title: Clinical Effects of Platelet-Rich Plasma and Hyaluronic Acid as an Additional Therapy for Talar Osteochondral Lesions Treated with Microfracture Surgery: A Prospective Randomized Clinical Trial.
abstract: BACKGROUND
  Osteochondral ankle injuries commonly affect the dome of the talus, and these injuries are a common cause of athletic disability. Various treatment options are available for these injuries including intra-articular hyaluronic acid (HA) and platelet-rich plasma (PRP) injections. The purpose of this study was to compare the effects of HA and PRP as adjunct therapies after arthroscopic microfracture in osteochondral lesions (OCLs) of the talus.
  
  
  METHODS
  In this prospective, randomized blinded study, 40 patients with talar OCLs in their ankle joints were treated with arthroscopic debridement and a microfracture technique. Thirteen randomly selected patients received PRP, 14 patients received HA, and the remaining 13 patients received saline as a control group. The participants were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog pain scale (VAS) scores after a 15.3-month (range, 11-25 months) follow-up.
  
  
  RESULTS
  Postoperatively, all the groups exhibited significantly increased AOFAS scores and decreased VAS scores compared with their preoperative results (P < .005). The AOFAS scores were significantly increased in the PRP group versus the HA and control groups (P < .005), although the increased AOFAS scores in the HA group versus the control group were also significant (P < .005). Similar to the AOFAS scores, the decrease in the VAS scores was significantly lower in the PRP group versus the HA and control groups (P < .005). In addition, the HA group had significantly lower VAS scores than the control group (P < .005).
  
  
  CONCLUSIONS
  Both PRP and HA injections improved the clinical outcomes of patients who underwent operation for talar OCLs in the midterm period and can be used as adjunct therapies for these patients. Because a single dose of PRP provided better results, we recommend PRP as the primary adjunct treatment option in the talar OCL postoperative period.
  
  
  METHODS
  Level I, prospective randomized study.
authors.affiliation: Inonu University, Turgut Ozal Medical Center, Department of Orthopedics and Traumatology, Malatya, Turkey ggormeli@yahoo.com.
authors.forename: Gökay
authors.initials: G
authors.lastname: Görmeli
authors.affiliation: Inonu University, Turgut Ozal Medical Center, Department of Orthopedics and Traumatology, Malatya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karakaplan
authors.affiliation: Inonu University, Turgut Ozal Medical Center, Department of Radiology, Malatya, Turkey.
authors.forename: Cemile Ayşe
authors.initials: CA
authors.lastname: Görmeli
authors.affiliation: Baskent University, Department of Orthopedics and Traumatology, Adana, Turkey.
authors.forename: Baran
authors.initials: B
authors.lastname: Sarıkaya
authors.affiliation: Vakıf Gureba University, Department of Orthopedics and Traumatology, İstanbul, Turkey.
authors.forename: Nurzat
authors.initials: N
authors.lastname: Elmalı
authors.affiliation: Inonu University, Turgut Ozal Medical Center, Department of Physiotherapy and Rehabilitation, Malatya, Turkey.
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Ersoy
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D003646:Debridement; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016037:Single-Blind Method; D013628:Talus / Q000293:injuries / Q000601:surgery*; D055675:Viscosupplements / Q000627:therapeutic use*; D064232:Visual Analog Scale
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: hyaluronic acid; microfracture; osteochondral lesions; platelet-rich plasma; talus