ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ ПЛАЗМЫ, ОБОГАЩЕННОЙ ТРОМБОЦИТАМИ, В ЛЕЧЕНИИ ТЕНДИНОПАТИИ СВЯЗКИ НАДКОЛЕННИКА
Ключевые слова:
обогащенная тромбоцитами плазма, тендинопатия собственной связки надколенника, колено прыгуна
Аннотация
Цель исследования: оценка эффективности применения аутологичной плазмы, обогащенной тромбоцитами (АПОТ), у профессиональных спортсменов и спортсменов-любителей в лечении тендинопатии связки надколенника (ТССН). Материалы и методы. Обобщены результаты лечения 40 спортсменов с ТССН. Диагнозы верифицированы с помощью МРТ (магнитно-резонансная томография). Объектами исследования были как профессиональные cпортсмены, так и любители. Все спортсмены были разделены на две группы по 20 чeловек. В группу I включили пациентов, в лечении которых использовали двукратную инъекцию aутологичной плазмы, обогащенной тромбоцитами (АПОТ), c промежутком между инъекциями 7 сут, а также стандартные методы лечения: лечебная физическая культура (ЛФК) и физиотерапия. Группу II (группа контроля) составили пациенты, в лечении которых применяли только стандартный протокол (ЛФК и физиотерапия). Результаты исследования оценивали с помощью теста приседания на одной ноге на доске с наклоном 25° (SLDS – Single leg decline squat), VISA-P-опросника Викторианского института спорта, оценивающего состояние собственной связки надколенника. Результаты. Установлено, что использование околосухожильных инъекций АПОТ – полезная методика терапии пациентов с ТССН, профеccиональные cпортсмены и cпортсмены-любители имеют одинаково положительную динамику при комплексном лечении с иcпользованием инъекций богатой тромбоцитами аутологичной плазмы. Заключение. Для повышения эффективности лечения спортсменов с тендинопатией собственной связки надколенника рекомендуется использовать аутологичную плазму, обогащенную тромбоцитами, в виде двукратных паратенониальных инъекций (с промежутком между инъекциями 7 сут) совместно со стандартным лечением в виде ограничения нагрузок, физиотерапии и реабилитационных упражнений.
Литература
1. Zou G., Zheng M., Chen W. et al. Autologous Plateletrich Plasma Therapy for Refractory Pain After Low-grade Medial Collateral Ligament Injury. Journal International Medicine Research, 2020, vol. 48 (2), pp. 56–65. DOI: 10.1177/0300060520903636
2. Clarsen B., Myklebust G., Bahr R. Development and Validation of a New Method for the Registration of Overuse Injuries in Sports Injury Epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br. Journal Sports Medicine, 2013, vol. 47 (8), pp. 495–502. DOI: 10.1136/bjsports-2012-091524
3. Fallouh L., Nakagawa K., Sasho T. et al. Effects of Autologous Platelet-rich Plasma on Cell Viability and Collagen Synthesis in Injured Human Anterior Cruciate Ligament. Journal Bone Joint Surgery American, 2010, vol. 92 (18), pp. 2909–2916. DOI: 10.2106/JBJS.I.01158
4. Zicaro J.P., Garcia-Mansilla I., Zuain A. et al. Has Plateletrich Plasma any Role in Partial Tears of the Anterior Cruciate Ligament? Prospective Comparative Study. World Journal Orthop., 2021, vol. 12 (6), pp. 423–432. DOI: 10.5312/wjo.v12.i6.423
5. Chalidis B., Givissis P., Papadopoulos P., Pitsilos C. Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. International Journal Molecular Science, 2023, vol. 24 (3), pp. 27–44. DOI: 10.3390/ijms24032744
