Prospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2021; 12(6): 423-432
Published online Jun 18, 2021. doi: 10.5312/wjo.v12.i6.423
Has platelet-rich plasma any role in partial tears of the anterior cruciate ligament? Prospective comparative study
Juan Pablo Zicaro, Ignacio Garcia-Mansilla, Andres Zuain, Carlos Yacuzzi, Matias Costa-Paz
Juan Pablo Zicaro, Ignacio Garcia-Mansilla, Andres Zuain, Carlos Yacuzzi, Matias Costa-Paz, Knee Division, Hospital Italiano de Buenos Aires, Buenos Aires 1181, Argentina
Author contributions: Zicaro JP and Garcia-Mansilla I designed the study and drafted the manuscript; Zuain A performed the literature review and edited the manuscript; Yacuzzi C, Zicaro JP and Costa-Paz M provided the patient selection and clinical procedures; All authors approved the final draft of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics in Investigation Committee Institutional Review Board (Approval No. 5624).
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: No conflicts of interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ignacio Garcia-Mansilla, MD, Academic Research, Surgeon, Knee division, Hospital Italiano de Buenos Aires, Peron 4190, Buenos Aires 1181, Argentina.
Received: December 30, 2020
Peer-review started: December 30, 2020
First decision: January 24, 2021
Revised: February 18, 2021
Accepted: May 7, 2021
Article in press: May 7, 2021
Published online: June 18, 2021
Research background

Platelet-rich plasma (PRP) is being widely used in many orthopedic areas. The use of PRP has for “healing” purposes is still controversial in the field of partial ligamentous lesions.

Research motivation

To our knowledge, there are no comparative series reported in the literature regarding the use of PRP for partial anterior cruciate ligament (ACL) tears.

Research objectives

The aim was to prospectively compare the patient-reported outcomes, rerupture rate and magnetic resonance (MR) findings in patients with partial ACL tears treated with a single PRP intra-articular injection compared to a control group.

Research methods

Patients who met the inclusion criteria for stable partial ACL tears were divided into two groups. One group received a single intra-articular leukocyte-poor PRP injection within the first 4 wk after the lesion. Both groups received the same rehabilitation protocol. Clinical objective outcomes (KT1000 arthrometric evaluation), subjective outcomes, time to return to sports, rerupture rate and MR findings were evaluated. PRP preparation data was detailed.

Research results

Forty patients where included, 21 treated with PRP injection (group 1) (mean follow-up of 25 mo) and 19 in the control group (group 2) (mean follow-up of 25 mo). Overall, 95% of patients in each group returned to their previous sport at a mean time of 4 mo. After 6 mo follow-up, more than 50% of patients improved the ACL signal intensity in the MR. Overall failure rate was 32% (n = 13) with no significant differences between groups.

Research conclusions

A single PRP intra-articular injection was not sufficient to enhance any of the outcome measures evaluated, including MR images and clinical evaluation. Overall, 67% of patients returned to sports in a mean of 4 mo without clinical instability either with or without an intra-articular PRP injection.

Research perspectives

Further rigorous and objective studies including more patients and different PRP preparations, such as less platelet concentrations or leukocyte-rich preparations, would be useful to determine the true efficacy of PRP for enhancing healing properties of partial ACL lesions.