Intra-articular platelet-rich plasma injection does not improve knee function following anterior cruciate ligament repair

1. At 12 months, patients with anterior cruciate ligament reconstruction randomized to receive postoperative intra-articular platelet-rich plasma injection were not found to have improved knee function compared to no postoperative injection.

Evidence Rating Level: 1 (Excellent)

Platelet-rich plasma (PRP), a product derived from autologous blood and rich in growth factors, has been viewed as a promising therapeutic option for various musculoskeletal disorders. However, there has been conflicting evidence for the efficacy of PRP use in patients undergoing anterior cruciate ligament reconstruction (ACLR), with recent studies showing that intraoperative injection was not associated with long term improvements. As there is a paucity of data to support the postoperative use of PRP for patients undergoing ACLR, this randomized controlled trial sought to compare the subjective outcomes and graft maturity in this patient population with and without postoperative intra-articular PRP injection. 60 patients (mean [SD] age = 30.0 [8.0] years) were assigned to the control group and 60 patients (mean [SD] age = 28.0 [7.9] years) to the PRP group, receiving 3 doses of intra-articular PRP injection at 4 weeks, 8 weeks and 3 months post operation. The primary outcome was the mean score obtained 12 months postoperatively from 4 subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS4). At 12 months, it was found that there was no statistical difference in KOOS4 scores between groups (78.3; SD = 12.0, 95% CI = 75.2 to 81.4 versus 76.8; SD = 11.9, 95% CI = 73.7 to 79.9, adjusted mean difference 2.0, 95% CI = -2.3 to 6.3, P = 0.36). Some participants in the PRP group reported intervention-related adverse events, such as pain at the injection site (6.7%) and knee swelling after injection (5.0%). Overall, postoperative intra-articular PRP injection in patients who underwent ACLR did not result in a significant improvement in knee symptoms or function.

Click to read the study in JAMA Network Open

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