6. Cook J.L., Khan K.M., Kiss Z.S., Griffiths L. Patellar Tendinopathy in Junior Basketball Players: a Controlled Clinical and Ultrasonographic Study of 268 Patellar Tendons in Players Aged 14–18 Years. Scandinavian Journal Medicine Science Sports, 2010, vol. 10, pp. 216–220. DOI: 10.1034/j.1600-0838.2000.010004216.x
7. Sánchez M., Azofra J., Anitua E. et al. Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: a Case Report. Medicine Science Sports Exerc., 2003, vol. 35 (10), pp. 1648–1652. DOI: 10.1249/01.MSS.0000089344.44434.50
8. Zhang J., Wang C., Li X. et al. Platelet-rich Plasma, a Biomaterial, for the Treatment of Anterior Talofibular Ligament in Lateral Ankle Sprain. Front Bioeng Biotechnology, 2022, vol. 22 (10), pp. 33–39. DOI: 10.3389/fbioe.2022.1073063
9. Cruciani M., Franchini M., Mengoli C. et al. Platelet-rich Plasma for Sports-related Muscle, Tendon and Ligament Injuries: an Umbrella Review. Blood Transfus, 2019, vol. 17 (6), pp. 465–478. DOI: 10.2450/2019.0274-19
10. Filardo G., Di Matteo B., Kon E. et al. Platelet-rich Plasma in Tendon-related Disorders: Results and Indications. Knee Surgery Sports Traumatology Arthrosc., 2018, vol. 26 (7), pp. 1984–1999. DOI: 10.1007/s00167-016-4261-4
11. Paoloni J., De Vos R.J., Hamilton B. et al. Platelet-rich Plasma Treatment for Ligament and Tendon Injuries. Clin Journal Sport Medicine, 2011, vol. 21 (1), pp. 37–45. DOI: 10.1097/JSM. 0b013e31820758c7
12. Belk J.W., Kraeutler M.J., Houck D.A. et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Metaanalysis of Randomized Controlled Trials. American Journal Sports Medicine, 2020, vol. 15 (1), p. 403. DOI: 10.1186/s13018-020-01919-9
13. Cheng M., Wang H., Yoshida R., Murray M.M. Platelets and Plasma Proteins are Both Required to Stimulate Collagen Gene Expression by Anterior Cruciate Ligament Cells in Three-dimensional Culture. Tissue Eng Part A, 2010, vol. 16 (5), pp. 1479–1489. DOI: 10.1089/ten.TEA.2009.0199
14. Zwerver J., Bredeweg S.W., van den Akker-Scheek I. Prevalence of Jumper's knee Among Nonelite Athletes from Different Sports: a Cross-sectional Survey. American Journal Sports Medicine, 2011, vol. 39 (9), pp. 1984–1988. DOI: 10.1177/0363546511413370
15. Cook J.L., Rio E., Purdam C.R. et al. Revisiting the Continuum Model of Tendon Pathology: what is its Merit in Clinical Practice and Research? Br Journal Sports Medicine, 2016, vol. 50 (19), pp. 1187–1191. DOI: 10.1136/bjsports-2015-095422
2. Clarsen B., Myklebust G., Bahr R. Development and Validation of a New Method for the Registration of Overuse Injuries in Sports Injury Epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br. Journal Sports Medicine, 2013, vol. 47 (8), pp. 495–502. DOI: 10.1136/bjsports-2012-091524
3. Fallouh L., Nakagawa K., Sasho T. et al. Effects of Autologous Platelet-rich Plasma on Cell Viability and Collagen Synthesis in Injured Human Anterior Cruciate Ligament. Journal Bone Joint Surgery American, 2010, vol. 92 (18), pp. 2909–2916. DOI: 10.2106/JBJS.I.01158
4. Zicaro J.P., Garcia-Mansilla I., Zuain A. et al. Has Plateletrich Plasma any Role in Partial Tears of the Anterior Cruciate Ligament? Prospective Comparative Study. World Journal Orthop., 2021, vol. 12 (6), pp. 423–432. DOI: 10.5312/wjo.v12.i6.423
5. Chalidis B., Givissis P., Papadopoulos P., Pitsilos C. Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. International Journal Molecular Science, 2023, vol. 24 (3), pp. 27–44. DOI: 10.3390/ijms24032744
