Platelet rich plasma use in allograft ACL reconstructions: two-year clinical results of a MOON cohort study

Robert A Magnussen, David C Flanigan, Angela D Pedroza, Kate A Heinlein, Christopher C Kaeding, Robert A Magnussen, David C Flanigan, Angela D Pedroza, Kate A Heinlein, Christopher C Kaeding

Abstract

Background: Platelet rich plasma has been promoted as a biologic agent to enhance tissue healing. As a concentration of autologous growth factors, it has gained increased use in musculoskeletal applications.

Methods: The purpose of this study was to evaluate the effect of intra-operative PRP on patient-reported outcomes 2 years after ACL reconstruction with tibialis anterior allograft. Fifty patients who underwent allograft ACL reconstruction with intra-operative application of PRP to the graft were matched with 50 allograft ACL -reconstructions without PRP use. The same surgeon performed all procedures with identical technique. Two year patient-reported outcomes including KOOS, IKDC, and Marx activity scores were obtained. Effusions in the immediate post-operative period, post-operative complications, and any subsequent procedures were also recorded.

Results: There was no difference between the groups with respect to additional surgeries or complications in the first 2 years after reconstruction. Decreased effusions at 10±4 days were noted in the PRP group, but this difference disappeared by 8±4 weeks. No differences in patient-reported outcomes were noted in the 58 patients with two-year outcome data.

Conclusion: The study demonstrated that although PRP application in tibialis allograft ACL reconstructions appeared safe; clinical benefit was minor and short-term. No differences in patient-reported outcomes or number of additional surgeries at 2 years were noted.

Level of evidence: Level III - retrospective comparative study.

Copyright © 2012 Elsevier B.V. All rights reserved.

Figures

Figure 1
Figure 1
Improvements in International Knee Documentation Committee (IKDC) and Knee Injury Outcome and Osteoarthritis Score (KOOS) subscales (Symptoms, Pain, Activities of Daily Living, Sport/Recreation Function, and Knee Related Quality of Life) following ACL reconstruction.
Figure 2
Figure 2
The incidence of effusions 10 ± 4 days and 8 ± 4 weeks following ACL reconstruction in the platelet-rich plasma (PRP) and control groups. Significant differences between the two groups are noted at 10 ± 4 days (p = 0.014) but no difference was noted at 8 ± 4 weeks (p = 0.31).

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