ABSTRACT
BACKGROUND: Intervertebral disc degeneration (IDD) is a common cause of low back pain. Microenvironmental and cytological changes of intervertebral disc are main factors inducing disc degeneration. However, the underlying mechanism still remains unclear.OBJECTIVE: To review the application of platelet rich plasma (PRP) in the treatment of IDD.METHODS: First, the article structure was designed, and then WanFang and CNKI databases were retrieved for related articles using Chinese and English keywords. After analyzing the abstract and main body, the eligible articles were enrolled according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION: Surgical treatment has achieved remarkable outcomes in the treatment of middle- and late-stage IDD. However, there is still no good conservative therapy for early degeneration. PRP has been extensively applied in the treatment of IDD due to its improvement in tissue healing and regeneration. PRP has been proved to be capable of effectively delaying and even reversing IDD through cytology tests and animal experiments. Some clinical trials have shown that PRP treatment can ease low back pain, while others have demonstrated that the combination of PRP and other biological treatments can significantly improve IDD. Nowadays, most of the experiments are limited in the study of cytology and zoology rather than clinical trials, and there is still no unified standard for extraction method, dose and optimal injection time of PRP. Moreover, there is little reported on its side effects. Consequently, the curative effect of PRP for IDD needs to be verified further.
ABSTRACT
<p><b>OBJECTIVE</b>To study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.</p><p><b>METHODS</b>Forty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.</p><p><b>CONCLUSION</b>The surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.</p>