Published online Jun 18, 2021. doi: 10.5312/wjo.v12.i6.423
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
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.
To our knowledge, there are no comparative series reported in the literature regarding the use of PRP for partial anterior cruciate ligament (ACL) tears.
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.
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.
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.
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.
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.