Ankle Joint Distraction Arthroplasty Assisted By Platelet-rich Plasma (PRP) Intra-articular Injection In The Treatment Of Ankle Post-traumatic Osteoarthritis Inyoungpatients

Objective To investigate the effectiveness of ankle joint distraction arthroplasty assisted by platelet-rich plasma(PRP)intra-articular injection in the treatment of ankle post-traumatic osteoarthritis in young patients.Method From June 2012 to June 2016,24 patients with ankle post-traumatic osteoarthritis were treated,including 19 males and 6 females with the average age(28.3 ± 4.3)years.Ilizarov apparatus was used to maintain distraction of 5mm ankle space.PRP intra-articular injection was performed in operation,4 weeks postoperatively and 12 weeks postoperatively.The full weight bearing with the Ilizarov apparatus was maintained for at least 3 months.Result All patients were followed up form 24 to 60 months,the averaged period was(28.6 ± 6.2)months.Among the 24 patients,2 patients eventually underwent ankle arthrodesis,while the remaining 22 patients retained ankle mobility.The Visual Analogue Score(VAS),the AOFAS Ankle Hindfood Scale(AOFAS),the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)score were significantly improved at 1 years after the operation and were maintained at 2 years after the operation.The results of imaging assessment showed that 16 patients' ankle joint space width was improved at 1 and 2 years after operation.And the degree of subchondral sclerosis was decreased.The results of range of motion(ROM)showed that the ankle dorsiflexion was better than that before operation.The plantarflexion was similar to that before operation.Conclusion Ankle joint distraction arthroplasty assisted by platelet-rich plasma(PRP)intra-articular injection is a effective treatment for ankle post-traumatic osteoarthritis in the young patients,postponing the time of ankle arthrodesis or ankle total arthroplasty.