Platelet rich plasma has been promoted as a biologic agent to enhance tissue healing. As a concentration of autologous growth factors, it has gained increased use in musculoskeletal applications.
The purpose of this study was to evaluate the effect of intra-operative PRP on patient-reported outcomes 2 years after ACL reconstruction with tibialis anterior allograft. Fifty patients who underwent allograft ACL reconstruction with intra-operative application of PRP to the graft were matched with 50 allograft ACL -reconstructions without PRP use. The same surgeon performed all procedures with identical technique. Two year patient-reported outcomes including KOOS, IKDC, and Marx activity scores were obtained. Effusions in the immediate post-operative period, post-operative complications, and any subsequent procedures were also recorded.
There was no difference between the groups with respect to additional surgeries or complications in the first 2 years after reconstruction. Decreased effusions at 10±4 days were noted in the PRP group, but this difference disappeared by 8±4 weeks. No differences in patient-reported outcomes were noted in the 58 patients with two-year outcome data.
The study demonstrated that although PRP application in tibialis allograft ACL reconstructions appeared safe; clinical benefit was minor and short-term. No differences in patient-reported outcomes or number of additional surgeries at 2 years were noted.
Level of evidence
Level III — retrospective comparative study.
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- Activity level and graft type as risk factors for anterior cruciate ligament graft failure: a case–control study.Am J Sports Med. 2009; 37: 2362-2367
- Fresh-frozen free-tendon allografts versus autografts in anterior cruciate ligament reconstruction: delayed remodeling and inferior mechanical function during long-term healing in sheep.Arthroscopy. 2008; 24: 448-458
- The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in a sheep model.Knee Surg Sports Traumatol Arthrosc. 2008; 16: 360-369
- On the horizon from the ORS.J Am Acad Orthop Surg. 2010; 18: 445-448
- Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture.J Orthop Res. 2005; 23: 281-286
- Chondrogenic differentiation of mesenchymal stem cells from bone marrow: differentiation-dependent gene expression of matrix components.Exp Cell Res. 2001; 268: 189-200
- Can platelet-rich plasma enhance tendon repair? A cell culture study.Am J Sports Med. 2008; 36: 1171-1178
- Platelet concentrate injection improves Achilles tendon repair in rats.Acta Orthop Scand. 2004; 75: 93-99
- Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing.J Cell Physiol. 2008; 215: 837-845
- Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament.J Orthop Res. 2007; 25: 81-91
- The use of platelets to affect functional healing of an anterior cruciate ligament (ACL) autograft in a caprine ACL reconstruction model.J Orthop Res. 2009; 27: 631-638
- The effect of growth factors on biomechanical properties of the bone–patellar tendon–bone graft after anterior cruciate ligament reconstruction: a canine model study.Am J Sports Med. 2004; 32: 870-880
- Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors.Arthroscopy. 2010; 26: 50-57
- Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis.Knee Surg Sports Traumatol Arthrosc. 2007; 15: 888-894
- The efficacy of autologous platelet gel in pain control and blood loss in total knee arthroplasty. An analysis of the haemoglobin, narcotic requirement and range of motion.Int Orthop. 2007; 31: 309-313
- The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment.Arthroscopy. 2010; 26: 269-278
- Autologous platelet gel and platelet-poor plasma reduce pain with total shoulder arthroplasty.J Extra Corpor Technol. 2007; 39: 177-182
- Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure.J Orthop Sports Phys Ther. 1998; 28: 88-96
- Development and evaluation of an activity rating scale for disorders of the knee.Am J Sports Med. 2001; 29: 213-218
- Evaluation of knee ligament injuries with the IKDC form.Knee Surg Sports Traumatol Arthrosc. 1993; 1: 226-234
- Has platelet-rich plasma any role in anterior cruciate ligament allograft healing?.Arthroscopy. 2009; 25: 1206-1213
- Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing?.Knee Surg Sports Traumatol Arthrosc. 2009; 17: 676-682
- Use of growth factors in ACL surgery: preliminary study.J Orthop Traumatol. 2005; 6: 76-79
- The effect of platelet-derived growth factors on knee stability after anterior cruciate ligament reconstruction: a prospective randomized clinical study.Wien Klin Wochenschr. 2010; 122: 91-95
Published online: December 26, 2012
Accepted: December 1, 2012
Received in revised form: November 19, 2012
Received: February 27, 2012
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.