title: Microfractureversusmicrofracture and platelet-rich plasma: arthroscopic treatment of knee chondral lesions. A two-year follow-up study.
abstract: OBJECTIVE
  the aim of this study was to describe and compare the clinical results obtained in patients affected by chondral lesions of the knee submitted to an arthroscopic treatment with the microfracture technique or microfracture + intraoperative autologous platelet-rich plasma (PRP) injection.
  
  
  METHODS
  a prospective observational study was performed in patients affected by chondral lesions of the knee (classed as grade III-IV according to Outer-bridge's classification) and early osteoarthritis (classed as grade 1-2 according to the Kellgren-Lawrence classification). Their mean age was 52.4 years. Thirteen patients were treated with the microfracture technique according to Steadman (Group A), while 14 were treated with microfracture + PRP injection (Group B). Both groups were assessed using series of measures (a visual analog scale for pain, the 36-Item Short Form Health Survey and the International Knee Documentation Committee Subjective Knee Form) to compare pre-operative and postoperative values at 3, 6, 12 and 24 months. Statistical analysis was conducted using a two-factor ANOVA for repeated measures.
  
  
  RESULTS
  the VAS score decreased from a pre-operative value of 6.62±1.26 to 3.54 ±2.26 at 24 months in Group A (p<0.001), and from 6.43±1.91 to 3.36±2.84 in Group B (p<0.001). The IKDC subjective score increased from a pre-operative value of 37.02±12.00 to 62.13±19.00 at two years in Group A (p<0.001) and from 34.63±15.00 to 67.11±26.74 in Group B (p<0.001); the SF-36 scores showed a similar trend. Although an improvement was recorded over time in both groups, in the short term the IKDC subjective score improvement seemed to be better in Group B; a similar trend was shown by the SF-36 and VAS scores. At two years, the IKDC Subjective Scale, VAS and SF-36 scores seemed to be similar in the two groups. Over time, no significant differences were found between the two groups in any of the three outcomes.
  
  
  CONCLUSIONS
  the use of autologous PRP in association with the microfracture technique seems to give better clinical and functional results in short-term follow-up, above all as regards pain. At two-year follow-up, however, the clinical results of the two groups were similar.
  
  
  METHODS
  Level II, prospective cohort study.
authors.affiliation: MESVA Department, Postgraduate School of Orthopaedics and Traumatology, University of L'Aquila, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Mancò
authors.affiliation: MESVA Department, Postgraduate School of Orthopaedics and Traumatology, University of L'Aquila, Italy.
authors.forename: Remo
authors.initials: R
authors.lastname: Goderecci
authors.affiliation: Immunotrasfusional Unit, San Salvatore Hospital, ASL 1, L'Aquila, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Rughetti
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: DE Giorgi
authors.affiliation: MESVA Department, Clinical Epidemiology Unit, University of L'Aquila, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Necozione
authors.affiliation: MESVA Department, Postgraduate School of Orthopaedics and Traumatology, University of L'Aquila, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Bernardi
authors.affiliation: MESVA Department, Postgraduate School of Orthopaedics and Traumatology, University of L'Aquila, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Calvisi
keywords: cartilage; chondral lesions; knee; micro-fracture; platelet-rich plasma (PRP)