Patellar Tendon Healing With Platelet-Rich Plasma A Prospective Randomized Controlled Trial

被引:85
作者
de Almeida, Adriano Marques [1 ]
Demange, Marco Kawamura [1 ]
Sobrado, Marcel Faraco [1 ]
Rodrigues, Marcelo Bordalo [1 ]
Pedrinelli, Andre [1 ]
Hernandez, Arnaldo Jose [1 ]
机构
[1] Univ Sao Paulo, Sch Med, Dept Orthoped & Traumatol, FIFA Med Ctr Excellence, BR-05403010 Sao Paulo, Brazil
关键词
platelet-rich plasma; patellar ligament; tendon; growth factors; healing; sports; CRUCIATE LIGAMENT RECONSTRUCTION; FIBROBLAST-GROWTH-FACTOR; CENTRAL; 3RD; DONOR SITE; INJECTION; REPAIR; KNEE; TENDINOPATHY; INJURIES;
D O I
10.1177/0363546512441344
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The patellar tendon has limited ability to heal after harvesting its central third. Platelet-rich plasma (PRP) could improve patellar tendon healing. Hypothesis: Adding PRP to the patellar tendon harvest site would improve donor site healing and improve clinical outcome at 6 months after anterior cruciate ligament (ACL) reconstruction with a patellar tendon graft. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Twenty-seven patients were randomly divided to receive (n = 12) or not receive (n = 15) PRP in the patellar tendon harvest site during ACL reconstruction. The primary outcome was magnetic resonance imaging (MRI) assessment of patellar tendon healing (gap area) after 6 months. Secondary outcomes were questionnaires and isokinetic testing of ACL reconstruction with a patellar tendon graft comparing both groups. Results: Patellar tendon gap area was significantly smaller in the PRP group (4.9 +/- 5.3 mm(2); 95% confidence interval [CI], 1.1-8.8) than in the control group (9.4 +/- 4.4 mm(2); 95% CI, 6.6-12.2; P = .046). Visual analog scale score for pain was lower in the PRP group immediately postoperatively (3.8 +/- 1.0; 95% CI, 3.18-4.49) than in the control group (5.1 +/- 1.4; 95% CI, 4.24-5.90; P = .02). There were no differences after 6 months in questionnaire and isokinetic testing results comparing both groups. Conclusion: We showed that PRP had a positive effect on patellar tendon harvest site healing on MRI after 6 months and also reduced pain in the immediate postoperative period. Questionnaire and isokinetic testing results were not different between the groups at 6 months.
引用
收藏
页码:1282 / 1288
页数:7
相关论文
共 38 条
[1]   LONG-TERM EXPLANT CULTURE OF RABBIT FLEXOR TENDON - EFFECTS OF RECOMBINANT HUMAN INSULIN-LIKE GROWTH FACTOR-I AND SERUM ON MATRIX METABOLISM [J].
ABRAHAMSSON, SO ;
LUNDBORG, G ;
LOHMANDER, LS .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1991, 9 (04) :503-515
[2]  
Alissa R, 2010, EUR J ORAL IMPLANTOL, V3, P121
[3]   The effect of transforming growth factor-beta on mechanical properties of the fibrous tissue regenerated in the patellar tendon after resecting the central portion [J].
Anaguchi, Y ;
Yasuda, K ;
Majima, T ;
Tohyama, H ;
Minami, A ;
Hayashi, K .
CLINICAL BIOMECHANICS, 2005, 20 (09) :959-965
[4]   Platelet concentrate injection improves Achilles tendon repair in rats [J].
Aspenberg, P ;
Virchenko, O .
ACTA ORTHOPAEDICA SCANDINAVICA, 2004, 75 (01) :93-99
[5]   Tissue engineering for tendon repair [J].
Bagnaninchi, Pierre-Olivier ;
Yang, Ying ;
El Haj, Alicia J. ;
Maffulli, Nicola .
BRITISH JOURNAL OF SPORTS MEDICINE, 2007, 41 (08)
[6]  
Battlehner CN, 1996, J SUBMICR CYTOL PATH, V28, P175
[7]   Patellar tendon defect during the first year after anterior cruciate ligament reconstruction: Appearance on serial magnetic resonance imaging [J].
Bernicker, JP ;
Haddad, JL ;
Lintner, DM ;
DiLiberti, TC ;
Bocell, JR .
ARTHROSCOPY, 1998, 14 (08) :804-809
[8]   Platelet-Rich Plasma Augmentation for Arthroscopic Rotator Cuff Repair A Randomized Controlled Trial [J].
Castricini, Roberto ;
Longo, Umile Giuseppe ;
De Benedetto, Massimo ;
Panfoli, Nicola ;
Pirani, Piergiorgio ;
Zini, Raul ;
Maffulli, Nicola ;
Denaro, Vincenzo .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2011, 39 (02) :258-265
[9]   Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study [J].
Cervellin, M. ;
de Girolamo, L. ;
Bait, C. ;
Denti, M. ;
Volpi, P. .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2012, 20 (01) :114-120
[10]  
Chan BP, 1997, CLIN ORTHOP RELAT R, P239