6. Cook J.L., Khan K.M., Kiss Z.S., Griffiths L. Patellar Tendinopathy in Junior Basketball Players: a Controlled Clinical and Ultrasonographic Study of 268 Patellar Tendons in Players Aged 14–18 Years. Scandinavian Journal Medicine Science Sports, 2010, vol. 10, pp. 216–220. DOI: 10.1034/j.1600-0838.2000.010004216.x
7. Sánchez M., Azofra J., Anitua E. et al. Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: a Case Report. Medicine Science Sports Exerc., 2003, vol. 35 (10), pp. 1648–1652. DOI: 10.1249/01.MSS.0000089344.44434.50
8. Zhang J., Wang C., Li X. et al. Platelet-rich Plasma, a Biomaterial, for the Treatment of Anterior Talofibular Ligament in Lateral Ankle Sprain. Front Bioeng Biotechnology, 2022, vol. 22 (10), pp. 33–39. DOI: 10.3389/fbioe.2022.1073063
9. Cruciani M., Franchini M., Mengoli C. et al. Platelet-rich Plasma for Sports-related Muscle, Tendon and Ligament Injuries: an Umbrella Review. Blood Transfus, 2019, vol. 17 (6), pp. 465–478. DOI: 10.2450/2019.0274-19
10. Filardo G., Di Matteo B., Kon E. et al. Platelet-rich Plasma in Tendon-related Disorders: Results and Indications. Knee Surgery Sports Traumatology Arthrosc., 2018, vol. 26 (7), pp. 1984–1999. DOI: 10.1007/s00167-016-4261-4
11. Paoloni J., De Vos R.J., Hamilton B. et al. Platelet-rich Plasma Treatment for Ligament and Tendon Injuries. Clin Journal Sport Medicine, 2011, vol. 21 (1), pp. 37–45. DOI: 10.1097/JSM. 0b013e31820758c7
12. Belk J.W., Kraeutler M.J., Houck D.A. et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Metaanalysis of Randomized Controlled Trials. American Journal Sports Medicine, 2020, vol. 15 (1), p. 403. DOI: 10.1186/s13018-020-01919-9
13. Cheng M., Wang H., Yoshida R., Murray M.M. Platelets and Plasma Proteins are Both Required to Stimulate Collagen Gene Expression by Anterior Cruciate Ligament Cells in Three-dimensional Culture. Tissue Eng Part A, 2010, vol. 16 (5), pp. 1479–1489. DOI: 10.1089/ten.TEA.2009.0199
14. Zwerver J., Bredeweg S.W., van den Akker-Scheek I. Prevalence of Jumper's knee Among Nonelite Athletes from Different Sports: a Cross-sectional Survey. American Journal Sports Medicine, 2011, vol. 39 (9), pp. 1984–1988. DOI: 10.1177/0363546511413370
15. Cook J.L., Rio E., Purdam C.R. et al. Revisiting the Continuum Model of Tendon Pathology: what is its Merit in Clinical Practice and Research? Br Journal Sports Medicine, 2016, vol. 50 (19), pp. 1187–1191. DOI: 10.1136/bjsports-2015-095422
2. Clarsen B., Myklebust G., Bahr R. Development and Validation of a New Method for the Registration of Overuse Injuries in Sports Injury Epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br. Journal Sports Medicine, 2013, vol. 47 (8), pp. 495–502. DOI: 10.1136/bjsports-2012-091524
3. Fallouh L., Nakagawa K., Sasho T. et al. Effects of Autologous Platelet-rich Plasma on Cell Viability and Collagen Synthesis in Injured Human Anterior Cruciate Ligament. Journal Bone Joint Surgery American, 2010, vol. 92 (18), pp. 2909–2916. DOI: 10.2106/JBJS.I.01158
4. Zicaro J.P., Garcia-Mansilla I., Zuain A. et al. Has Plateletrich Plasma any Role in Partial Tears of the Anterior Cruciate Ligament? Prospective Comparative Study. World Journal Orthop., 2021, vol. 12 (6), pp. 423–432. DOI: 10.5312/wjo.v12.i6.423
5. Chalidis B., Givissis P., Papadopoulos P., Pitsilos C. Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. International Journal Molecular Science, 2023, vol. 24 (3), pp. 27–44. DOI: 10.3390/ijms24032744
