探讨自体富血小板血浆(PRP)关节腔内注射辅助手术治疗对膝关节软骨损伤患者功能康复的影响。

回顾性分析徐州矿务集团总医院膝关节软骨损伤患者106例(2017年1月至2018年3月)临床资料，接受微骨折术联合PRP治疗者计为研究组(n＝53)，接受微骨折术联合玻璃酸钠治疗者计对照组(n＝53)。比较两组治疗前及治疗后3、6、9个月视觉模拟评分(VAS)、日本骨科协会评分(JOA)、特种外科医院膝关节(HSS)功能评分、炎性因子水平及不良反应。

治疗后3、6、9个月两组VAS评分较治疗前降低，且研究组低于对照组(F_时间＝34.842，F_组别＝23.766，F_交互＝15.591，均为P<0.05)。治疗后3、6、9个月两组JOA评分较治疗前增高，且研究组高于对照组(F_时间＝69.734，F_组别＝44.069，F_交互＝28.318，均为P<0.05)。治疗后3、6、9个月两组HSS评分较治疗前增高，且研究组高于对照组(F_时间＝61.012，F_组别＝48.338，F_交互＝25.443，均为P<0.05)。治疗后研究组血清白介素(IL)-6、肿瘤坏死因子-α(TNF-α)水平明显低于治疗前(t＝64.233、42.920，均为P<0.05)，且研究组明显低于对照组(t＝12.576、8.324，均为P<0.05)。研究组不良反应发生率(5.7%)低于对照组(18.9%)(χ²＝4.296，P<0.05)。

采取PRP关节腔内注射辅助手术治疗膝关节软骨损伤，可有效减轻患者疼痛程度，改善其关节功能，且安全性较高。

To investigate the effect of intra articular injection of autologous platelet-rich plasma (PRP) as an adjuvant surgical treatment on functional recovery in patients with knee cartilage injury.

A retrospective analysis of the clinical data of 106 patients with knee cartilage injury in Xuzhou Mining Group General Hospital (January 2017 to March 2018) was conducted. The patients who received microfracture surgery combined with PRP treatment were assigned in the study group (n=53), while those who received microfracture surgery combined with sodium hyaluronate treatment were assigned in the control group (n=53). The visual analogue scale (VAS), Japanese Orthopaedic Association(JOA) scores, the Hospital for Special Surgery (HSS) knee joint function scores, inflammatory factor levels, and adverse reactions were compared between the two groups before and in three, six, and nine months after treatment.

The VAS scores of the two groups in three, six, and nine months after treatment were lower than those before treatment, and the study group were lower than the control group (F_time=34.842, F_group=23.766, F _interaction=15.591, all P<0.05). Three, six, and nine months after treatment, the JOA scores in the two groups were higher than those before treatment, and the study group was higher than the control group (F_time=69.734, F_group=44.069, F _interaction=28.318, all P <0.05). Three, six, and nine months of treatment, the HSS scores of the two groups were higher than those before treatment, and the study group was higher than the control group (F_time=61.012, F_group=48.338, F _interaction=25.443, all P <0.05). The levels of serum interleukin (IL) -6 and tumor necrosis factor (TNF)-α in the study group after treatment were significantly lower than those before the treatment(t=64.233、42.920, both P<0.05), and levels of IL-6 and TNF-α in the study group were lower than the control group (t=12.576, 8.324, both P<0.05). The incidence of adverse reactions in the study group (5.7%) was lower than that in the control group (18.9%)(χ²=4.296, P<0.05).

Intraarticular injection of PRP as an adjunctive surgical treatment for knee cartilage injury can effectively alleviate pain and improve joint function.