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福建医科大学附属协和医院运动损伤科,福州 350001
何秋雨,Email:15392307908@163.com,研究方向:运动损伤。
连成杰,Email:lianchj@hospital.cqmu.edu.cn。
收稿:2025-12-03,
修回:2026-03-22,
录用:2026-03-30,
纸质出版:2026-10-28
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何秋雨,赵沛,张华,等.富血小板血浆联合关节镜下内置加强带技术治疗距腓前韧带损伤的疗效和安全性研究[J].重庆医科大学学报,2026,51(10):1487-1494.
He Qiuyu,Zhao Pei,Zhang Hua,et al.Efficacy and safety of platelet-rich plasma combined with arthroscopic internal brace technique for the treatment of anterior talofibular ligament injury[J].Journal of Chongqing Medical University,2026,51(10):1487-1494.
何秋雨,赵沛,张华,等.富血小板血浆联合关节镜下内置加强带技术治疗距腓前韧带损伤的疗效和安全性研究[J].重庆医科大学学报,2026,51(10):1487-1494. DOI: 10.13406/j.cnki.cyxb.004084.
He Qiuyu,Zhao Pei,Zhang Hua,et al.Efficacy and safety of platelet-rich plasma combined with arthroscopic internal brace technique for the treatment of anterior talofibular ligament injury[J].Journal of Chongqing Medical University,2026,51(10):1487-1494. DOI: 10.13406/j.cnki.cyxb.004084.
目的
2
研究自体富血小板血浆(platelet-rich plasma,PRP)联合踝关节镜下内置加强带(Internal Brace)技术治疗距腓前韧带(anterior talofibular ligament,ATFL)损伤的早期临床疗效及安全性。
方法
2
本研究为单中心回顾性队列研究。回顾性分析福建医科大学附属协和医院2019年4月至2025年3月收治的38例因ATFL损伤行踝关节镜下Internal Brace修复术的患者临床资料,根据患者知情同意后自主选择是否联合PRP辅助治疗分为对照组(13例,单纯关节镜下Internal Brace修复术)和PRP组(25例,关节镜下Internal Brace修复术+PRP关节腔注射)。2组患者均接受相同的标准化术后康复方案。比较2组基线资料,术前及术后6周、3个月、6个月的美国足踝外科医师协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分、疼痛视觉模拟量表(visual analogue scale,VAS)评分和术后6个月疗效满意度,并对2组并发症情况进行评估。
结果
2
2组患者术前AOFAS评分和VAS评分差异均无统计学意义,术后各时间点AOFAS评分和VAS评分均较术前明显改善。组间比较发现,AOFAS评分存在显著的组别×时间交互作用(
P
=0.010),VAS评分交互作用差异无统计学意义(
P
=0.128)。术后6个月疗效满意度PRP组优于对照组,但差异无统计学意义。此外,PRP组重返运动时间明显短于对照组(
P
=0.023)。所有患者围术期及随访期间无切口感染、植入物排异、关节腔积液、神经损伤等严重并发症。2组中各有1例患者于术后1个月出现足背外侧区域皮肤感觉过敏,足跖屈时加重,均于术后3个月内自行恢复。
结论
2
PRP辅助关节镜下Internal Brace技术治疗ATFL损伤可改善术后早期(6周至3个月)的功能恢复,但该优势在后期(6个月后)趋于消失。
Objective
2
To investigate the early clinical efficacy and safety of autologous platelet-rich plasma(PRP) combined with arthroscopic internal brace technique for the treatment of anterior talofibular ligament(ATFL) injury.
Methods
2
A single-center retrospective cohort study was conducted. Clinical data from 38 patients who underwent arthroscopic internal brace repair for ATFL injury at Fujian Medical University Union Hospital between April 2019 and March 2025 were retrospectively analyzed. Based on patient preference after informed consent,patients were divided into a control group(
n
=13,arthroscopic internal brace repair alone) and a PRP group(
n
=25,arthroscopic internal brace repair combined with intra-articular PRP injection). Both groups received identical standardized postoperative rehabilitation protocols. Baseline data,American Orthopaedic Foot and Ankle Society (AOFAS) scores and Visual Analogue Scale(VAS) pain scores preoperatively and at 6 weeks,3 months,and 6 months postoperatively,as well as treatment satisfaction at 6 months postoperatively,were compared between the two groups. Complications were also evaluated for both groups.
