Abstract:Objective To analyze the clinical effects of extracorporeal shockwave combined with autologous platelet rich plasma (PRP) injection in ankle after arthroscopic microfracture of talus osteochondral injury.Methods A total of 92 patients who underwent arthroscopic micro fracture surgery at Beijing Tongren Hospital Affiliated to Capital Medical University from January 2022 to December 2023 were randomly divided into a control group and a combination group, with 46 patients in each group. Both groups were treated with extracorporeal shock wave therapy after arthroscopic micro fracture surgery, while the combined group was treated with extracorporeal shock wave combined with autologous PRP ankle joint injection after surgery. The American Association of Orthopaedic Ankle and Ankle Function Scores (AOFAS) and Visual Analog Scale (VAS) scores of the two groups were compared before surgery, 3 months after surgery, and 12 months after surgery, as well as the excellent and good rate of ankle joint function, cartilage regeneration, and complications during follow-up.Results Comparison of VAS scores between two groups before surgery and at 3 and 12 months after surgery, using repeated measurement data analysis of variance, the results showed that: (1) There was a difference in VAS scores between different time points (P <0.05); (2) There was a difference in VAS scores between the combination group and the control group (P <0.05), and the combination group had lower VAS scores at 3 and 12 months after surgery, indicating better relative analgesic effects; (3) There was a difference in the trend of VAS score changes between the combination group and the control group (P <0.05), the AOFAS scores of the two groups were compared before surgery, 3 and 12 months after surgery, and repeated measurement data analysis of variance was used. The results showed that: (1) There was a difference in AOFAS scores between different time points (P <0.05); (2) There was a difference in AOFAS scores between the combination group and the control group (P <0.05), and the AOFAS scores of the combination group were relatively high at 3 and 12 months after surgery, with better ankle joint function recovery; (3) There was a difference in the trend of AOFAS score changes between the combination group and the control group (P <0.05), 12 months after surgery, the excellent and good rate of ankle joint function in the combination group was higher than that in the control group (P <0.05). Among them, there was no statistically significant difference in the excellent and good rates of Hepple I and Ⅱ in the combination group compared to the control group (P >0.05), while the excellent and good rate of Hepple Ⅲ in the combination group was higher than that in the control group (P <0.05); Before surgery, there was no significant difference in the maximum cross-sectional area of cartilage injury between the two groups (P >0.05). After 12 months of surgery, the maximum cross-sectional area of cartilage injury in the combined group was significantly lower than that in the control group (P <0.05). During the 12 month follow-up period after surgery, there was no statistically significant difference in the incidence of complications between the two groups (P >0.05).Conclusion Extracorporeal shockwave combined with autologous PRP ankle injection has significant effects on arthroscopic microfracture surgery for Hepple patients with osteochondral injury of talus from stage I to Stage Ⅲ, and has a more prominent effect in Hepple patients with stage Ⅲ, which can effectively improve ankle joint motion, reduce ankle pain and enhance ankle joint function. It has positive significance for promoting the growth of cartilage and bone.
