Rehabilitation in Patients with Anterior Cruciate Ligament Reconstruction Using Auxiliary Platelet-Rich Plasma Therapy

Abstract

Background: The main target after successful AnteriorCruciate Ligament (ACL) reconstruction is early rehabilitation. New options such as PRP (platelet rich plasma) may improve clinical outcomes.Objective: The aim of our study was to evaluate two consecutive series of patients who underwent ACL reconstruction, one with PRP treatment and one without it.Material and method: Two groups of consecutive patients underwent arthroscopic ACL reconstruction, using the SemiT and BPTB techniques. Postoperatively all patients included in this study followed the same standardized rehabilitation protocol. In addition, patients in the first group received three intraarticular PRP injections as auxiliary therapy. Injections were performed at week two, four and six. The patients were evaluated at enrolment and every four and twelve weeks using the Tegner Lysholm Knee Scoring Scale (Scoring Scale: poor <65/ fair 65-83 / good 84-90 / excellent > 90). Each patient was operated on and evaluated afterwards by the same team of surgeons.Results: At 12 weeks interval, Group A had a higher mean clinical score than Group B (94.67 vs 92.50) although marginally not statistically significant (p=0.0503, 95% CI: −4.336 to 0.002911). Regarding pain in patients from Group A compared with patients from Group B, we saw a statistically significant difference at 4 weeks interval (16.90 vs. 18.89, p=0.0370, 95% CI: 0.1260 to 3.842) and no significant difference at 12 weeks interval (21.19 vs. 21.94, p=0.3744, 95%CI: −0.9452 to 2.453). In terms of swelling points scored between the two groups, there was no statistically significant difference at 4 week interval (5.048 vs. 4.00, p=0.1979, 95% CI: −2.667 to 0.5714) but there is a significant difference in favor of patients from Group A at 12 weeks interval (8.475 vs. 5.556, p=0.0002, 95% CI: −4.323 to −1.159).Conclusions: In the short term, the local treatment showed improvement on the overall clinical status of the patients (less pain, improved mobility, less swelling) undergoing rehabilitation after ACL reconstruction, although further studies are required.

Effects of Platelet-Rich Plasma on Clinical Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

“… 4 , 33 The IKDC and Lysholm scores in the PRP group at 3 months postoperatively were greater than those in the control group. Albu et al 1 also reported PRP therapy improving clinical scores, reducing pain and swelling at 3 months postoperatively, and speeding up the rehabilitation process. PRP improves joint homeostasis via the release of growth factors and bioactive molecules, reduces pain and knee swelling, and leads to improved knee function in the short- and medium-term postoperative periods.…”

“…PRP improves joint homeostasis via the release of growth factors and bioactive molecules, reduces pain and knee swelling, and leads to improved knee function in the short- and medium-term postoperative periods. 1 The medium- and long-term (6 and 12 months postoperatively) benefits of PRP in improving knee function were lacking, as proven by the IKDC and Lysholm scores. This finding might indicate that PRP has a short duration of action in the knee joint.…”