Results
2
There were no significant differences in preoperative AOFAS and VAS pain scores between the two groups. AOFAS and VAS pain scores at each postoperative time point were significantly improved compared with preoperative scores. Intergroup comparison revealed a significant group × time interaction for AOFAS scores(
P
=0.010),while the interaction for VAS pain scores was not significant(
P
=0.128). The PRP group showed higher treatment satisfaction than the control group at 6 months postoperatively,but the difference was not significant. In addition,the time to return to sports was significantly shorter in the PR
P group than that in the control group(
P
=0.023). No severe complications such as incision infection,implant rejection,joint effusion,or nerve injury occurred in either group during the perioperative period or follow-up. One patient in each group developed hyperesthesia in the dorsolateral foot at 1 month postoperatively,which worsened with plantar flexion,and resolved spontaneously within 3 months postoperatively.
Conclusion
2
The combination of PRP with arthroscopic internal brace technique for the treatment of ATFL injury improved early postoperative functional recovery(from 6 weeks to 3 months),but this advantage diminished in the later stage(after 6 months).
de Azevedo Sodré Silva A , Sassi LB , Martins TB , et al . Epidemiology of injuries in young volleyball athletes:a systematic review [J ] . J Orthop Surg Res , 2023 , 18 ( 1 ): 748 .
Bridgman SA , Clement D , Downing A , et al . Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England,and a survey of UK practice for severe ankle sprains [J ] . Emerg Med J , 2003 , 20 ( 6 ): 508 - 510 .
Waterman BR , Owens BD , Davey S , et al . The epidemiology of ankle sprains in the United States [J ] . J Bone Joint Surg Am , 2010 , 92 ( 13 ): 2279 - 2284 .
Guillo S , Bauer T , Lee JW , et al . Consensus in chronic ankle instability:aetiology,assessment,surgical indications and place for arthroscopy [J ] . Orthop Traumatol Surg Res , 2013 , 99 ( 8 Suppl ): S411 - S419 .
杨焕纳 , 梁 琰 , 韩大伟 , 等 . 人工真皮联合自体皮修复儿童手指电烧伤后骨骼和/或肌腱外露创面的效果 [J ] . 中华烧伤与创面修复杂志 , 2023 ( 12 ): 1180 - 1184 .
Yang HN , Liang Y , Han DW , et al . Effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns [J ] . Chin J Burns Wounds , 2023 ( 12 ): 1180 - 1184 .
Coetzee JC , Ellington JK , Ronan JA , et al . Functional results of open broström ankle ligament repair augmented with a suture tape [J ] . Foot Ankle Int , 2018 , 39 ( 3 ): 304 - 310 .
3rd Waldrop NE , Wijdicks CA , Jansson KS , et al . Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair:a biomechanical comparison [J ] . Am J Sports Med , 2012 , 40 ( 11 ): 2590 - 2596 .
Kirk KL , Campbell JT , Guyton GP , et al . ATFL elongation after Brostrom procedure:a biomechanical investigation [J ] . Foot Ankle Int , 2008 , 29 ( 11 ): 1126 - 1130 .
黄 秋 , 朱文辉 , 蔡叶华 , 等 . 关节镜下Internal Brace增强术与改良Broström修复术治疗慢性踝关节不稳的疗效对比 [J ] . 中国运动医学杂志 , 2022 , 41 ( 5 ): 355 - 360 .
Huang Q , Zhu WH , Cai YH , et al . Comparison of arthroscopic internal brace augmentation versus arthroscopic modified broström repair surgery for chronic lateral ankle instability [J ] . Chin J Phys Med , 2022 , 41 ( 5 ): 355 - 360 .
Jain NP , Ayyaswamy B , Griffiths A , et al . Is Internal brace augmentation a gold standard treatment compared to isolated Modified Brostrom Gould repair for chronic lateral ligament ankle instability? Effect on functional outcome and Return to preinjury activity:a retrospective analysis [J ] . Foot , 2022 , 50 : 101865 .
张洪禹 , 于栀子 , 甘 阳 . 富血小板血浆在软骨、肌腱及骨组织损伤抗炎修复中应用的研究进展 [J ] . 中华医院感染学杂志 , 2024 , 34 ( 1 ): 156 - 160 .
Zhang HY , Yu ZZ , Gan Y . Progress of research on application of platelet rich plasma in anti-inflammation and repair of cartilage,tendon and bone tissue injuries [J ] . Chin J Nosocomiology , 2024 , 34 ( 1 ): 156 - 160 .
Zhang JY , Wang C , Li XQ , et al . Platelet-rich plasma,a biomaterial,for the treatment of anterior talofibular ligament in lateral ankle sprain [J ] . Front Bioeng Biotechnol , 2022 , 10 : 1073063 .
Banerjee S , Mishra S , Rajnish RK , et al . Efficacy of autologous platelet-rich plasma for the treatment of ankle sprain:a systematic review of literature with limited meta-analysis [J ] . Indian J Orthop , 2025 , 59 ( 7 ): 910 - 919 .
