The effect of plasma preparation rich in growth factors on patellar stability after medial patellofemoral ligament reefing

Abstract

Introduction: Although more than 100 operative procedures have been described for the treatment of patellar instability, there is no single universally successful procedure. For the most patients with lateral patellar instability medial patellofemoral ligament (MPFL) reefing is recommended. When we perform MPFL reefing we are not aware of the quality and strength of the MPFL tissue. In the presence of recurrent patellar instability, the quality and strength of MPFL tissue is often compromised and it disturbs patellar stability after MPFL reefing. Biomedicine development, recognizing the ligament healing process show us that autologous blood products, particularly PRP can enhance healing in soft tissue injuries. Purpose: The purpose of this study was to determine the potential effect of Plasma preparation rich in growth factors on patellar stability after MPFL reefing. Material and methods: Plasma preparation rich in growth factors was produced from a unit of autologous whole blood using Arthrex ACP double syringe system.Platelet gel was prepared by adding bovine thrombin and 10% solution of calcium chloride.The platelet gel was applied locally into the place where suturing of the MPFL was performed. In this prospective, randomized and double blind study12 patients were included:6 patients in the PG group who received platelet gel and 6 patients in the control group who were not treated with platelet gel. Patellar stability was evaluated before surgery and 3 months after surgery with Axial stress radiographs. Results: The calculated 3 month improvement was 12.67 ± 2.51 in the control group and 17.33 ± 1.52 in the PG group, (p = 0.064). Although there was greater improvement in patellar stability in PG group comparing to the control group, the difference was not statistically significant (p > 0.05). The main reason for this was probably the small number of patients included in the study. Conclusion: Results showed that growth factors from the plasma preparation rich in growth factors have positive effect on patellar stability after MPFL reefing.We believe that they stimulate and accelerate physiological healing and reparative tissue processes in ligament healing. More studies should be made, including more patients, if we want to get more relevant results.