André Luís Lugnani de Andrade1, Amanda Veiga Sardeli2, Thiago Alves Garcia3, Bruno Livani4, William Dias Belangero4. 1. Faculty of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil. drandre@unicamp.br. 2. Laboratory of Exercise Physiology-FISEX, University of Campinas-UNICAMP, Campinas, Brazil. 3. Orthopaedic Biomaterials Laboratory, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil. 4. Faculty of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.
Abstract
PURPOSE: Platelet rich plasma (PRP) has been used in association with anterior cruciate ligament resconstruction (ACLR) to improve rehabilitation. The purpose was to systematically review the literature to compare the effects of PRP on ACLR in its objective and subjective outcomes. METHODS: A systematic review of the MEDLINE, Web of Science, Embase, Scopus, and Cochrane databases was performed. Two independent reviewers included all the English language literature of patients undergoing primary ACLR with autograft combined with PRP. The outcomes analyzed were graft ligamentization (MRI), tibial and femoral tunnel widening (MRI), knee laxity, IKDC, Lysholm, Tegner activity scale and visual analog scale. RESULTS: Nine studies were included with a total of 525 patients. PRP did not improve ligamentization of graft (standardized mean difference (SMD): 0.01 [95% CI: - 0.37; 0.39]), did not lead to lesser tunnel widening (SMD: 0.71 [95% CI: - 0.12; 1.54]), or lead to lesser knee laxity (raw mean difference: 0.33 [95% CI: - 0.84; 0.19]). Although there was statistical significance for PRP effects on Lysholm score and VAS (p < 0.01), their magnitude was limited. CONCLUSION: PRP showed no improvement in objective outcomes like ligamentization and less tunnel widening, while it showed just small improvements in terms of Lysholm, VAS and knee laxity. Therefore, there is not enough evidence to support a recommendation in favor of PRP and more research is needed. LEVEL OF EVIDENCE: I.
PURPOSE: Platelet rich plasma (PRP) has been used in association with anterior cruciate ligament resconstruction (ACLR) to improve rehabilitation. The purpose was to systematically review the literature to compare the effects of PRP on ACLR in its objective and subjective outcomes. METHODS: A systematic review of the MEDLINE, Web of Science, Embase, Scopus, and Cochrane databases was performed. Two independent reviewers included all the English language literature of patients undergoing primary ACLR with autograft combined with PRP. The outcomes analyzed were graft ligamentization (MRI), tibial and femoral tunnel widening (MRI), knee laxity, IKDC, Lysholm, Tegner activity scale and visual analog scale. RESULTS: Nine studies were included with a total of 525 patients. PRP did not improve ligamentization of graft (standardized mean difference (SMD): 0.01 [95% CI: - 0.37; 0.39]), did not lead to lesser tunnel widening (SMD: 0.71 [95% CI: - 0.12; 1.54]), or lead to lesser knee laxity (raw mean difference: 0.33 [95% CI: - 0.84; 0.19]). Although there was statistical significance for PRP effects on Lysholm score and VAS (p < 0.01), their magnitude was limited. CONCLUSION: PRP showed no improvement in objective outcomes like ligamentization and less tunnel widening, while it showed just small improvements in terms of Lysholm, VAS and knee laxity. Therefore, there is not enough evidence to support a recommendation in favor of PRP and more research is needed. LEVEL OF EVIDENCE: I.
Authors: Lars Engebretsen; Kathrin Steffen; Joseph Alsousou; Eduardo Anitua; Norbert Bachl; Roger Devilee; Peter Everts; Bruce Hamilton; Johnny Huard; Peter Jenoure; Francois Kelberine; Elizaveta Kon; Nicola Maffulli; Gordon Matheson; Omer Mei-Dan; Jacques Menetrey; Marc Philippon; Pietro Randelli; Patrick Schamasch; Martin Schwellnus; Alan Vernec; Geoffrey Verrall Journal: Br J Sports Med Date: 2010-12 Impact factor: 13.800
Authors: Jose Fabio Santos Duarte Lana; Joseph Purita; Christian Paulus; Stephany Cares Huber; Bruno Lima Rodrigues; Ana Amélia Rodrigues; Maria Helena Santana; João Lopo Madureira; Ângela Cristina Malheiros Luzo; William Dias Belangero; Joyce Maria Annichino-Bizzacchi Journal: Regen Med Date: 2017-07-31 Impact factor: 3.806
Authors: Robert A Magnussen; David C Flanigan; Angela D Pedroza; Kate A Heinlein; Christopher C Kaeding Journal: Knee Date: 2012-12-24 Impact factor: 2.199