Comparison between two different platelet-rich plasma preparations and control applied during anterior cruciate ligament reconstruction. Is there any evidence to support their use?
BACKGROUND
To compare the clinical, analytical and graft maturation effects of two different platelet-rich plasma (PRP) preparations applied during anterior cruciate ligament (ACL) reconstruction.


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.


RESULTS
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.


CONCLUSIONS
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.


METHODS
II.
Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain. Electronic address: avalazc@gmail.com.
Andrés
A
Valentí Azcárate
Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Jose
J
Lamo-Espinosa
Radiologic Department, Clínica Universidad de Navarra, Pamplona, Spain.
Jesús Dámaso
JD
Aquerreta Beola
Haematology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Milagros
M
Hernandez Gonzalez
Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Gonzalo
G
Mora Gasque
Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Juan Ramón
JR
Valentí Nin
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002097:C-Reactive Protein / Q000032:analysis; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D053657:Platelet-Rich Plasma; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
D005782:Gels; D002097:C-Reactive Protein
Anterior cruciate ligament reconstruction; Graft maturation; Platelet-rich plasma