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Leucocyte-poor-platelet-rich plasma intra-operative injection in chondral knee injuries improve patients outcomes. A prospective randomized trial

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Abstract

Purpose

Evaluate the effects of intra-operative leucocyte-poor-platelet-rich plasma (PRP) (type P3-Bβ with endogenous activation) injection in International Cartilage Repair Society (ICRS) grade III knee chondral injuries treated by chondroplasties, to increase and ameliorate the repair tissue.

Methods

Patients were divided into two groups. Group A (control) consisted of 31 patients and Group B (PRP) 33 patients, totaling 64 patients analyzed. Patients also could had associated injuries (meniscal and/or ACL) being equally divided between both groups to avoid bias. PRP was injected at the end of surgery in group B. The patient outcomes were assessed using subjective International Knee Documentation Committee (IKDC) form, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Tegner activity forms, prior to the surgery and three, six, 12, and 24 months after surgery (medium-term follow up).

Results

IKDC and KOOS scores showed increase at each evaluation time points after surgery in both groups, but the treated Group (B) showed a higher increase with statistically significant difference. The Tegner activity scores were higher for the treated group only at six and 12 months.

Conclusion

Based on the subjective IKDC, KOOS, and Tegner scores, those patients affected by ICRS grade III chondral injuries undergoing arthroscopic chondroplasty who were also treated with PRP showed better and faster outcomes than the control group. Independently from the associated injury (meniscal or ACL). This difference could be measured for up to two years.

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Acknowledgements

We appreciate the work of the Research Support Department of Botucatu Medical School—UNESP, which helped with the statistical analyses. We also like to thank Ms. Tiemi Matsu for helping with statistical analyses. We are very grateful to Ms. Dora Horvath and FD English School with the work of improving the English of the text. Finally, we would like to show our gratitude to Ms. Madalena Sbizera who prepared the PRP for us.

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Authors and Affiliations

  1. Unort.E Hospital de Ortopedia, Av. Higienópolis no 2600, Londrina, PR, 86050-000, Brazil

    Marcus Vinicius Danieli, João Paulo Fernandes Guerreiro & Alexandre Oliveira Queiroz

  2. Departamento de Cirurgia, Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil

    Hamilton da Rosa Pereira & Daniele Cristina Cataneo

Authors
  1. Marcus Vinicius Danieli
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  2. João Paulo Fernandes Guerreiro
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  3. Alexandre Oliveira Queiroz
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  4. Hamilton da Rosa Pereira
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  5. Daniele Cristina Cataneo
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Contributions

MVD carried out the conception and design, performed the surgeries and collected the data, has been involved in drafting the manuscript, and approved the final version.

JPFG contributed with the design, data collection, and revision of final version.

AOQ contributed with design and data collection.

HRP contributed with the conception and design and review the final version.

DCC contributed with the conception and design, has been involved in drafting the manuscript, and approved the final version.

Corresponding author

Correspondence to Marcus Vinicius Danieli.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was previously approved by the Ethics Research Committee of the Botucatu Medical School—UNESP (protocol number: CAAE: 0026.0.083.357-11) and by the Ethics Research Committee of the Irmandade Santa Casa de Londrina—BIO ISCAL (protocol number: 3995-2011).

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Level of evidence: II, randomized controlled trial

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Danieli, M.V., Guerreiro, J.P.F., Queiroz, A.O. et al. Leucocyte-poor-platelet-rich plasma intra-operative injection in chondral knee injuries improve patients outcomes. A prospective randomized trial. International Orthopaedics (SICOT) 45, 463–471 (2021). https://doi.org/10.1007/s00264-020-04830-4

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  • DOI: https://doi.org/10.1007/s00264-020-04830-4

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