高水平运动员跟腱断裂术后早期康复加用冻干血小板衍生因子浓缩液治疗的临床疗效

IF 3.5 3区环境科学与生态学 Q3 CELL & TISSUE ENGINEERING

Regenerative Therapy Pub Date : 2025-05-28 DOI:10.1016/j.reth.2025.05.007

Shota Morimoto, Futoshi Morio, Yuta Matsumae, Masashi Nakamura, Yoshitaka Nakao, Toshiya Tachibana, Tomoya Iseki

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引用次数: 0

摘要

背景：竞技运动员经常发生跟腱断裂（ATRs）。为了改善atr的治疗效果，已经进行了各种各样的研究，但对运动员来说，结果仍然令人不满意。目的总结在高水平运动员atr手术治疗和早期康复中添加冻干血小板衍生因子浓缩物（FD-PFC）的经验。方法回顾性分析8名患有ATR的高水平运动员（Tegner活动评分≥8），这些运动员在2019年5月至2021年11月期间接受了FD-PFC术后注射以及早期康复方案的手术治疗。所有患者均采用改良侧锁环缝合技术进行手术，并在术后实施早期康复方案。术后4周，超声引导下将制备好的FD-PFC注入跟腱缝合部位。临床结果的评估包括以下因素：术前和术后1年测量美国骨科足踝学会踝关节-后足量表（AOFAS）评分，进行20次连续双足和单足提跟的时间（DHR/SHR），恢复原始运动的时间，以及与手术或FD-PFC注射相关的并发症。此外，在术后12周和24周对所有患者进行磁共振成像（MRI）以评估跟腱成熟度。结果8例患者中男7例，女1例，手术时平均年龄28.5±5.2岁（范围23 ~ 39岁）。所有患者均为高水平运动员，Tegner活动评分平均为9.0±0.5（范围8-10）。平均AOFAS评分由术前36.0±9.4分显著提高至术后1年的96.8±3.6分(p <；0.001)。20例连续DHR和20例连续SHR的平均时间分别为6.8±0.8周和10.1±1.6周。所有患者均能恢复到损伤前的运动水平，平均时间为18.3±2.7周。此外，没有与手术或注射相关的并发症。此外，术后12周时，t2加权MRI显示25%（8例患者中2例）的缝合肌腱呈高信号强度，24周时为0%（8例患者中0例）。结论在手术治疗中加入FD-PFC注射，配合早期康复方案，可使高水平atr运动员早日恢复到损伤前的运动水平，获得满意的效果。这种治疗方案可能对患有atr的运动员有用。

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Clinical outcome of adding injection of freeze-dried platelet-derived factor concentrate to operative treatment accompanied by an early rehabilitation for Achilles tendon rupture in high-level athletes

Background

Achilles tendon ruptures (ATRs) often occur in competitive athletes. Various studies have been conducted to improve the treatment outcomes for ATRs, but the results remain unsatisfactory for athletes.

Purpose

To review our experiences of adding injections of freeze-dried platelet-derived factor concentrate (FD-PFC) to surgical treatment with an early rehabilitation for ATRs in high-level athletes.

Methods

We retrospectively analyzed 8 high-level athletes (Tegner activity score ≥8) with ATR, who received postoperative injection of FD-PFC in addition to surgical treatment with an early rehabilitation protocol between May 2019 and November 2021. In all patients, surgery was performed using the modified side-locking loop suture technique, and an early rehabilitation protocol was implemented postoperatively. The prepared FD-PFC was injected into the Achilles tendon suture site under ultrasound guidance at 4 weeks postoperatively. Evaluation of the clinical outcomes included the following factor: the American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS) score measured preoperatively and at one year postoperatively, time to ability to perform 20 continuous double- and single-leg heel raises (DHR/SHR), time to return to the original sport, and complications related to surgery or FD-PFC injection. In addition, magnetic resonance imaging (MRI) was performed for all patients at 12 and 24 weeks postoperatively to evaluate Achilles tendon maturation.

Results

The 8 patients consisted of 7 males and one female athletes with a mean age of 28.5 ± 5.2 years (range, 23–39 years) at the time of surgery. All patients were high-level athletes with a mean Tegner activity score of 9.0 ± 0.5 (range, 8–10). The mean AOFAS score improved significantly from 36.0 ± 9.4 preoperatively to 96.8 ± 3.6 at one year postoperatively (p < 0.001). The mean time to be able to perform 20 continuous DHR and 20 continuous SHR was 6.8 ± 0.8 weeks and 10.1 ± 1.6 weeks, respectively. All patients could return to their original sport at pre-injury levels with the mean time of 18.3 ± 2.7 weeks. Also, there were no complications related to surgery or injection. Furthermore, T2-weighted MRI showed the high signal intensity of the sutured tendon in 25 % (2 of 8 patients) at 12 weeks and 0 % (0 of 8 patients) at 24 weeks postoperatively.

Conclusions

The addition of FD-PFC injections to surgical treatment with an early rehabilitation protocol could provide satisfactory results for high-level athletes with ATRs, enabling them early return to their original sports at pre-injury level. This treatment option may be useful for athletes with ATRs.

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来源期刊

Regenerative Therapy Engineering-Biomedical Engineering

CiteScore

6.00

自引率

2.30%

发文量

106

审稿时长

49 days

期刊介绍： Regenerative Therapy is the official peer-reviewed online journal of the Japanese Society for Regenerative Medicine. Regenerative Therapy is a multidisciplinary journal that publishes original articles and reviews of basic research, clinical translation, industrial development, and regulatory issues focusing on stem cell biology, tissue engineering, and regenerative medicine.