摘要
目的探讨人工全膝关节置换术(TKA)联合富血小板血浆(PRP)治疗对创伤性膝关节炎患者术后恢复情况及血清分泌性蛋白DKK-1、骨保护素(OPG)表达水平的影响。方法选取2017年1月至2019年7月于武汉市汉口医院行初次单侧TKA的创伤性膝关节炎患者139例,按治疗方法不同分为手术组与联合组,其中手术组(69例)实施TKA手术,联合组(70例)在对照组的基础上注射PRP。比较2组患者临床治疗效果、并发症发生情况、美国特种外科医院膝关节评分(HSS)、视觉模拟评分(VAS)及DKK-1、OPG表达水平。结果联合组治疗有效率为100%,高于手术组的88.41%,差异具有统计学意义(P=0.010);联合组并发症总发生率为5.71%,手术组为4.35%,组间比较差异无统计学意义(P=0.984);治疗前,2组患者HSS、VAS评分比较,差异无统计学意义(P> 0.05);治疗后2组患者HSS评分较治疗前均上升,且联合组高于手术组,差异具有统计学意义(P <0.05);VAS评分均较治疗前下降,且联合组低于手术组,差异具有统计学意义(P <0.05)。治疗前,2组患者DKK-1、OPG表达水平比较,差异无统计学意义(P> 0.05);治疗后,2组患者DKK-1表达水平均较治疗前下降,且联合组低于手术组,差异具有统计学意义(P <0.05);OPG表达水平均较治疗前上升,且联合组高于手术组,差异具有统计学意义(P <0.05)。结论 TKA联合PRP治疗可促进创伤性膝关节炎患者术后恢复,降低DKK-1表达水平并提高OPG表达水平。
Objective To investigate the effect of total knee arthroplasty( TKA) combined with platelet-rich plasma( PRP) on the postoperative recovery and the expression levels of serum secretory protein dickkopf-1( DKK-1) and osteoprotegerin( OPG) in patients with traumatic arthritis. Methods From January 2017 to July 2019,139 patients with traumatic knee arthritis who underwent unilateral TKA for the first time in Hankou Hospital of Wuhan city were selected and divided into two groups according to different treatment methods. Among them,the operation group( 69 cases) received TKA operation,while the combined group( 70 cases) received PRP injection on the basis of the control group. The clinical effects,complications,HSS,VAS,DKK-1 and OPG expression levels were compared between the two groups.Results The effective rate of the combined group was 100%,which was higher than that of the operation group( 88. 41%),and the difference was statistically significant( P = 0. 010). The total incidence of complications was 5. 71% in the combined group and 4. 35% in the operation group,with no statistically significant difference( P = 0. 984). Before treatment,there was no statistically significant difference in terms of HSS and VAS scores of the two groups( P > 0. 05). After treatment,HSS scores of the two groups increased compared with those before treatment,and HSS score of the combined group was higher than that of the operation group,with statistically significant difference( P < 0. 05). VAS scores were all lower than those before treatment,and VAS score of the combined group was higher than that of the operation group,with statistically significant difference( P < 0. 05). Before treatment,there was no statistically significant difference in terms of DKK-1 and OPG expression level of the two groups( P > 0. 05). After treatment,DKK-1 expression level of the two groups decreased compared with that before treatment,and the combined group was lower than that of the operation group,with statistically significant difference( P <0. 05). O
作者
常乐
宋琳娜
冯世波
CHANG Le;SONG Lin-na;FENG Shi-bo(Department of Orthopedics,Hankou Hospital of Wuhan City,Wuhan Hubei 430012,China;Operating Room,Hankou Hospital of Wuhan City,Wuhan Hubei 430012,China)
出处
《局解手术学杂志》
2020年第8期640-644,共5页
Journal of Regional Anatomy and Operative Surgery
