Comparison between two different platelet-rich plasma preparations and control applied during anterior cruciate ligament reconstruction. Is there any evidence to support their use?

Azcárate, Andrés Valentí; Lamo-Espinosa, José María; Beola, Jesús Dámaso Aquerreta; Gonzalez, Milagros Hernandez; Gasque, Gonzalo Mora; Nin, Juan Ramón Valentí

doi:10.1016/s0020-1383(14)70008-7

Cited by 34 publications

(41 citation statements)

References 40 publications

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“…It was suggested that growth factors played a substantial role in enhancing knee stability. Conversely, four RCTs[ 24 - 27 ] were not able to document any clinical benefit from PRP administration. In particular the trial authored by Valentí Azcárate et al[ 24 ] included 150 patients divided into three treatment groups and evaluated up to 24 mo.…”

Section: Resultsmentioning

confidence: 99%

“…Conversely, four RCTs[ 24 - 27 ] were not able to document any clinical benefit from PRP administration. In particular the trial authored by Valentí Azcárate et al[ 24 ] included 150 patients divided into three treatment groups and evaluated up to 24 mo. Two different PRP formulations (PRGF and lab made PRP) were tested without demonstrating any clinical benefit over control groups, either in terms of objective or subjective measurements, with the exception of swelling, which was observed to be less 24 h after surgery in the PRGF group compared to PRP and control groups.…”

Section: Resultsmentioning

confidence: 99%

“…Concerning the graft-bone tunnel integration, eight papers (six RCTs)[ 17 , 21 , 24 , 31 - 35 ] investigated this specific issue. In only two RCTs the use of PRP provided beneficial effects in terms of better corticalization of the tunnel walls[ 32 ] or higher vascularization at the graft-bone interface[ 33 ], whereas in the remaining trials[ 17 , 21 , 24 , 31 , 34 , 35 ] no inter-group difference was observed over time. Among the papers reporting negative results for PRP in this specific parameter, there is also only one study[ 17 ] documenting the role of bone marrow concentrate, which was not able to provide beneficial effects.…”

Section: Resultsmentioning

confidence: 99%

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Biologic agents for anterior cruciate ligament healing: A systematic review

Matteo¹,

Loibl²,

Andriolo³

et al. 2016

WJO

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AIMTo systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing.METHODSA systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair. Exclusion criteria were articles written in other languages, reviews, or studies analyzing other applications of PRP/stem cells in knee surgery not related to promoting ACL healing.RESULTSThe database search identified 394 records that were screened. A total of 23 studies were included in the final analysis: In one paper stem cells were applied for ACL healing, in one paper there was a concomitant application of PRP and stem cells, whereas in the remaining 21 papers PRP was used. Based on the ACL injury pattern, two papers investigated biologic agents in ACL partial tears whereas 21 papers in ACL reconstruction. Looking at the quality of the available literature, 17 out of 21 studies dealing with ACL reconstruction were randomized controlled trials. Both studies on ACL repair were case series.CONCLUSIONThere is a paucity of clinical trials investigating the role of stem cells in promoting ACL healing both in case of partial and complete tears. The role of PRP is still controversial and the only advantage emerging from the literature is related to a better graft maturation over time, without documenting beneficial effects in terms of clinical outcome, bone-graft integration and prevention of bony tunnel enlargement.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Biologic agents for anterior cruciate ligament healing: A systematic review

Matteo¹,

Loibl²,

Andriolo³

et al. 2016

WJO

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“…Sixteen RCTs, including 740 patients, evaluated the use of PRP as an adjunct to ACL reconstruction with patellar ligament (Bone-Patella Tendon-Bone-BPTB) autograft [29][30][31][32][33][34][35] or hamstrings graft [33,[36][37][38][39][40][41][42][43][44] (Table 6).…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 99%

“…Seven studies reported functional results via IKDC scores [30,32,34,38,39,43,44], but only four of them provided data allowing for synthesis [30,32,43,44] ( Figure 7B) and no significant differences (p Seven studies reported functional results via IKDC scores [30,32,34,38,39,43,44], but only four of them provided data allowing for synthesis [30,32,43,44] ( Figure 7B) and no significant differences (p = 0.83) were detected. A further four studies provided only categorical output data (excellent, good, regular, poor) with non-significant odds ratio (1.39 (0.27, 7.21), p = 0.7).…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 99%

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Tramś

Kulinski

Kozar-Kamińska

et al. 2020

Life

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In recent years, the interest in biological treatment of knee lesions has increased, especially the application of platelet-rich plasma is of particular note. The number of articles evaluating platelet-rich plasma (PRP) efficacy in the recovery of knee disorders and during knee surgery has exponentially increased over the last decade. A systematic review with meta-analyses was performed by assessing selected studies of local PRP injections to the knee joint. The study was completed in accordance with 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A multistep search of PubMed, Embase, Cochrane Database of Systematic Reviews, and Clinicaltrials.gov was performed to identify studies on knee surgery and knee lesion treatment with PRP. Of the 4004 articles initially identified, 357 articles focusing on knee lesions were selected and, consequently, only 83 clinical trials were analyzed using the revised Cochrane risk-of-bias tool to evaluate risk. In total, seven areas of meta-analysis reported a positive effect of PRP. Among them, 10 sub-analyses demonstrated significant differences in favor of PRP when compared to the control groups (p < 0.05). This study showed the positive effects of PRP, both on the recovery of knee disorders and during knee surgery; however further prospective and randomized studies with a higher number of subjects and with lower biases are needed.

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