6. Cook J.L., Khan K.M., Kiss Z.S., Griffiths L. Patellar Tendinopathy in Junior Basketball Players: a Controlled Clinical and Ultrasonographic Study of 268 Patellar Tendons in Players Aged 14–18 Years. Scandinavian Journal Medicine Science Sports, 2010, vol. 10, pp. 216–220. DOI: 10.1034/j.1600-0838.2000.010004216.x
7. Sánchez M., Azofra J., Anitua E. et al. Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: a Case Report. Medicine Science Sports Exerc., 2003, vol. 35 (10), pp. 1648–1652. DOI: 10.1249/01.MSS.0000089344.44434.50
8. Zhang J., Wang C., Li X. et al. Platelet-rich Plasma, a Biomaterial, for the Treatment of Anterior Talofibular Ligament in Lateral Ankle Sprain. Front Bioeng Biotechnology, 2022, vol. 22 (10), pp. 33–39. DOI: 10.3389/fbioe.2022.1073063
9. Cruciani M., Franchini M., Mengoli C. et al. Platelet-rich Plasma for Sports-related Muscle, Tendon and Ligament Injuries: an Umbrella Review. Blood Transfus, 2019, vol. 17 (6), pp. 465–478. DOI: 10.2450/2019.0274-19
10. Filardo G., Di Matteo B., Kon E. et al. Platelet-rich Plasma in Tendon-related Disorders: Results and Indications. Knee Surgery Sports Traumatology Arthrosc., 2018, vol. 26 (7), pp. 1984–1999. DOI: 10.1007/s00167-016-4261-4
11. Paoloni J., De Vos R.J., Hamilton B. et al. Platelet-rich Plasma Treatment for Ligament and Tendon Injuries. Clin Journal Sport Medicine, 2011, vol. 21 (1), pp. 37–45. DOI: 10.1097/JSM. 0b013e31820758c7
12. Belk J.W., Kraeutler M.J., Houck D.A. et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Metaanalysis of Randomized Controlled Trials. American Journal Sports Medicine, 2020, vol. 15 (1), p. 403. DOI: 10.1186/s13018-020-01919-9
13. Cheng M., Wang H., Yoshida R., Murray M.M. Platelets and Plasma Proteins are Both Required to Stimulate Collagen Gene Expression by Anterior Cruciate Ligament Cells in Three-dimensional Culture. Tissue Eng Part A, 2010, vol. 16 (5), pp. 1479–1489. DOI: 10.1089/ten.TEA.2009.0199
14. Zwerver J., Bredeweg S.W., van den Akker-Scheek I. Prevalence of Jumper's knee Among Nonelite Athletes from Different Sports: a Cross-sectional Survey. American Journal Sports Medicine, 2011, vol. 39 (9), pp. 1984–1988. DOI: 10.1177/0363546511413370
15. Cook J.L., Rio E., Purdam C.R. et al. Revisiting the Continuum Model of Tendon Pathology: what is its Merit in Clinical Practice and Research? Br Journal Sports Medicine, 2016, vol. 50 (19), pp. 1187–1191. DOI: 10.1136/bjsports-2015-095422
References
1. Zou G., Zheng M., Chen W. et al. Autologous Plateletrich Plasma Therapy for Refractory Pain After Low-grade Medial Collateral Ligament Injury. Journal International Medicine Research, 2020, vol. 48 (2), pp. 56–65. DOI: 10.1177/03000605209036362. Clarsen B., Myklebust G., Bahr R. Development and Validation of a New Method for the Registration of Overuse Injuries in Sports Injury Epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br. Journal Sports Medicine, 2013, vol. 47 (8), pp. 495–502. DOI: 10.1136/bjsports-2012-091524
3. Fallouh L., Nakagawa K., Sasho T. et al. Effects of Autologous Platelet-rich Plasma on Cell Viability and Collagen Synthesis in Injured Human Anterior Cruciate Ligament. Journal Bone Joint Surgery American, 2010, vol. 92 (18), pp. 2909–2916. DOI: 10.2106/JBJS.I.01158
