Time-Dependent Effect of Platelet-Rich Plasma in Reducing Donor-Site Pain After Anterior Cruciate Ligament Reconstruction

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) has a high incidence among sports players, and one important side effect of the surgery is graft donor site morbidity. Although some evidence suggests that application of platelet-rich plasma (PRP) during ACLR reduces pain and improves knee function, it is not a universal finding. Purpose: To perform a meta-analysis of previous studies testing the effects of PRP on donor site morbidity after ACLR. Study Design: Systematic review and meta-analysis. Methods: We reviewed PubMed (Medline), Web of Science, Embase, Scopus, and Cochrane databases to find studies testing the effects of PRP on the donor site of ACLR autograft. After identifying 4 studies, we conducted 2 meta-analyses, 1 for the effects of PRP on pain, assessed by visual analog scale (VAS), and the other for the functional knee scores. We also tested the ability of time after ACLR to predict the PRP-related reduction of pain. Results: In the 4 studies identified, 157 patients were analyzed. Although the VAS score was lower with PRP at 6 months (raw mean difference [RMD], –0.97 [95% CI, −1.59 to −0.36]; P = .001) and 12 months (RMD, −0.61 [95% CI,−1.02 to −0.21]; P = .003), the effects of PRP disappeared at 24 months (RMD, −0.08 [95% CI,−0.38 to 0.22]; P = .586). A univariate regression analysis reinforced the ability of time after ACLR to predict the PRP-related reduction of VAS pain score ( r2 = 0.98). However, knee function after ACLR was not improved by the use of PRP (standardized mean difference, 0.71 [95% CI,−0.17 to 1.60]; P = .114). Conclusion: PRP applied to a bone–patellar tendon–bone donor site could reduce knee pain within a year, and this reduction had a correlation with time, meaning that the effect of PRP decreased with time after surgery. However, pain reduction did not reach clinical relevance and did not lead to better functional knee scores.

Platelet-rich plasma, a biomaterial, for the treatment of anterior talofibular ligament in lateral ankle sprain

“…Platelet alpha granules produce growth factors, which cause chemotaxis, cell migration, angiogenesis, proliferation, differentiation, and matrix synthesis. PRP is gradually making its way to the forefront of sports and rehabilitation medicine, and its involvement in many soft injuries has recently become the focus of study (Huang et al, 2020;Andrade et al, 2021;Hohmann et al, 2021).…”

Clinical Use of Platelet-Rich Plasma to Promote Tendon–Bone Healing and Graft Maturation in Anterior Cruciate Ligament Reconstruction—A Randomized Controlled Study

“…This finding is consistent with that of another study [ 11 ]. While some researchers [ 12 ] have concluded that PRP had no effect on either post-operative knee pain or functional improvement, others found that, while PRP did not appear to improve post-operative knee function, it could relieve post-operative pain [ 13 , 14 ]. Our results did not indicate that pain relief was greater in the study group compared with that in the control group.…”

Nanofibrous scaffolds for the healing of the fibrocartilaginous enthesis: advances and prospects

“…65 Studies have shown that the use of PRP during tendon implantation into bone tunnel can induce fibrocartilage formation to promote fibrocartilaginous enthesis healing and relieve pain. 61,66 However, because of individual differences, the concentration and platelet activity of autologous PRP are difficult to control. 67 Furthermore, the American Academy of Orthopaedic Surgeons (AAAS) clinical practice guidelines state that there is no high level of evidence to support the use of platelet-derived products for biologically enhanced RCR, and that the evidence for the reduction of RCR with PRP is limited.…”