Clinical efficacy of gel-based platelet-rich plasma combined with arthroscopic microfracture surgery in the treatment of osteochondral injuries of the talus
Objective To investigate the early clinical effect of gel-based platelet-rich plasma(PRP)combined with arthroscopic microfracture surgery(AMS)in managing osteochondral injuries of the talus(OLT).Methods A total of 45 patients with post-traumatic OLT admitted to Wuxi Ninth People's Hospital from Feb.2020 to Feb.2022 were prospectively selected,including 28 males and 17 females aged 18-43(mean 28.0)years.The course of injuries was 17-32(mean 23.0)months.All the patients received AMS and according to the random num-ber table,22 cases were injected with sodium hyaluronate(2 mL once a week for 6 weeks postoperatively,SH joint group)and 23 were injected with PRP(3 mL once a week for 6 weeks postoperatively,PRP joint group).The de-gree of bone marrow edema(BME),VAS,ankle range of motion(ROM),and American Association of Foot and An-kle Surgery(AOFAS)scores before and 6 months after treatment were recorded,as well as complications.Results At 6 months after treatment,compared with the SH joint group,the PRP joint group showed much smaller BME at the subchondral bone(cm3,0.37±0.11 vs.0.46±0.15)and VAS(2.0±0.6 vs.3.1±1.0,both P＜0.05);much lar-ger metatarsal flexion ROM(25.49°±3.72° vs.22.88°±2.83°)and dorsiflexion ROM(15.43°±2.54° vs.13.57°±2.03°,both P＜0.05);much higher AOFAS scores of pain(34.7±5.6 vs.29.7±5.9),function(39.8±7.4 vs.32.1±4.4),alignment(7.7±1.6 vs.6.0±1.5)and total scores(87.2±4.8 vs.80.6±5.1,all P＜0.05);and much lower scores by Magnetic Resonance Observation of Cartilage Repair Tissue(35.4±8.2 vs.42.3±9.5,P＜0.05).Moreover,the good-to-excellent rate of the ankle joint function was much higher in the PRP joint group(87.0％,20/23 vs.54.5％,12/22,P＜0.05),and the incidence of complications was much lower(8.7％,2/23 vs.36.4％,8/22,P＜0.05).Conclusion For patients with OLT,gel-based PRP joint with AMS can improve the foot and ankle joint function,relieve BME and pain,increase ankle ROM,and reduce complications.
Osteochondral lesions of the talusPlatelet rich plasmaArthroscopic microfracture surgeryBone marrow edemaPainAnkle function
万方数据
维普
