镜下距腓前韧带修复联合富血小板血浆治疗慢性外侧踝关节不稳的疗效分析

Treatment of Chronic Lateral Ankle Instability with Wire Anchor Fixation Combined with Platelet-Rich Plasma under Arthroscopy of the Anterior Peroneal Ligament

摘要: 目的：观察关节镜下距腓前韧带(anterior talofibular ligament, ATFL)带线锚钉固定联合富血小板血浆(PRP)治疗慢性外侧踝关节不稳(Chronic Lateral Ankle Instability, CLAI)的疗效。方法：回顾性分析我院符合纳入标准的34名患者，其中13名患者行关节镜下ATFL带线锚钉固定联合PRP治疗，21例患者行单纯ATFL带线铆钉固定治疗。对比患者术前术后疼痛视觉模拟评分(VAS)、美国足踝骨科协会(AOFAS)踝与后足评分及日本足踝外科学会(JSSF)评分，评价临床治疗效果。行踝关节应力位X线片检查，测量距骨倾斜角和距骨前移。结果：术后全部患者均获得随访，平均随访(17.18 ± 3.71)个月。术后3个月VAS评分两组具有显著差异(P < 0.05)。JSSF评分差异有统计学意义(P = 0.013)。结论：关节镜下ATFL带线锚钉固定联合PRP治疗CLAI，术后可减轻踝关节疼痛、增强踝关节稳定性。

Abstract: Objective: To observe the effect of suture anchor fixation of anterior talofibular ligament combined with platelet rich plasma (PRP) in the treatment of chronic lateral ankle instability. Methods: 34 patients who met the inclusion criteria in our hospital were retrospectively analyzed. Among them, 13 patients were treated with ATFL wire-anchor fixation combined with PRP under arthroscopy, and 21 patients were treated with ATFL wire-rivets alone. The preoperative and postoperative pain visual analog scale (VAS), American Foot and Ankle Orthopaedic Association (AOFAS) ankle and posterior foot score and Japanese Foot and Ankle Surgery Society (JSSF) score were compared to evaluate the clinical treatment effect. Ankle stress radiographs were performed to measure the An-gle of talus tilt and talus anterograde. Results: All patients were followed up for an average of (17.18 ± 3.71) months. VAS scores 3 months after operation were significantly different between the two groups (P < 0.05). JSSF score showed statistically significant difference (P = 0.013). Conclusion: Ar-throscopic ATFL wire anchor fixation combined with PRP in the treatment of CLAI can reduce ankle pain and enhance ankle stability.