology,Pathogenesis,and Mesenchymal Stem Cells: What Else Is New? An Update [J].Int J Mol Sci,2023,24(7):6405.[4]Chang AH,Almagor O,Lee JJ,et al.The Natural History of Knee Osteoarthritis Pain Experience and Risk Profiles [J].J Pain,2023,24(12):2175-2185.[5]李明,刘华,章云峰,等.自体骨软骨移植联合富血小板血浆技术治疗膝关节软骨缺损初步随访结果[J].中国骨与关节损伤杂志,2018,33(2):138-140.[6]Richardson C,Plaas A,Block JA.Intra-articular Hyaluronan Therapy for Symptomatic Knee Osteoarthritis [J].Rheum Dis Clin North Am,2019,45(3):439-451.[7]Mass H,Katz JN.The influence of meniscal pathology in the incidence of knee osteoarthritis: a review [J].Skeletal Radiol,2023,52(11):2045-2055.[8]段东东,石华峰,谢辉,等.富血小板血浆联合人工皮负压吸引修复腓骨长短肌腱外露及软组织缺损的临床研究[J].生物骨科材料与临床研究,2023,20(1):53-55,61.[9]温宁,梁传兴,林伟明.关节镜下全内缝合法联合自体富血小板血浆治疗半月板损伤疗效观察[J].中国实用乡村医生杂志,2024,31(7):49-52.[10]吴驷东,杨杰,徐扬.自体富血小板血浆联合关节镜下清理术治疗半月板损伤合并膝关节炎的疗效[J].检验医学与临床,2023,20(20):3090-3094.[11]马浩哲,郑成.膝关节骨性关节炎经关节腔内注射自体富血小板血浆治疗效果分析[J].江汉大学学报(自然科学版),2019,47(1):83-86.[12]中国中西医结合学会骨伤科专业委员会.膝骨关节炎中西医结合诊疗指南[J].中华医学杂志,2018,98(45):3653-3658.[13]Jang S,Lee K,Ju JH.Recent Updates of Diagnosis,Pathophysiology,and Treatment on Osteoarthritis of the Knee [J].Int J Mol Sci,2021,22(5):2619.[14]Primorac D,Molnar V,Rod E,et al.Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations[J].Genes (Basel),2020,11(8):854.[15]宿显良,娄秋华,秦方园,等.自体富血小板血浆治疗膝关节炎的初步结果[J].中国矫形外科杂志,2021,29(17):1601-1604.[16]陈玉泉,洪建明,徐俊.不同浓度富血小板血浆修复膝关节软骨损伤的疗效对比[J].医学理论与实践,2019,32(10):1550-1551.[17]孙仁义,贾堂宏.关节腔内注射透明质酸钠与富血小板血浆治疗膝关节骨性关节炎的比较[J].中国组织工程研究,2020,24(14):2164-2169.[18]崔亮,杨宗宇,魏余晋,等.同种异体骨移植辅助PRP技术对HeppleV型距骨骨软骨损伤患者短期效果及TGF-β1、PDG、VEGF的影响[J].分子诊断与治疗杂志,2023,15(7):1142-1146.[19]朱凯,陈红梅,张燕,等.膝关节腔内及周围痛点注射富血小板血浆治疗Kellgren-LawrenceⅡ、Ⅲ级膝骨关节炎疗效观察[J].实用骨科杂志,2022,28(10):923-926.[20]苏剑.富血小板血浆联合关节镜手术治疗膝关节骨性关节炎的疗效分析[D].桂林：桂林医学院,2023.[21]林放,周谋,许育兵,等.自体富血小板血浆治疗关节损伤的疗效观察[J].中国输血杂志,2021,34(7):685-687.[22]白志强,聂庆虎,刘灿,等.关节镜清理术联合自体富血小板血浆对轻中度膝骨关节炎的治疗效果及机制[J].贵州医科大学学报,2022,47(5):610-614.[23]周立康.保留残端重建术联合自体富血小板血浆对前交叉韧带损伤患者腱骨愈合与疼痛情况的效果观察[J].现代医学与健康研究电子杂志,2022,6(18):52-55.[24]李志达,黄永升,全校宗.个性化定制自体富血小板血浆用于膝关节骨性关节炎治疗的临床研究[J].现代诊断与治疗,2020,31(8):1252-1253.[25]刘义,徐丽丽,党红胜,等.微创手术联合关节腔内注射富血小板血浆治疗膝关节骨性关节炎疗效观察[J].中华实用诊断与治疗杂志,2018,32(9):890-892.[26]陈群群,霍少川,周驰,等.自体富血小板关节腔内注射治疗晚期膝骨关节炎对疼痛及疼痛介质的影响[J].川北医学院学报,2019,34(4):415-418.[27]王剑敏,易进,黄凤琪,等.自体富血小板血浆关节腔内注射治疗膝骨性关节炎的疗效分析[C]//榆林市医学会.第二届全国医药研究论坛论文集(三).厦门市陆军第73集团军医院,2023:786-789.[28]陈晓昱.雷公藤甲素对MIA模型大鼠膝骨关节炎c-Jun、MMP-9表达及血清炎性标志物的影响[J].实用药物与临床,2015,18(11):1293-1296.

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更新日期/Last Update: 1900-01-01