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富血小板血浆联合间充质干细胞促进前交叉韧带腱骨愈合的临床疗效研究
陈宇1, 徐跻峰, 章水均, 毕擎
浙江省人民医院(杭州医学院附属省人民医院)骨科
摘要:
目的探讨富血小板血浆(PRP)联合间充质干细胞(MSCs)促进前交叉韧带(ACL)腱骨愈合的临床疗效。方法选取ACL损伤患者56例,按照随机数字表法分为联合组和单一组各28例。两组患者均接受ACL重建术,单一组在关节腔内注射PRP凝胶,联合组在关节腔内注射PRP凝胶及MSCs,分别于术前及术后3、6、12个月比较两组胫骨隧道斜矢状面位最大层面直径、Lysholm评分及国际膝关节文献委员会(IKDC)评分变化。结果两组患者术后3、6、12个月胫骨隧道斜矢状面位最大层面直径均明显低于术前(均P<0.05),且术后6、12个月联合组均明显低于单一组(均P<0.05);两组患者术后3、6、12个月Lysholm评分均明显高于术前(均P<0.05),且联合组均明显高于单一组(均P<0.05);两组患者术后3、6、12个月IKDC评分均明显高于术前(均P<0.05),且联合组明显高于单一组(均P<0.05)。结论PRP联合MSCs可明显促进ACL重建术后腱骨愈合,改善膝关节功能,较PRP单一使用效果更加显著。
关键词:  前交叉韧带重建术 腱骨愈合 富血小板血浆 间充质干细胞
DOI:10.12056/j.issn.1006-2785.2018.40.12.2018-184
分类号:
基金项目:浙江省医药卫生科技计划项目(2017KY011)
Intraarticular injection of platelet-rich plasma with mesenchymal stem cells promotes tendon-bone healing of anterior cruciate ligament
Abstract:
Objective To evaluate the clinical efficacy of intraarticular injection of platelet-rich plasma (PRP) with mesenchymal stem cells (MSCs) in promoting tendon-bone healing of anterior cruciate ligament (ACL). Methods Fifty six patients with ACL injury admitted in our hospital from June 2014 to May 2016 were randomly divided into study group (28 cases) and control group (28 cases). Patients in both groups received ACL reconstruction, PRP or PRP with MSCs were injected into the articular cavity in control and study groups, respectively. The reduction degree of tibia tunnel, Lysholm score and International Knee Documentation Committee (IKDC) score of two groups were assessed and compared at 3, 6 and 12 months after operation between two groups. Results The maximum diameters of oblique sagittal plane of tibial tunnel in the two groups at 3, 6 and 12 months after operation were significantly decreased compared to those before operation(all P<0.05), the tibial tunnel diameters in study group at 6 and 12 months after operation were significantly lower than those in control group (both P<0.05). The Lysholm scores were significantly increased at 3, 6 and 12 months after operation in both groups(all P<0.05), while the scores in study group were significantly higher than those in control group (all P<0.05). The IKDC score at 3, 6 and 12 months after operation were significantly increased (all P<0.05), while the scores in study group were significantly higher than those in control group (all P<0.05). Conclusion PRP combined with MSCs can significantly promote tendon-bone healing after ACL reconstruction and improve knee joint function, which is more marked than PRP alone.
Key words:  Reconstruction of anterior cruciate ligament Tendon-bone healing PRP MSCs