Platelet-rich plasma prevents blood loss and pain and enhances early functional outcome after total knee arthroplasty: a prospective randomised controlled study

Abstract

Purpose: The purpose of this study was to determine whether platelet-rich plasma (PRP) might prevent blood loss and postoperative pain and expedite wound healing following total knee arthroplasty (TKA).

Methods: Forty consecutive patients with knee arthritis who were matched for age, sex and body mass index (BMI) were randomly allocated to either receive or not receive PRP application over the wound, including capsule, medial and lateral recesses, during TKA. Postoperative haemoglobin, blood loss, blood transfusion, visual analogue scale (VAS) score, wound score, Knee Society Score (KSS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded and evaluated.

Results: The platelet-rich plasma and control groups comprised 17 and 23 patients, respectively. The PRP group recorded significantly less reduction in haemoglobin and need for blood transfusion (p = 0.00 and p = 0.001, respectively), experienced less pain (p = 0.00) and required fewer narcotics than the control (p = 0.00). There was significant difference in range of motion (ROM) at three months (p = 0.01), no significant difference in wound scores (p = 0.311) and significant difference in KSS and WOMAC scores at 12 weeks (p = 0.00, 0.00). However no significant difference was found at six months.

Conclusions: PRP has significant effect in preventing blood loss, postoperative pain and need for narcotics after TKA and has a positive effect on short-term clinical outcome.

Figures

Fig. 1

a Greater decrease in haemoglobin (Hb) postoperatively following unilateral total knee replacement (TKR) in the autologous platelet gel (APG) and control groups; this difference was statistically significant (p = 0.00). b Greater decrease in Hb postoperatively following bilateral TKR in APG and control groups; this difference was statistically significant (p = 0.00)

Fig. 2

Number of blood units transfusion in autologous platelet gel (APG) and control groups; this difference was stastically significant (p = 0.00)

Fig. 3

a Significantly reduced numbers of narcotic doses during hospital stay following unilateral total knee replacement (TKR) in autologous platelet gel (APG) versus control groups. b Significantly reduced numbers of narcotic doses during hospital stay following bilateral TKR in APG versus control groups

Fig. 4

Mean Knee Society Score (KSS) and trend of autologous platelet gel (APG) and control groups at subsequent follow-ups. There was significant difference between groups at 6 weeks and 3 months (p = 0.00, 0.00) but it was insignificant at 6 months (p = 0.285)

Fig. 5

Mean Western Ontario and McMaster Osteoarthritis Index (WOMAC) scores and trend of autologous platelet gel (APG) and control groups at follow-ups. There was significant difference between groups at 6 weeks and 3 months (p = 0.00, 0.00) but it was insignificant at 6 months (p = 0.193)