Efficacy of platelet-rich plasma in arthroscopic anterior cruciate ligament reconstruction: a meta-analysis

doi:10.3969/j.issn.2095-4344.2820

Abstract

Abstract:

BACKGROUND: Platelet-rich plasma has a favorable effect in the treatment of articular cartilage defects and bone defects. But there is still no consensus in its use for arthroscopic anterior cruciate ligament reconstruction.

OBJECTIVE: To evaluate the clinical efficacy of platelet-rich plasma in arthroscopic anterior cruciate ligament reconstruction by a meta-analysis.

METHODS: The randomized controlled trials concerning arthroscopic anterior cruciate ligament reconstruction with or without the use of platelet-rich plasma were retrieved in PubMed, EMbase, the Cochrane Library, CNKI, WanFang, VIP and CBM from inception to September 2019. According to inclusion and exclusion criteria, two searchers screened the literature, extracted the data and evaluated the quality independently, using RevMan 5.3 software for the meta-analysis. A total of 595 patients were enrolled in 10 randomized controlled trials. Both groups received arthroscopic anterior cruciate ligament reconstruction. The trial group was treated with platelet-rich plasma, while the control group was blank control or treated with normal saline.

RESULTS AND CONCLUSION: Meta-analysis results showed that in the Lysholm score, the trial group was superior to the control group at 3 and 6 months after surgery [mean difference (MD)=9.26, 95% confidence interval (CI) (6.58, 11.94), P < 0.000 01; MD=5.14, 95%CI (3.04, 7.23), P < 0.000 01]. There was no significant difference between the two groups at 12 months after surgery [MD=2.17, 95%CI (-0.09, 4.42), P=0.06]. In the International Knee Documentation Committee (IKDC) score, the trial group was superior to the control group at 3 and 6 months after surgery [MD=6.29, 95%CI (3.74, 8.85), P < 0.000 01; MD=1.86, 95%CI (0.25, 3.47), P=0.02]. There was no significant difference in the proportion of normal, nearly normal and abnormal IKDC scores between the two groups [odds ratio (OR)=1.11, 95%CI (0.59, 2.08), P=0.75; OR=1.06, 95%CI (0.55, 2.05), P=0.87; OR=0.43, 95%CI (0.09, 2.02), P=0.28]. In the KT-1000/2000 arthrometer measurement, the trial group was better than the control group [MD=-1.08, 95%CI (-2.02, 0.15), P=0.02]. In the Visual Analogue Scale score, there was no significant difference between the two groups at 3 and 12 months after surgery [MD=-0.99, 95%CI (-2.06, 0.07), P=0.07; MD=-0.08, 95%CI (-0.99, 0.84), P=0.87]. The methods used to measure the width of bone tunnel were different among the studies. Therefore, descriptive analysis was carried out and it was concluded from limited evidence that the two groups had similar results. To conclude, in the arthroscopic anterior cruciate ligament reconstruction, platelet-rich plasma could improve the function of the knee joint in the short and medium term after surgery, as well as the stability of the knee joint. However, there was no significant difference in short-term or long-term pain relief and prevention of bone tunnel widening between the two groups. Due to the limitation of current literature quality and sample size, more high-quality studies are needed to verify the above conclusions.

Key words: platelet-rich plasma, arthroscopy, anterior cruciate ligament reconstruction, meta-analysis

CLC Number:

Huang Junhan, Chen Ping, Liu Jun, Chen Haiyun, Pan Jianke, Lü Yang, He Xiangzhong. Efficacy of platelet-rich plasma in arthroscopic anterior cruciate ligament reconstruction: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(29): 4737-4743.

Figures/Tables 9

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