Patellar Tendon Healing With Platelet-Rich Plasma: A Prospective Randomized Controlled Trial

de Almeida, Adriano Marques MD, MS
Demange, Marco Kawamura MD, PhD
Sobrado, Marcel Faraco
Rodrigues, Marcelo Bordalo MD
Pedrinelli, André MD, PhD
Hernandez, Arnaldo José MD, PhD

Investigation performed at the Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil

^*Address correspondence to Adriano Marques de Almeida, MD, MS, Department of Orthopedics and Traumatology, São Paulo University Medical School, FIFA Medical Centre of Excellence, R. Dr. Ovidio Pires de Campos, 333, Cerqueira César, 05403-010 São Paulo, Brazil (e-mail: [email protected]).

^†Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil.

^‡São Paulo University Medical School, São Paulo, Brazil.

One or more of the authors has declared the following potential conflict of interest or source of funding: Criogenesis and Haemonetics Corp provided the personnel support and platelet-rich plasma separation system used in this study.

American Journal of Sports Medicine 40(6):p 1282-1288, June 2012. | DOI: 10.1177/0363546512441344

Background:

The patellar tendon has limited ability to heal after harvesting its central third. Platelet-rich plasma (PRP) could improve patellar tendon healing.

Hypothesis:

Adding PRP to the patellar tendon harvest site would improve donor site healing and improve clinical outcome at 6 months after anterior cruciate ligament (ACL) reconstruction with a patellar tendon graft.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

Twenty-seven patients were randomly divided to receive (n = 12) or not receive (n = 15) PRP in the patellar tendon harvest site during ACL reconstruction. The primary outcome was magnetic resonance imaging (MRI) assessment of patellar tendon healing (gap area) after 6 months. Secondary outcomes were questionnaires and isokinetic testing of ACL reconstruction with a patellar tendon graft comparing both groups.

Results:

Patellar tendon gap area was significantly smaller in the PRP group (4.9 ± 5.3 mm; 95% confidence interval [CI], 1.1-8.8) than in the control group (9.4 ± 4.4 mm; 95% CI, 6.6-12.2; P = .046). Visual analog scale score for pain was lower in the PRP group immediately postoperatively (3.8 ± 1.0; 95% CI, 3.18-4.49) than in the control group (5.1 ± 1.4; 95% CI, 4.24-5.90; P = .02). There were no differences after 6 months in questionnaire and isokinetic testing results comparing both groups.

Conclusion:

We showed that PRP had a positive effect on patellar tendon harvest site healing on MRI after 6 months and also reduced pain in the immediate postoperative period. Questionnaire and isokinetic testing results were not different between the groups at 6 months.