Comparison between two different platelet-rich plasma preparations and control applied during anterior cruciate ligament reconstruction. Is there any evidence to support their use?
Valentí Azcárate A (1), Lamo-Espinosa J (2), Aquerreta Beola JD (3), Hernandez Gonzalez M (4), Mora Gasque G(2), Valentí Nin JR (2).
(1) Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain. Electronic address: firstname.lastname@example.org.
(2) Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain.
(3) Radiologic Department, Clínica Universidad de Navarra, Pamplona, Spain.
(4) Haematology Department, Clínica Universidad de Navarra, Pamplona, Spain.
To compare the clinical, analytical and graft maturation effects of two different platelet-rich plasma (PRP) preparations applied during anterior cruciate ligament (ACL) reconstruction.
MATERIALS AND METHODS:
A total of 150 patients with ACL disruption were included in the study. Arthroscopic ACL reconstruction with patellar tendon allograft was conducted on all knees using the same protocol. One hundred patients were prospectively randomised to either a group to receive double-spinning platelet-enriched gel (PRP) with leukocytes (n=50) or to a non-gel group (n=50). Finally, we included 50 patients treated with a platelet-rich preparation from a single-spinning procedure (PRGF Endoret(®) Technology) without leukocytes. Inflammatory parameters, including C-reactive protein (CRP) and knee perimeters (PER), were measured 24 hours and 10 days after surgery. Postoperative pain score (visual analogue score [VAS]) was recorded the day after surgery. Follow-up visits occurred postoperatively at 3, 6, and 12 months. The International Knee Documentation Committee scale (IKDC) was included to compare functional state, and MRI was conducted 6 months after surgery.
The PRGF group showed a statistically significant improvement in swelling and inflammatory parameters compared with the other two groups at 24 hours after surgery (p<0.05). The results did not show any significant differences between groups for MRI and clinical scores.
PRGF used in ACL allograft reconstruction was associated with reduced swelling; however, the intensity and uniformity of the graft on MRI were similar in the three groups, and there was no clinical or pain improvement compared with the control group.
LEVEL OF EVIDENCE:
CITATION Injury. 2014 Oct;45 Suppl 4:S36-41. doi: 10.1016/S0020-1383(14)70008-7.