富血小板血浆在前交叉韧带重建中的应用：一项关于临床与影像学结果的系统综述与Meta分析更新
简介
本研究通过荟萃分析33项RCT，评估了PRP作为ACL重建辅助治疗的效果。关键发现：PRP能显著促进移植物韧带化，尤其在术后12个月时MRI低信号改善明显，骨-髌腱-骨移植物获益最大。PRP可有效减轻术后早期（1-9个月）疼痛，并改善术后3个月内的膝关节稳定性（KT-1000测量）。然而，其对长期功能评分（如Lysholm、Tegner）的提升作用不明确，且…
英文摘要
Background/Objectives: To evaluate the efficacy of platelet-rich plasma (PRP) as an adjunctive treatment in anterior cruciate ligament reconstruction (ACLR) and its impact on key clinical outcomes. Methods: A systematic search was conducted across five databases until 11 November 2024, including 33 randomized controlled trials (RCTs) that investigated PRP in ACLR. Outcomes analyzed included ligamentization (MRI hypointensity grades), pain VAS scores, functional scores (IKDC, Lysholm, Tegner), knee stability (KT-1000 arthrometer), and tunnel characteristics. Subgroup analyses were performed based on PRP application site, graft type, risk of bias, and follow-up duration. Results: PRP significantly enhanced ligamentization, particularly at 12 months, with marked reductions in MRI hypointensity grades. Patellar tendon grafts demonstrated the most substantial benefits. PRP also significantly reduced postoperative pain, with effects most pronounced in the early recovery period (1-9 months). However, the analgesic benefits diminished over time. Improvements in IKDC scores were observed only in studies with a high risk of bias, while Lysholm and Tegner scores showed no consistent differences between PRP and controls. Knee stability improved significantly with PRP, but this effect was limited to early follow-up periods (3 months). The heterogeneity in PRP preparation methods, application protocols, and patient populations limited the generalizability of the findings. Conclusions: PRP enhances ligamentization and provides short-term pain relief and stability benefits in ACLR. However, its impact on long-term functional recovery and other clinical outcomes remains limited and inconsistent. Standardization of PRP protocols and further high-quality research are necessary to refine its application and therapeutic potential.