2021 ISAKOS Biennial Congress ePoster
Effect Of Platelet Rich Plasma On Healing Of Autologous Graft Following Acl Reconstruction
Sumit Banerjee, MS (Orth), MCh(Orth), Jodhpur, Rajasthan INDIA
Kishore Munde, MS (Orth), Jodhpur INDIA
Nitesh Gahlot, MBBS, MS Ortho, DNB Ortho, FACS, MNAMS, Jodhpur, Rajasthan INDIA
Taruna Yadav, MD, Jodhpur INDIA
Saptarshi Mandal, MD, Jodhpur INDIA
All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, INDIA
FDA Status Cleared
Summary
This prospective randomized study was done to assess the effect of platelet concentrates on accelerating rate of ACL graft healing at 6 months post ACL reconstruction using hamstring autograft. In the study we found comparable radiological results and better functional results in PRP group.
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Abstract
Introduction
ACL tear is the one of the most commonly encountered injury in sports medicine. Though ACL reconstruction is considered as gold standard treatment modality, lengthy rehabilitation following ACL reconstruction is due to slower graft healing in the tunnels. Orthobiologics such as PRP are increasingly used to accelerate rate of healing in various musculoskeletal conditions. Since platelets are rich in multiple growth factors the idea of concentrating them at the injured site to accelerate and optimize the healing mechanisms set the rationale for development of PRP.
Methodology
Total eighty-five patients undergoing primary arthroscopic ACL reconstruction between August 2018 to October 2019 were included in this prospective randomized study. They were randomized into two groups: PRP group (n=43) and non-PRP group (n=42). PRP prepared by double spin PRP preparation method and given intraoperatively in PRP group study subjects. All patients underwent MRI scans and functional assessment at 6 months. Figueroa’s score was used to assess graft maturation radiologically, while anteroposterior knee stability testing with ADT and Lachman test, knee ROM examination along with Lysholm score were used to assess functional outcome.
Results
Five patients were lost to follow up. Total 80 patients, 40 in each group were analyzed. Radiologically assessment for healing of intraarticular portion of graft and graft tunnel interface in terms of Figueroa’s scores was equivocal (P>0.05). But functional outcome was significantly better in PRP group in terms of Lysholm score at 6 months follow up (P<0.05). 5 patients in non PRP group (12.5%) had ADT and Lachman test positive (Grade 1+), while 2 patients in PRP group (5%) had positive ADT and Lachman test (P > 0.05). Post-operative knee ROM at 6 months in both groups did not show any significant difference.
Conclusion
Radiological outcome was equivocal in both the groups. Better functional results in PRP group might be attributed to improved biomechanical strength of the graft, though further high-quality randomized control studies are needed to validate this fact.