Platelet-rich plasma (PRP) applied during total knee arthroplasty

Guerreiro, João Paulo Fernandes; Danieli, Marcus Vinicius; Queiroz, Alexandre Oliveira; Deffune, Elenice; Ferreira, Rosana Rossi

doi:10.1016/j.rboe.2015.02.014

Cited by 15 publications

(33 citation statements)

References 23 publications

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“…PRP is currently being used to treat acute and chronic tendinopathies in the clinical and surgical settings [7,8]. It also had been certificated by several studies that PRP could improve wound healing in total knee replacements and rotator cuff injuries [9][10][11]. Recently, the clinical injection application of PRP is widespread in various chronic tendinopathies [8,12] which make injectable PRP gel scaffold possible.…”

Section: Introductionmentioning

confidence: 99%

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

Zhi-cheng

Ren

et al. 2020

J Orthop Surg Res

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Background: Injectable tissue engineered nucleus pulposus is a new idea for minimally invasive repair of degenerative intervertebral disc. The platelet-rich plasma (PRP) and adipose-derived stromal cells (ADSCs) could be harvested from autologous tissue easily. PRP contains numerous autologous growth factors and has reticulate fibrous structure which may have the potential to make ADSCs differentiate into nucleus pulposus-like cells. The goal of this study was to explore the feasibility of constructing a possible injectable tissue engineered nucleus pulposus with PRP gel scaffold and ADSCs. Methods: After identification with flow cytometry, the rabbit ADSCs were seeded into PRP gel and cultured in vitro. At the 2nd, 4th, and 8th week, the PRP gel/ADSCs complex was observed by macroscopy, histological staining, BrdU immunofluorescence, and scanning electron microscopy. The glycosaminoglycans (GAG) in the PRP gel/ADSCs complex were measured by safranin O staining with spectrophotometry. In PRP gel/ADSCs complex, gene expression of HIF-1α, aggrecan, type II collagen were tested by RT-PCR. The injectability of this complex was evaluated. Results: Macroscopically, the complex was solidified into gel with smooth surface and good elasticity. The safranin O dye was almost no positive staining at 2nd week; however, the positive staining of extracellular matrix was enhanced obviously at 4th and 8th week. The HE staining and SEM demonstrated that the cells were well-distributed in the reticulate scaffold. BrdU immunofluorescence showed that ADSCs can survive and proliferate in PRP gel at each time points. The level of GAG at 4th week was higher than those at 2nd week (P < 0.05), and significant difference was also noted between 4th and 8th week (P < 0.05). HIF-1α, aggrecan, type II collagen gene expression at 4th week were much more than those at 2nd week (P < 0.05), and significant differences were also noted between 4th and 8th week (P < 0.05). The flow rate of complex was 0.287 mL/min when passed through the 19-gauge needle with the 100 mmHg injection pressure. Conclusions: Our preliminary findings suggest that the PRP gel make it possible for rabbit ADSCs differentiated into nucleus pulposus-like cells after coculture in vitro. According to the results, it is a better feasible method for construction of autologous injectable tissue engineered nucleus pulposus.

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Section: Introductionmentioning

confidence: 99%

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

Zhi-cheng

Ren

et al. 2020

J Orthop Surg Res

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“…The use of a less aggressive surgical approach, for example, is now widespread for this purpose but may lead to increased bleeding [ 35 ]. In a previous study, our group showed that the application of platelet-rich plasma in total knee replacement surgery reduced postoperative pain but did not reduce bleeding [ 36 ]. The literature does not show that TXA is effective in controlling pain or movement gain, as our study has shown, in the first 48 hours after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Application of Tranexamic Acid in Total Knee Arthroplasty – Prospective Randomized Trial

Guerreiro¹,

Badaro²,

Balbino³

et al. 2017

TOORTHJ

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Background:The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has shown good results. Bleeding may cause local complications consequently greater pain and reduced function postoperatively. No study has related the use of TXA to these facts.Objective:The aim was to evaluate the effects of TXA haemoglobin, Western Ontario and McMaster Universities Index (WOMAC), pain intensity and flexion gain after TKA.Methods:43 patients were randomized and then underwent TKA. TXA was applied to 22 of these patients before closure of the joint capsule. Haemoglobin measurements (mg/dL) were taken preoperatively and 24 and 48 hours after surgery. The WOMAC questionnaire and pain visual analogue scale (VAS) were applied, and flexion gain was measured up to the second postoperative month. Statistical analysis compared the results to determine whether there were differences between the groups for each of the evaluated times.Results:There were differences in favour of the drug 48 hours postoperatively for the haemoglobin variable (p = 0.01), in pain evaluation, 24 and 48 hours, postoperatively (p < 0.01) and in flexion gain, 24 hours after surgery (p = 0.03). There were no significant differences between the groups in the haemoglobin evaluation 24 hours postoperatively, in pain assessment 7 days, 21 days and 2 months, postoperatively, in flexion gain 48 hours, 7 days, 21 days and 2 months, postoperatively and in WOMAC after 2 months.Conclusion:In addition to reducing bleeding, topical TXA improved pain and increased flexion gain in the first hours after TKA.Trial Registration:RBR-9b4qgq

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“…However, other researchers have found that plateletrich plasma does not reduce blood loss in TKA [69][70][71][72] . In a randomized controlled trial, Morishita et al found that there was no significant difference in blood loss between the platelet-rich plasma group and a control group (826.2 mL vs 830.2 mL; P = 0.96) in TKA 72 .…”

Section: Topical Hemostatic Agentsmentioning

confidence: 92%

“…However, other researchers have found that platelet‐rich plasma does not reduce blood loss in TKA. In a randomized controlled trial, Morishita et al .…”

Section: Intraoperative Strategiesmentioning

confidence: 95%

Perioperative Blood Management Strategies for Total Knee Arthroplasty

Lü

Peng

Zhou

et al. 2018

Orthopaedic Surgery

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Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period. These benefits improve rehabilitation success and increase patients' postoperative satisfaction. Preoperative anemia, coupled with intraoperative and postoperative blood loss, is a major factor associated with higher rates of blood transfusion in TKA. Thus, treatment of preoperative anemia and prevention of perioperative blood loss are the primary strategies for perioperative blood management in TKA. This review, combined with current evidence, analyzes various methods of blood conservation, including preoperative, intraoperative, and postoperative methods, in terms of their effectiveness, safety, and cost. Because many factors can be controlled to reduce blood loss and transfusion rates in TKA, a highly efficient, safe, and cost-effective blood management strategy can be constructed to eliminate the need for transfusions associated with TKA.

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Platelet-rich plasma (PRP) applied during total knee arthroplasty

Cited by 15 publications

References 23 publications

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

Application of Tranexamic Acid in Total Knee Arthroplasty – Prospective Randomized Trial

Perioperative Blood Management Strategies for Total Knee Arthroplasty

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