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

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

1. Adriano Marques de Almeida, MD, MS (adrianoalmeida@usp.br),
2. Marco Kawamura Demange, MD, PhD,
3. Marcel Faraco Sobrado,
4. Marcelo Bordalo Rodrigues, MD,
5. André Pedrinelli, MD, PhD and
6. Arnaldo José Hernandez, MD, PhD

+ Author Affiliations

1. Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil
2. Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil
3. São Paulo University Medical School, São Paulo, Brazil
4. Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil
5. Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil
6. Department of Orthopedics and Traumatology, São Paulo University Medical School, São Paulo, Brazil

Abstract

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 mm²; 95% confidence interval [CI], 1.1-8.8) than in the control group (9.4 ± 4.4 mm²; 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.