Li D , Tang Q , Liu Q , et al . Arthroscopic anterior talofibular ligament repair with Internal Brace and lasso-loop technique for chronic ankle lateral instability [J ] . Int Orthop , 2022 , 46 ( 12 ): 2821 - 2828 .
程 强 , 骆 虎 , 孙文爽 , 等 . 富血小板血浆联合改良Broström-Gould法修复距腓前韧带的早期临床疗效 [J ] . 骨科 , 2023 , 14 ( 2 ): 172 - 176 .
Cheng Q , Luo H , Sun WS , et al . Early clinical effectiveness of platelet-rich plasma after modified broström-Gould method for repairing anterior talofibular ligament [J ] . Orthopaedics , 2023 , 14 ( 2 ): 172 - 176 .
袁霆 , 陈世益 , 敖英芳 , 等 . 富血小板血浆在骨关节外科临床应用专家共识(2018年版) [J ] . 中华骨科杂志 , 2018 , 38 ( 11 ): 641 - 648 .
Yuan T , Chen S Y , Ao YF , et al . Expert consensus on clinical application of platelet-rich plasma in orthopaedic surgery(2018 edition) [J ] . Chin J Orthop , 2018 , 38 ( 11 ): 641 - 648 .
施忠民 , 陈 城 , 马燕红 , 等 . 中国慢性踝关节外侧不稳定术后康复专家共识 [J ] . 中华骨与关节外科杂志 , 2019 , 12 ( 10 ): 747 - 753 .
Shi ZM , Chen C , Ma YH , et al . Expert consensus in post-operative rehabilitation for chronic lateral ankle instability in China [J ] . Chin J Bone Jt Surg , 2019 , 12 ( 10 ): 747 - 753 .
Kitaoka HB , Alexander IJ , Adelaar RS , et al . Clinical rating systems for the ankle-hindfoot,midfoot,hallux,and lesser toes [J ] . Foot Ankle Int , 1994 , 15 ( 7 ): 349 - 353 .
Carlsson AM . Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale [J ] . Pain , 1983 , 16 ( 1 ): 87 - 101 .
Sullivan GM , Jr Artino AR . Analyzing and interpreting data from likert-type scales [J ] . J Grad Med Educ , 2013 , 5 ( 4 ): 541 - 542 .
欧娈海 , 李哲 , 王浩 , 等 . Internal Brace与带线锚钉通过改良Broström术治疗慢性踝关节不稳的疗效对比 [J ] . 临床骨科杂志 , 2023 , 26 ( 4 ): 16 - 20 .
Ou LH , Li Z , Wang H , et al . Comparison of Internal Brace versus suture anchor through modified Broström procedure for chronic ankle instability [J ] . J Clin Orthop , 2023 , 26 ( 4 ): 16 - 20 .
Chalidis B , Givissis P , Papadopoulos P , et al . Molecular and biologic effects of platelet-rich plasma(PRP) in ligament and tendon healing and regeneration:a systematic review [J ] . Int J Mol Sci , 2023 , 24 ( 3 ): 2744 .
Jawanda H , Khan ZA , Warrier AA , et al . Platelet-rich plasma,bone marrow aspirate concentrate,and hyaluronic acid injections outperform corticosteroids in pain and function scores at a minimum of 6 months as intra-articular injections for knee osteoarthritis:a systematic review and network meta-analysis [J ] . Arthroscopy , 2024 , 40 ( 5 ): 1623 - 1636 . e1.
陈施羊 , 张 华 , 周爱国 , 等 . 同种异体半月板移植联合富血小板血浆关节腔内注射的临床对照研究 [J ] . 重庆医科大学学报 , 2018 , 43 ( 10 ): 1364 - 1369 .
Chen SY , Zhang H , Zhou AG , et al . A comparative study of Meniscus allograft transplantation with intra-articular platelet-rich plasma injection [J ] . J Chongqing Med Univ , 2018 , 43 ( 10 ): 1364 - 1369 .
蔡振华 , 肖木洲 , 罗 恒 , 等 . 富血小板血浆联合仙灵骨葆胶囊治疗大鼠膝骨关节炎的应用研究 [J ] . 重庆医科大学学报 , 2025 , 50 ( 5 ): 623 - 629 .
Cai ZH , Xiao MZ , Luo H , et al . Application of platelet-rich plasma combined with Xianling Gubao Capsule in treatment of rats with knee osteoarthritis [J ] . J Chongqing Med Univ , 2025 , 50 ( 5 ): 623 - 629 .
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