4. Zicaro J.P., Garcia-Mansilla I., Zuain A. et al. Has Plateletrich Plasma any Role in Partial Tears of the Anterior Cruciate Ligament? Prospective Comparative Study. World Journal Orthop., 2021, vol. 12 (6), pp. 423–432. DOI: 10.5312/wjo.v12.i6.423
5. Chalidis B., Givissis P., Papadopoulos P., Pitsilos C. Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. International Journal Molecular Science, 2023, vol. 24 (3), pp. 27–44. DOI: 10.3390/ijms24032744
6. Cook J.L., Khan K.M., Kiss Z.S., Griffiths L. Patellar Tendinopathy in Junior Basketball Players: a Controlled Clinical and Ultrasonographic Study of 268 Patellar Tendons in Players Aged 14–18 Years. Scandinavian Journal Medicine Science Sports, 2010, vol. 10, pp. 216–220. DOI: 10.1034/j.1600-0838.2000.010004216.x
7. Sánchez M., Azofra J., Anitua E. et al. Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: a Case Report. Medicine Science Sports Exerc., 2003, vol. 35 (10), pp. 1648–1652. DOI: 10.1249/01.MSS.0000089344.44434.50
8. Zhang J., Wang C., Li X. et al. Platelet-rich Plasma, a Biomaterial, for the Treatment of Anterior Talofibular Ligament in Lateral Ankle Sprain. Front Bioeng Biotechnology, 2022, vol. 22 (10), pp. 33–39. DOI: 10.3389/fbioe.2022.1073063
9. Cruciani M., Franchini M., Mengoli C. et al. Platelet-rich Plasma for Sports-related Muscle, Tendon and Ligament Injuries: an Umbrella Review. Blood Transfus, 2019, vol. 17 (6), pp. 465–478. DOI: 10.2450/2019.0274-19
10. Filardo G., Di Matteo B., Kon E. et al. Platelet-rich Plasma in Tendon-related Disorders: Results and Indications. Knee Surgery Sports Traumatology Arthrosc., 2018, vol. 26 (7), pp. 1984–1999. DOI: 10.1007/s00167-016-4261-4
11. Paoloni J., De Vos R.J., Hamilton B. et al. Platelet-rich Plasma Treatment for Ligament and Tendon Injuries. Clin Journal Sport Medicine, 2011, vol. 21 (1), pp. 37–45. DOI: 10.1097/JSM. 0b013e31820758c7
12. Belk J.W., Kraeutler M.J., Houck D.A. et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Metaanalysis of Randomized Controlled Trials. American Journal Sports Medicine, 2020, vol. 15 (1), p. 403. DOI: 10.1186/s13018-020-01919-9
13. Cheng M., Wang H., Yoshida R., Murray M.M. Platelets and Plasma Proteins are Both Required to Stimulate Collagen Gene Expression by Anterior Cruciate Ligament Cells in Three-dimensional Culture. Tissue Eng Part A, 2010, vol. 16 (5), pp. 1479–1489. DOI: 10.1089/ten.TEA.2009.0199
14. Zwerver J., Bredeweg S.W., van den Akker-Scheek I. Prevalence of Jumper's knee Among Nonelite Athletes from Different Sports: a Cross-sectional Survey. American Journal Sports Medicine, 2011, vol. 39 (9), pp. 1984–1988. DOI: 10.1177/0363546511413370
15. Cook J.L., Rio E., Purdam C.R. et al. Revisiting the Continuum Model of Tendon Pathology: what is its Merit in Clinical Practice and Research? Br Journal Sports Medicine, 2016, vol. 50 (19), pp. 1187–1191. DOI: 10.1136/bjsports-2015-095422
Опубликован
2025-06-25
Как цитировать
CимоновР., Самойлов, А., & Рылова, Н. (2025). ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ ПЛАЗМЫ, ОБОГАЩЕННОЙ ТРОМБОЦИТАМИ, В ЛЕЧЕНИИ ТЕНДИНОПАТИИ СВЯЗКИ НАДКОЛЕННИКА. Человек. Спорт. Медицина, 25(1), 193-198. https://doi.org/10.14529/hsm250124
Выпуск
Раздел
Восстановительная и спортивная медицина
Copyright (c) 2025 Человек. Спорт. Медицина
Это произведение доступно по лицензии Creative Commons «Attribution-NonCommercial-NoDerivatives» («Атрибуция — Некоммерческое использование — Без производных произведений») 4.0 Всемирная.
